According to former workers, the Department of Health and Human Services (HHS) mass termination and billion-dollar cuts have fallen into key programs – from child support services to HIV treatment abroad – and creates “real dangers”, with the disease outbreak going to be missed, according to former workers.
HHS workers are now led by Robert F Kennedy Jr. and warned in public health that the reduction in chaos, flaws and radical reductions will have widespread negative impacts in the United States and beyond.
Although Donald Trump's administration reduced the HHS workforce from 82,000 to 62,000 through shooting and buyouts, Elon Musk's so-called "Doge" grant also had a clear impact on the state government and led to the firing of state public health agencies.
For example, in the South Carolina Department of Public Health, more than 70 employees were fired in March due to fund cuts.
“The monitoring of disease is how we know when people’s health is abnormal, such as how there are more cases of food and drug than usual, or the virus begins to spread in the community,” an epidemiologist in the department was phased out. “It’s a system that allows us to discover patterns, detect outbreaks early and respond before more people get sick.”
"When you lose public health personnel, you lose time, lose accuracy, lose responsiveness, and ultimately affect people's health," they added. "Without us, an outbreak can fly under radar and can delay or confusing reactions. It's a real danger when these characters are cut.
“It’s invisible work until it’s not.
A South Carolina Department of Public Health spokesman declined to comment on the details, but noted that the employees employed through the grant are temporary. “When the grant funding is no longer received, their employment may end, as happens with some of the temporary grant employees funded by these grants,” they said.
In Washington, HHS is harder than any other federal department. Grants from hundreds of state, local and tribal governments and research institutions have been canceled, with unpaid obligations worth more than $6.8 billion.
HHS receives about a quarter of all federal spending, with most paying states Medicare and Medicaid, health plans and services for insurance plans; medical research; and food and drug safety. Trump's budget proposal calls for a 26.2% reduction in the department's discretionary spending, or $33.3 billion.
RFK JR has a history of promoting conspiracy theories and medical misinformation, nominated by Trump and approved by the Senate along the party, with Mitch McConnell, the only Republican.
Kennedy JR claims 20% of the sacks are wrong, and although not happening, the workers will be restored.
A HHS spokesperson blamed any such errors on data collection issues and did not comment on any other aspect of the Guardian report.
At the Centers for Disease Control and Prevention, the staff working in maternal and child health in the President’s AIDS Relief Emergency Program (PEPFAR) Program (PEPFAR) Program was shocked and was included in the effective reduction because earlier in the government, their work received partial exemptions from the federal funding freeze.
All federal experts on HIV prevention in children abroad have been fired, part of the effective reduction.
"Our initial focus was that the name was a mistake. We hoped that around that time there was a 20% error that we would be included," said an epidemiologist. He was included in the effective reduction, but asked to remain anonymous because they are currently on administrative leave. They also noted that they are in planning and provide new pediatric HIV treatments that will be dispersed this year, and that work is now at risk.
They said 22 epidemiologists in the CDC division have been fired. Pepfar was founded in 2003 by George W. Bush to prevent the spread of HIV from mothers to children and attribute it to saving 26 million lives.
"On April 1, we were very shocked," said another epidemiologist who was affected by the effective reduction of the CDC. "We really thought it was a mistake to have our branches cut off. The State Department said that service was a priority and needed to continue, but then we were cut by the HHS."
They noted that HIV treatment has stopped in regions that rely on U.S. Agency for International Development programs, such as Zambia.
They added: "This is one of the most successful global health programs in history, with data driven by a high degree of accountability, and the money spent has achieved impact. Now, we care that they are continuing to use Pepfar as Pepfar, but they are tearing down all the systems and structures that make it successful," they added. “The U.S. has made huge investments in this program over 20 years, many of which are now revoked. We have now broken systems that may reduce and ultimately eliminate our investment in these programs.”
Within the HHS, the Children and Family Government is responsible for implementing the child support payments that are ordered by the court. ACF says it can charge $5 in child support, while it can receive every dollar of federal funds.
A HHS child support expert who asked to remain anonymous for fear of retaliation, said the department's effective reduction has increased the workload for those who have not been shot multiple times, so there is no way for state and tribal agencies to ensure they meet federal requirements.
“The area staff that directly oversees the program has disappeared,” they said. “There are two employees across the area managing a quarter of the program, without management, without support, understanding of the program.”
Experts say the agency was under informal stop orders after the Trump administration took office, where staff were not allowed to provide guidance or support to grantees, or even answer calls until late February. On April 1, when child support experts claimed that about half of ACF staff engaged in child support were fired.
Their departments oversee child support programs at the state, tribal and local levels. Experts warn that if the ACF does not provide critical training and assistance, states “probably lose millions of dollars” and that states do not have qualified employees. “That’s the long-term impact on vulnerable children and families in the country.”
They added: “The full function of the program is to provide financial stability to children and families so that they do not rely on any other government programs or that they are less dependent on these programs because the children are supported by both parents.”
At the Medicare and Medicaid Service Center within the HHS, one of 300 workers terminated, as part of the reduction of force, saying it was illegal and that any appropriate procedures were not followed. The National Finance Ministry Employees Union filed a complaint about the way the shooting was shot, which included incorrect information about the notification.
They explained that on April 1, they received a universal letter informing them of their valid intentions. A few hours later, they were locked in the government login. "We started sending emails to the remaining management trying to clarify our status. No one can give us an answer," the worker said.
On April 7, they discovered through their Paystub that they were scheduled for administrative leave despite never receiving notice. They didn't receive RIF notifications until a few weeks later,,,,, After request.
"Based on my tenure, as a veteran with disabilities, I should at least have the opportunity to redistribute," they said. "I wasn't angry about losing my job. This happened. I've been fired. The first time was in the private sector, which was more human and more understanding, and I got a different offer.
"On the other hand, it's infinite hatred. This government has done everything it can to make it a hell for all civil servants."