Government Shutdown

PUBLISHED: Jan 22, 2018
Relevant to: Ambulatory Care, Behavioral Health, Clinical Lab, Community Mental Health Centers, Critical Access Hospitals, Dialysis Facilities, Home Health, Hospice, Hospitals, Long Term Care, Medical Office, Pharmacy

According to the FY 2018 US Department of Health and Human Services (HHS) Staffing Plan for Operations in the Absence of Enacted Annual Appropriations, approximately 50% of HHS employees will be put on furlough during the government shutdown. The percentages vary among HHS’ agencies and offices, with grant-making and employee-intensive agencies having the vast majority of their staff on furlough, and agencies with a substantial direct service component having most of their staff retained.

Below is a summary of activities, as of January 18, 2018, that will be open or closed:

  • Indian Health Service (IHS) – IHS would continue to provide direct clinical health care services as well as referrals for contracted services that cannot be provided through IHS clinics.
  • Health Resources and Services Administration (HRSA) – HRSA would continue activities funded through sources other than annual appropriations including the Community Health Centers, National Health Service Corps, Maternal Infant, and Child Health Home Visiting program. Additionally, HRSA would continue the National Practitioner Databanks and Hansen’s Disease Program.
  • Substance Abuse and Mental Health Services Administration (SAMHSA) – SAMHSA would continue programs such as the Disaster Distress Helpline, Treatment Locator, Treatment Referral Line, and Suicide Prevention Lifeline using available grant balances but without technical assistance or facilitation from SAMHSA. SAMHSA will have staff ready to receive and properly route any letters indicating suicidal ideation to the appropriate local Suicide Lifeline, and to review opioid prescription limit waivers.
  • Assistant Secretary for Preparedness and Response (ASPR) – ASPR would continue to maintain a core level of readiness and staffing for all-hazards preparedness and response operations including the Secretary’s Operations Center, the National Disaster Medical System, and specialized medical countermeasure response under the safety of human life exception.
  • National Institutes of Health (NIH) – NIH would continue patient care for current NIH Clinical Center patients, minimal support for ongoing protocols, animal care services to protect the health of NIH animals, and minimal staff to safeguard NIH facilities and infrastructure.
  • Centers for Disease Control and Prevention (CDC) – CDC will continue minimal support to protect the health and well-being of US citizens here and abroad through a significantly reduced capacity to respond to outbreak investigations, processing of laboratory samples, and maintaining the agency’s 24/7 emergency operations center. CDC will also ensure that staff that are currently supporting the ongoing hurricane response will continue their important work to respond to immediate and ongoing public health needs in the affected areas. CDC would also continue World Trade Center Health Program and certain childhood obesity activities, which are supported through mandatory funding, and CDC would continue activities supported with funding not affected by the lapse in appropriations, such as: U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), CDC’s Global AIDS program, the Energy Employees Occupational Illness Compensation Program Act (EEOICPA), Vaccines for Children (VFC) program, certain asbestos exposure in Libby, Montana, Ebola response and preparedness, and Global Health Security Agenda implementation.
  • Agency for Healthcare Research and Quality (AHRQ) – AHRQ would continue to maintain oversight of ongoing projects funded by the Patient-Centered Outcomes Research Trust Fund (PCORTF).
  • Food and Drug Administration (FDA) – FDA would continue limited activities related to its user fee funded programs including the activities in the Center for Tobacco Products. FDA would also continue select vital activities including maintaining critical consumer protection to handle emergencies, high-risk recalls, civil and criminal investigations, import entry review, and other critical public health issues.
  • Centers for Medicare & Medicaid Services (CMS) – CMS would continue key Federal Exchange activities, such as open enrollment eligibility verification, using Federal Exchange user fee carryover. In the short term, the Medicare Program will continue largely without disruption during a lapse in appropriations. Additionally, other non-discretionary activities including Health Care Fraud and Abuse Control, and Center for Medicare & Medicaid Innovation activities would continue. States will have sufficient funding for Medicaid through the second quarter, due to the continuation of authority under the CR for appropriated entitlements, and CMS will maintain the staff necessary to make payments to eligible states from remaining Children’s Health Insurance Program (CHIP) carryover balances.

Activities that would not continue include:

  • IHS – IHS would be unable to provide funding to Tribes and Urban Indian health programs, and would not perform national policy development and issuance, oversight, and other functions, except those necessary to meet the immediate needs of the patients, medical staff, and medical facilities.
  • HRSA – HRSA would be unable to make payments for the Children’s Hospital GME Program and Vaccine Injury Compensation Claims.
  • ACF – ACF would not continue quarterly formula grants for Social Services Block Grant, Child Welfare Services and the Community Service Block Grant programs. Additionally, new competitive grants, including Head Start and other social services programs, would not be made.
  • Administration for Community Living (ACL) – ACL would not be able to fund the Senior Nutrition programs, Native American Nutrition and Supportive Services, Prevention of Elder Abuse and Neglect, the Long-Term Care Ombudsman program, Protection and Advocacy for persons with developmental disabilities, or Independent Living Centers and services.
  • NIH – NIH would not admit new patients (unless deemed medically necessary by the NIH Director), or initiate new protocols, and would discontinue some veterinary services. NIH will not take any actions on grant applications or awards.
  • CDC – HHS would use the full extent of the authority under the ADA to protect life and property under a lapse in appropriations. CDC's immediate response to urgent disease outbreaks, including seasonal influenza, would continue. To continue ongoing influenza surveillance, CDC would collect data being reported by states, hospitals, and others, and report out critical information needed for state and local health authorities and providers to track, prevent and treat the disease. For disease surveillance activities not directly related to protection of life and limiting disease progression, limits on CDC staff resources under the lapse would result in more time to review, analyze, and report out public health information. CDC would be unable to support most non-communicable disease prevention programs, continuous updating of disease treatment and prevention recommendations, and technical assistance, analysis, and other support to state and local partners.
  • AHRQ – AHRQ would be unable to fund new grants and contracts or monitor previously-funded projects related to health services research initiatives, including research on improving patient safety and reducing healthcare-associated infections.
  • SAMHSA – SAMHSA would be unable to fund new or monitor existing grants or contracts, including activities requiring on-site supervision.
  • FDA – FDA will be unable to support the majority of its food safety, nutrition, and cosmetics activities. FDA will also have to cease safety activities such as routine establishment inspections, some compliance and enforcement activities, monitoring of imports, notification programs (e.g., food contact substances, infant formula), and the majority of the laboratory research necessary to inform public health decision-making.
  • ASPR – ASPR would be unable to fund activities related to medical countermeasures against chemical, biological, radiological, nuclear, and emerging threats, the Hospital Preparedness Program, and fully staff the National Disaster Medical System.
  • ONC – ONC will be unable to continue work on standards coordination, implementation, and testing as required by the Health Information Technology for Economic and Clinical Health Act and the 21st Century Cures (Cures) Act. ONC will be unable to increase interoperability and coordinate federal efforts to ensure improvements of usability related to the use of health IT. ONC will not continue working with its partners to combat information blocking and advance other policy and rulemaking activities as required under the Cures Act.

Follow the link below to learn more about the HHS FY2018 Contingency Staffing Plan

Want to read the full alert and receive alert emails?

Browse Additional Alerts