HHC Cuts Violate the APA

Twenty-three states and the District of Columbia are suing the Trump administration over concerns that an $11 billion funding loss would severely impact nursing home residents and community health. A team of attorney generals, co-led by Rhode Island Attorney General Peter Neronha, requested the judge to reinstate the funding, noting that the budget cuts were unlawful and would cause “irreparable harm.”

They also noted that these cuts violate the Administrative Procedure Act (APA) because it is “arbitrary and capricious.” People will die because of these arbitrary cuts. President and CEO of Care Providers of Minnesota, Toby Pearson, told Skilled Nursing News that these cuts would have “real, tangible” impacts on state skilled nursing and assisted living activities.

“We have made real progress to improve the safety of our facilities with staff training, HVAC upgrades, and shared best practices to keep our residents safe,” Pearson said. “We have no interest in seeing that go backward, and these cuts jeopardize all progress that has been made.”

The Department of Health and Human Services (HHS) announced that it plans to pull $11 billion in COVID-era grants from the Centers for Disease Control and Prevention (CDC) for infectious disease research. An additional $1 billion in cuts was for federal mental health and substance abuse grants.

In a statement, Neronha said that these cuts were “massive and egregiously irresponsible” and that the decision from the Administration should put the country on high alert for the “depths this administration is willing to go.” A decrease in funding or taking away funding entirely leaves states “at greater risk for future pandemics and the spread of otherwise preventable disease and cutting off of vital public health services,” according to the lawsuit.

“Americans expect their government to protect them from harm. By eliminating billions in critical funding for essential public health initiatives, the Administration is effectively telling the American people to fend for themselves,” added Neronha.

This funding ultimately provides crucial support for identifying, tracking, and addressing infectious diseases within the nursing home community. It also ensures access to immunizations and fortifies emergency preparedness, among other public health needs. While issuing funding cuts, HHS told states that the infectious disease grants were no longer needed “now that the pandemic is over.”

Some of these grants were supposed to be extended till 2027, but after this, they ran “concurrent” with the agency’s firing of 10,000 federal public health employees. Despite relevant statutes indicating the opposite, The agency assumed that these grants were only intended for use during the pandemic without any legal or factual support. HHS fails to undertake any individualized assessments, grants, or cooperative agreements to analyze the benefits of public health funding. Congress initially made wide-ranging public health investments intended to extend beyond the pandemic. ”

After the pandemic was declared over, Congress reviewed the Covid-19 related laws, rescinded $27 billion in funds, but determined not to rescind any of the funding at issue here,” the attorneys general said. Public health emergency funds ended on May 11, 2023, which included a variety of policy changes, waivers, and funding support for nursing homes.

With the loss and cuts of these funds, nursing homes will struggle to maintain financial stability while unable to maintain current staffing levels and trying to meet new federal staffing requirements.