23-05-2025
Michigan Health and Human Services director details impacts of federal cuts on state-level efforts
Michigan Department of Health and Human Services Director Elizabeth Hertel discusses Gov. Gretchen Whitmer's Fiscal year 2026 budget recommendations on Feb. 19, 2025. | Kyle Davidson
Downsizing and mass job cuts put forth by U.S. Secretary of Health and Human Services Robert F. Kennedy Jr., have already hampered public health officials in Michigan, Department of Health and Human Services Director Elizabeth Hertel declared in court filings earlier this month.
Kennedy announced in March that his department would be working to eliminate 20,000 total employees, consolidating DHHS's 28 divisions into 15 and closing half of its regional offices.
However, Michigan Attorney General Dana Nessel and 19 other attorneys general took action, arguing these cuts would functionally dismantle the DHHS, leaving it unable to do its job, with Nessel warning the decision could bring 'immeasurable harm' to the nation and healthcare if the courts do not step in.
A federal judge has since blocked the Trump Administration from issuing further job cuts and reorganizing the Executive Department until a lawsuit brought by a collection of government workers' and healthcare workers unions is resolved.
As part of these cuts, the DHHS is eliminating roughly 3,500 employees at the Food and Drug Administration, 2,400 at the Centers for Disease Control, 1,200 at the National Institutes of Health and 300 at the Centers for Medicare & Medicaid Services.
HHS Dismantling_Hertel Decl as filed_5.9.25
In a declaration filed as part of the case, Hertel detailed how the reduction of staff and closure of several labs at the CDC alongside cuts at the FDA are hindering the state's work on disease testing, public health and tobacco monitoring.
While the Michigan Department of Health and Human services runs its own Bureau of Laboratories, which is enmeshed with labs operated by the CDC and other states' public health agencies, the CDC's lab closures and staffing cuts have left states to fill the gaps.
The Bureau was directly impacted by the closure of the CDC Viral Hepatitis Laboratory Branch and its discontinuation of hepatitis testing, and according to Hertel has not received consistent communication from the CDC about test discontinuations.
'As a result of sporadic changes to test offerings by CDC laboratories, the MDHHS Bureau of Laboratories has been unable to determine which tests to prioritize with confidence,' Hertel said.
MDHHS also expects to see higher levels of test submissions for Hepatitis C due to the CDC's decision to discontinue testing.
'The MDHHS Bureau of Laboratories serves as the National HIV and Hepatitis C virus NAT Reference Center in cooperation with the CDC and the Association of Public Health Laboratories… if MDHHS shifts its lab capacity to Hepatitis C testing, the MDHHS Bureau of Laboratories staff will have less capacity to respond to other public health emergencies,' Hertel warned.
The department has also felt a lack of central coordination on tests discontinued by the CDC, Hertel said, noting that if the national agency is not at full capacity, there won't be a central coordinating agency for responding to disease outbreaks.
Bureau of Laboratories staff have also reported difficulties contacting CDC staff, Hertel said.
In addition to its impacts on lab testing, DHHS cuts have also significantly impacted the state-level department's work on public health, with Hertel noting that the state relies on a partnership with several CDC programs for infectious disease detection and response activities. As a result, MDHHS staff say communications with CDC subject matter experts is now slow, reduced, or sometimes non-existent.
Because key program staff are no longer with the CDC, there has also been confusion on points of contact and a reduced knowledge base, Hertel said.
'As a result, the CDC has failed to provide timely response to inquiries of urgent nature, reduced or eliminated national calls, and can no longer effectively serve as a national coordinator of infectious diseases efforts,' she said.
As an example, Hertel pointed to reports from her staff that the CDC is no longer sending out-of-state travel notifications about potential disease exposures to Michigan residents, including notices for diseases with critical timelines, like measles. Staff reported that the CDC was not able to coordinate a recent multi-state effort to investigate a complex and urgent case of human rabies, and is no longer hosting 50-state calls on the Highly Pathogenic Avian Influenza response, despite ongoing concerns of a global bird flu outbreak.
