Sarah Jane Tribble, KFF Health News and Henry Larweh
Slightly-known federal company that sends more than $12 billion annually to help neighborhood well being facilities, dependancy remedy providers, and workforce initiatives for America’s neediest individuals has been hobbled by the Trump administration’s staffing purges.
The cuts are “just a little astonishing,” stated Carole Johnson, who beforehand led the Health Resources and Services Administration. She left the company in January with the administration change and has described the sweeping employees cuts as a “big threat” to the company’s potential to distribute billions of {dollars} in grants to hospitals, clinics, nonprofits, and different organizations nationwide.
Since February, a few quarter of staff at HRSA — together with analysts, auditors, scientists, grant managers, and nursing consultants — have left, in keeping with a KFF Health News evaluation.
The company, headquartered in a nondescript gray-and-glass workplace constructing tucked into aspect streets in Rockville, Maryland, employed about 2,700 staffers in early 2025. Employees labored behind the scenes to handle and monitor hundreds of initiatives nationwide that fund major well being suppliers, HIV/AIDS remedy and prevention, maternal and youngster care packages, rural hospitals, and workforce coaching.
On the bottom, HRSA’s grants have helped create telehealth initiatives for mothers in rural New Mexico, funded workforce training for Indigenous nurses in South Dakota, and supported Healthy Start packages for expectant moms and infants in places like rural Georgia.
Ryan Alcorn, a co-founder and the chief govt of GrantExec, an organization that helps organizations match and apply for funding, stated each American advantages from the packages HRSA’s funding helps: “When the safety net fails, hospitals become overwhelmed, unpaid costs rise, and premiums go up for everyone.”
Several former HRSA leaders, who’ve been in contact with workers, confirmed the magnitude of the cuts estimated by KFF Health News. Johnson stated she believes the precise variety of staff misplaced is bigger.
More than 700 staff had been fired or selected to go away from February via the top of June. The evaluation is predicated on knowledge from the HHS worker listing, which can not embody staff who opted out of being listed, and will not be a precise rely of the employee roster, which is in flux.
Johnson, who’s now a senior fellow on the Century Foundation, and several other different former workers interviewed by KFF Health News stated they’re involved that particular packages might be eradicated, but in addition that decreased staffing might have an effect on ongoing program oversight. The company’s workforce ethos, Johnson stated, is one through which “if there were two people left at HRSA, they would work around the clock to try to get the money out.”
For at the least one program, revealed during a tense moment on Capitol Hill in July, cash to assist low-income and minority college students has already stopped flowing to colleges and universities. The Scholarship for Disadvantaged Students program, established through congressional legislation, helped colleges pay for college kids to coach to grow to be dentists, doctor assistants, midwives, and nurses — all of whom are briefly provide in rural and a few city areas. Candice Chen, performing affiliate administrator of HRSA’s well being workforce bureau, confirmed the company “did have competitions that were canceled.”
When U.S. Rep. Diana DeGette (D-Colo.) requested whether or not they had been canceled by the Trump administration, Chen paused earlier than talking once more: “Well, the funding decisions were made across the administration.”
Asked concerning the canceled funding, officers from a number of colleges declined to remark. Patrick Gonzales, a spokesperson for the University of Texas-Rio Grande Valley, stated in an emailed assertion that the varsity is “helping students navigate this transition with clarity and care.”
U.S. Sen. Angela Alsobrooks (D-Md.) has known as for Health and Human Services Secretary Robert F. Kennedy Jr.’s resignation or firing, “whichever one comes first,” saying there was “no defensible answer” to eliminating hundreds of staff throughout federal businesses.
In April, practically a dozen Democratic senators despatched a letter to Kennedy demanding solutions concerning the mass firings, noting HRSA is the “primary agency tasked with improving access to health care for vulnerable populations.”
