CT loses $155M in federal aid for public health programs

President Donald J. Trump’s administration canceled roughly $155 million in grants this week that affect infectious disease management, genetic screening of newborns and substance abuse prevention in Connecticut, leaving state officials scrambling Thursday to assess the depth of potentially lost services.

Officials said the cuts would slow state and municipal efforts to identify new infectious strains, track and respond to outbreaks, enhance vaccination rates and to swiftly deliver life-saving treatments to at-risk infants.

Gov. Ned Lamont and other state officials pledged to battle to preserve these programs, but they also acknowledged a larger unanswered question must be addressed soon: How much canceled federal aid — if it cannot be reclaimed in court — should Connecticut replace with its own resources?

“It’s just insane when something like this gets short-changed and put off,” Lamont said during a late-morning press conference at the University of Connecticut Health Center in Farmington. “And that’s where we are today. So, I feel the pain and the fear that I hear.”

Connecticut’s Department of Public Health absorbed the bulk of the federal cut, learning Tuesday that it had lost $149 million at the close of business the prior day, Commissioner Manisha Juthani said. The lost funds could weaken a wide array of programs, she said.

Among the initiatives affected are:

• Efforts to track existing infectious diseases and identify new strains of contagion;

• Cooperative programs with local health departments to enhance immunization rates;

• Staffing assigned to key public health functions like responding to disease outbreak in nursing homes;

• Lab testing in emergency outbreak situations.

“These cuts that are happening in academic medical centers, that are happening in public health, are going to be devastating to communities,” she said, noting her department had planned to spend most of these now-canceled federal funds over the next 15 months.

One of the most dangerous cutbacks, Juthani added, involves development of an enhanced information sharing system for the genetic testing of newborns.

Connecticut screens all newborns, more than 33,000 annually, for about 60 rare genetic conditions. Initial testing flagged nearly 400 infants last year for subsequent analyses, after which 154 were confirmed to have dangerous illnesses, said Dr. Juan C. Salazar, chairman of the health center’s Department of Pediatrics and physician-in-chief at the Connecticut Children’s Medical Center.

“If left undiagnosed in a timely basis, those kids can die, and they can die very quickly,” Salazar said, adding in some cases it involves only a few days.

Salazar recalled getting the call from a pediatrician: a newborn had screened positive for Severe Combined Immunodeficiency. He advised the doctor to send the infant to his clinic for assessment immediately. For now, he might seem fine, but if left untreated, the genetic disorder could quickly prove fatal.

That alert had come to the pediatrician’s office via fax, an antiquated system that Salazar said can create a “Swiss cheese” effect: most information gets through, but some faxes may fail to send, or a faxed result can simply float from the machine to the floor when it gets printed out and delay treatment if it gets found at all. 

In this case, the fax went through, the information got to the pediatrician, and Salazar was able to quickly arrange for a bone marrow transplant.

“That kid is absolutely healthy and cured because a bone marrow transplant is curative,” Salazar said. “If that didn’t happen — if the fax got lost, it didn’t get through, two weeks later that child could have come into our emergency department with severe sepsis and would have died.”

DHMAS also sees cuts

The state health department isn’t the only agency that lost federal funds this week.

The Department of Mental Health and Addiction Services estimates it’s lost $6 million, according to Lamont and Commissioner Nancy Navarretta, who said Connecticut planned to utilize these funds between now and September.

These cuts “will be immediately disruptive to the behavioral health system in Connecticut,” a safety net the state provides in cooperation with dozens of small community-based nonprofit agencies.

These include programs that:

• Linked unhoused clients with mental health, employment and other support services;

• Perinatal screening for substance use;

• Mental health and other early intervention treatments;

• And local Harm Reduction Centers that help administer Naxolone, a medicine used to swiftly reverse the effects of an opioid overdose.

“We will continue to work to identify solutions to mitigate these unfortunate cuts to the best of our ability,” Navarretta said. “We know that our nonprofit providers already have limited resources, and we were counting on this revenue to continue these critical programs.”

The private, nonprofit social services community in Connecticut has been lobbying Lamont and the General Assembly for years to dramatically increase the rates it pays them to serve clients with developmental disabilities, as well as those dealing with substance abuse and mental health issues.

The CT Community Nonprofit Alliance says the industry loses hundreds of millions of dollars annually because state payments haven’t kept pace with inflation for decades.

Alliance CEO Gian-Carl Casa said “The federal cuts hitting Connecticut today are likely the first of many that will target our most vulnerable residents. While we don’t know yet how these cuts will be implemented, we do know that nonprofits are already struggling to make ends meet, and further cuts will be devastating.”

Should CT use local dollars to replace cuts in federal aid?

Casa said it’s time for Lamont and the General Assembly immediately to begin supplanting some of those lost federal dollars with state resources.

“Connecticut has a history of bipartisan support for community nonprofits and the people they serve, and today state government needs to step up,” Casa said.