' Overall, the mass termination of CDC personnel appears to have created a climate of fear for remaining staff, thereby undermining the ability of remaining CDC staff to effectively carry out their jobs by supporting state health departments like MDHHS,' Hertel said.
These cuts have similarly left MDHHS without access to updated health data and data systems needed to identify emerging health crises and address disparities in healthcare, Hertel said.
Cuts at the CDC have also bled into state-level efforts in preventing HIV, AIDS, viral hepatitis, sexually transmitted infections and tuberculosis.
The CDC has also cut the entirety of its Pregnancy Risk Assessment Monitoring System team and shut down the program's data collection system. While Michigan was able to retrieve its 2024 data before the system shutdown, the CDC's team would normally statistically weight that data, meaning the unweighted data obtained by the state is unusable.
'To use the data, MDHHS would be required to contract with a survey statistician to properly weight this data, expending significant resources that would otherwise have been available from CDC staff,' Hertel said.
The CDC also assists the state in monitoring and responding to lead poisoning in children, Hertel said. However, following significant cuts at the Childhood Lead Poisoning Prevention Program, the MDHHS Environmental Health Bureau has received zero communication from the program.
While the CDC previously sent notices about newly identified food and consumer products containing lead, those notices have stopped, Hertel said.
MDHHS has similarly experienced issues in its environmental public health efforts including less frequent communications, the end of public health programming work groups with other states, and limited and inconsistent guidance from the CDC leaving the CDC Tracking Data Explorer without updated state-level data on drinking water, biomonitoring and radon.
While the CDC also helps the state administer several chronic disease and injury control programs, significant staffing shortages and the loss or potential loss of CDC contracts has left MDHHS with little or no guidance, Hertel said, creating uncertainty regarding the future of these programs.
The MDHHS Division of Child and Adolescent Health has also been impacted, Hertel said, with the Administration for Children and Families indefinitely postponing annual training for Personal Responsibility Education Program (PREP) teen pregnancy prevention grantees.
Hertel also pointed to the effectively shuttering of the CDC's Office on Smoking and Health as a major loss, noting the important role it played in preventing and reducing cigarette use by collecting and sharing information on smoking and its health impacts, including state level data on tobacco-use cessation treatments and high-quality reports on tobacco use trends.
She also noted the loss of the FDA's Center for Tobacco Products, which was effectively shuttered when all members of its staff were terminated on April 1.
'Among other duties, [the Center for Tobacco Products] conducted compliance checks on vendors and retailers to ensure that tobacco products are not sold to those under the age of twenty-one, reviewed premarket applications for new tobacco products before they can be marketed in the United States, enforced advertising and promotion restrictions, and educated the public about the risks of tobacco use including the dangers of e-cigarettes and other tobacco products,' Hertel explained, later noting the state relied on both the Center for Tobacco Products and and the Office on Smoking and Health for its Tobacco programs.
If Michigan does not receive support and funds from the Office on Smoking and Health, it stands to lose $2,347,639 in grant funding and other resources, Hertel said. Most of that funding supports Michigan Quitlink, which provides services to all Michigan residents for tobacco dependence treatment at a cost of just over $1.2 million annually. It also supports efforts to prevent youth tobacco use, offer healthcare provider training on tobacco dependence treatment and offer improved resources for schools to address vaping.
A loss of support from the Center for Tobacco Products could also shutter the state's program ensuring retailers comply with laws banning the sale of tobacco products to underaged customers, as it has been unable to approve and process MDHHS's request for additional funds to remain fully operational during a 2-month contract extension, or issue a solicitation for new state funding.
If the state program is shuttered, eight full time staff members would be laid off and $1.485 million dollars would be lost annually, Hertel said.
An MDDHS spokesperson declined a followup interview on Hertel's behalf.
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