HHS didn’t reply to the senators’ letter. Kennedy and the Department of Health and Human Services “has refused to answer basic questions about why the administration conducted mass firings in this office,” stated Sen. Lisa Blunt Rochester (D-Del.).
President Donald Trump’s proposed fiscal 2026 budget eliminates HRSA in addition to a few of its packages, together with grants to rural hospitals, workforce coaching, Ryan White HIV/AIDS packages, and emergency medical providers for kids. HRSA spokesperson Andrea Takash stated in an emailed response that HHS is “undertaking organizational changes that support multiple goals while ensuring continuity of essential services.”
HRSA continues to course of new funding bulletins and awards for the well being facilities, workforce packages, youngster and maternal well being initiatives, and “many more of our critical programs and services,” Takash stated.
HRSA’s largest bureau helps hundreds of neighborhood well being facilities that serve over 31 million people nationwide. Before the top of September, the company’s grants are nonetheless scheduled to pay out billions extra to well being clinics and different organizations nationwide.
Cuts to well being facilities might come beneath extra scrutiny as a result of their funding has “a lot of bipartisan” help, stated Celli Horstman, a senior analysis affiliate on the Commonwealth Fund, a well being analysis nonprofit. HRSA’s funding, which incorporates Section 330 grants, goes to “keeping the doors open” at federally certified well being facilities nationwide, Horstman stated.
An further 42% of well being middle funding comes from Medicaid, a federal and state insurance coverage program that covers individuals with low incomes and people with disabilities, she stated. Congress lately voted to scale back Medicaid funding.
Joe Stevens, spokesperson for the Virginia Community Healthcare Association, stated well being facilities are rethinking “how they do business” due to the Medicaid cuts and the elevated administrative challenges confronted when processing their HRSA grants, which have been more difficult to acquire since February. Virginia’s well being clinics deal with about 400,000 individuals yearly, Stevens stated.
“It’s a system that’s been in place for 50-plus years, and this is the first time they’re having issues receiving their funds,” he stated, noting that clinics now should additionally present an itemized listing of how the cash is for use after grants have been accepted.
“Our health centers are understaffed, so having somebody to have to enter that information every two weeks is just more time,” Stevens stated.
For months, HRSA employees throughout all departments have labored via modifications to their know-how techniques and transitioned work to others as workers left their jobs. Workers have continued to course of grants regardless of an govt order that froze federal funding and a March announcement that HHS would lay off 10,000 staff and shut down total businesses — together with HRSA.
One former worker stated that, at this level, “all we’re doing now is keeping the lights on.”
Michael Warren, who left the company in June, ran HRSA’s Maternal and Child Health Bureau. Warren described the bureau’s staffing cuts as “substantial.” The bureau awarded greater than $628 million in grants between Oct. 1, 2024, and July 22, 2025, to packages that included offering block grants to states and funding dwelling visiting packages, via which skilled staffers work with households with younger youngsters.
Warren, who’s now the chief medical and well being officer for the March of Dimes, stated America faces a disaster as one of many “most dangerous places in the world to give birth among other high-income countries, and that shouldn’t be the case.”
With tears brimming, Warren stated his former workers “wake up every morning, they work all day, and they go to sleep every night thinking about what they can do for mothers, children, and families.”
Methodology
For this text, KFF Health News calculated workforce reductions on the Health Resources and Services Administration utilizing public data from the Department of Health and Human Services directory posted on-line. We in contrast the quantity and sort of workers listed with HRSA in February to these in early July. Our worker totals exclude individuals listed as interns, fellows, pupil trainees, or volunteers. The listing isn’t an official rely of HRSA workers, nevertheless it provides detailed snapshots of traits thus far this yr. Reporters additionally cross-checked the estimates with former workers.
We’d like to talk with present and former personnel from the Department of Health and Human Services or its element businesses who consider the general public ought to perceive what’s occurring inside the federal well being forms. Please message KFF Health News on Signal at (415) 519-8778 or get in touch here.
