Ebola spotlights emergency-preparedness cuts

Congress enacted major legislation after 9/11 to help local officials better prepare for health emergencies such as bioterrorism or infectious disease outbreaks. In 2003, HHS distributed more than $1.5 billion to bolster responses by local health officials.

But emergency preparedness funding for the nation’s public health and healthcare systems has fallen victim to the overall climate of fiscal austerity in Washington, with the budget sequestration cuts taking a chunk out of both programs. Those cuts have been supported both by the Obama administration and congressional Republicans.

But that may change with the current Ebola scare. The cases in Texas, which have raised questions about whether federal, local and hospital officials were ready to treat and contain the virus, could heighten pressure to boost funding.

In the years since those national emergencies in the early 2000s, funding for the programs has steadily eroded. Funding for HHS’ hospital preparedness program in fiscal 2014 was $255 million, about half of what it was a decade earlier. Funding for the Centers for Disease Control and Prevention’s State and Local Preparedness and Response Capability Program has dropped to $655 million, more than one-third below peak appropriations.

The recent lower funding levels translate into reduced training programs and fewer public health workers, experts say. Local health departments have lost 44,000 jobs since 2008, according to the National Association of County and City Health Officials.

“It’s been very traumatic in terms of impacting the ability of what can be done,” said Jeff Schlegelmilch, a managing director at the Columbia University National Center for Disaster Preparedness.

Last week, Sen. Robert Casey (D-Pa.) sent a letter to the leaders of the Senate Appropriations Committee calling for additional spending on the hospital preparedness program. “Without an ongoing commitment to preparing for these events … we cannot adequately ensure that our health system is ready for Ebola or any other emergency,” he wrote.