Lamont noted that state government receives more than $10 billion annually from Washington, including $6 billion from the Medicaid program alone.

“I can’t promise that we’re going to be able to make up all the shortfall,” Lamont said, adding that he expects his administration and the General Assembly will tackle that topic in special session in the summer or fall, when a clearer picture on the federal budget — and cuts in aid to states — could be available.

Some of Lamont’s fellow Democrats in the state legislature’s majority say Connecticut can’t afford to wait any longer. Trump and the Republican-led Congress clearly are trying to dramatically curtail federal spending, local Democrats say, and the state can’t wait four to six more months to decide which programs it will preserve and which it will forfeit.

“The rules of the game are changing every day,” said Rep. Cristin McCarthy-Vahey, D-Fairfield, co-chairwoman of the Public Health Committee.

“This is a public health disaster,” said her co-chair, Sen. Saud Anwar, D-South Windsor. “This is an assault on the people of the state of Connecticut. This is an assault on the children, even the newborns.”

House Speaker Matt Ritter, D-Hartford, said Thursday afternoon that legislative leaders already have begun discussions on fiscal interventions, adding that while a late summer or fall special session to adjust state finances remains likely, some action must be taken before the regular session closes on June 4.

“There is a laser-like focus on this issue,” he said, adding that with each abrupt cut in federal funding President Trump orders without congressional approval, it moves up the timeline. 

This is “a rapidly changing situation but it’s not getting better,” Ritter said.

That could put Lamont, a fiscal moderate, increasingly at odds with his own party, which already has challenged him to reform an aggressive series of state budget caps that have generated huge surpluses since 2017 — but at the expense of core programs such as health care, social services, education and municipal aid.

Connecticut has generated surpluses averaging $1.8 billion over the past seven years, a total that represents about 8% of the General Fund. It has used that black ink to build a record-setting $4.1 billion rainy day fund and used another $8.5 billion to reduce the state’s massive pension debt.

Critics say the state could redirect hundreds of millions of dollars to mitigate cuts in federal funding while keeping state finances well in balance.

Legislators passed a bill Wednesday aimed at safeguarding Connecticut against some public health cuts by the federal government, including $30 million to address “unexpected shortfalls” in public health funding and $5 million for communications during public health emergencies. The proposal also seeks to codify certain federal laws into state law if they change, including language related to fluoride levels in drinking water and the guarantee to emergency services regardless of ability to pay, known as EMTALA.

“We need to have a serious conversation about fiscal guardrail reform. This is an urgent situation,” Anwar said, adding that between cuts in public health funding and looming cuts to Medicaid, the state needs to have a plan.

Senate President Pro Tem Martin M. Looney, D-New Haven, and Senate Majority Leader Bob Duff, D-Norwalk, challenged Connecticut Republicans to protest the Trump cuts.

“If Republicans in Connecticut are truly worried about opioid addiction and preventing the next pandemic, then where is their outrage?” they wrote in a joint statement. “Will they be willing to support additional state appropriations and revenue to replace the reckless and heartless federal cuts?”

Sen. Heather Somers, R-Groton, ranking member of the Public Health and Appropriations committees, said the details are still vague, and the state needs to understand specifically where the cuts will hit and get creative about how to fill the gaps for critical services.

“We have to wait to see how things shake out,” Somers said. “I’m not trying to make light of the cuts. I’m just trying to be creative about how we can work around them.”

House Minority Leader Vincent J. Candelora, R-North Branford, said Connecticut Republicans are happy to find more resources to bolster public health and assist vital residents.

Candelora said Democrats here aren’t interested in working with the GOP, though, because Republicans will look to trim wasteful state spending where possible.

For example, Republicans have protested more than $600 million in reserves currently held by the state system that oversees Connecticut’s community colleges and regional state universities.

Candelora also noted that Lamont and the General Assembly have given state employees average raises of 4.5% over the past four years, saying this exceeds increases that most of the private sector receive.

“We are more than willing to come to the table and try to solve these budget problems,” Candelora added. “Unlike the Democrat Party, we don’t have sacred cows that we protect at all costs. … We’ve got to look at savings everywhere.”

Connecticut’s congressional delegation — U.S. Sens. Richard Blumenthal and Chris Murphy, and U.S. Reps. John Larson, Joe Courtney, Rosa DeLauro, Jim Himes and Jahana Hayes — responded to the cuts with a joint statement Thursday evening.

“The Trump administration’s sudden termination of funding — appropriated and authorized by Congress — for state and local public health departments in Connecticut is both illegal and morally bankrupt,” the statement reads. “These cuts will have devastating impacts on our communities. Fewer people will have access to the mental health and addiction treatment they need, and it will hamstring our efforts to stop the spread of infectious diseases like measles. Our delegation will fight tooth and nail to reverse this dangerous decision.”