Federal Government Shutdown Update: HHS Contingency Plan Released

September 22, 2023

Funding for the federal government expires on Sept. 30. If Congress does not approve a continuing resolution (CR) a government shutdown will occur. While the situation in Washington, D.C. remains fluid, the ASTHO government affairs team believes the likelihood of a government shutdown is extremely high.

Last night, HHS released its FY24 contingency plan for a potential shutdown. We encourage all state and territorial health officials to review the document in full. Overall, HHS will retain approximately 51,293 (58%) staff and will be furloughing 37,325 (42%) staff as of day two of a funding hiatus.

ASTHO will be monitoring Congressional developments closely over the upcoming week. We will share all relevant information as it becomes available.

Below are the public health provisions included in the HHS contingency plan.

CDC will continue support to protect the health and well-being of U.S. citizens here and abroad through response to outbreaks, maintaining laboratory functions, the President's Emergency Plan for AIDS Relief (PEPFAR), and the agency's 24/7 emergency operations center. CDC would also continue the World Trade Center (WTC) Health Program, the Energy Employees Occupational Illness Compensation Program Act (EEOICPA), and the Vaccines for Children (VFC) program, which are supported through mandatory funding.

CDC's immediate response to urgent disease outbreaks and critical investigation needs in areas such as food, healthcare, vectors (mosquitoes and ticks), and high-consequence pathogens would continue. 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 diseases.

HRSA staff will continue programs and activities that are funded through carryover funding, or user fees, which include:

  • Ryan White Parts A and B
  • President's Emergency Plan for AIDS Relief
  • Ending the HIV Epidemic
  • National Practitioner Databank
  • Health Center Federal Tort Claims Act Program
  • National Health Service Corps Discretionary
  • Rural Residency Program
  • Countermeasures Injury Compensation Program
  • Health Centers Program
  • Teaching Health Centers GME
  • National Health Service Corps
  • PPPHCE Act costs

There will also be 73 staff paid from full-year mandatory and discretionary appropriations to support the following programs: Family to Family Health Information Systems, Jackie Walorski Maternal and Child Home Visiting Program and the Bipartisan Safer Communities Act Program—Pediatric Mental Health Care Access and Primary Care Training and Enhancement.

CMS will have sufficient funding for Medicaid to fund the first quarter of FY24. CMS will maintain the staff necessary to make payments to eligible states for the Children's Health Insurance Program (CHIP). CMS will continue Federal Exchange activities, such as eligibility verification, using Federal Exchange user fee carryover.

ASPR will continue support of COVID-19, hurricane, and other emergency responses. ASPR is leading the Federal Government's response to COVID-19, and a large number of staff are supporting the medical countermeasure (MCM) program by negotiating, awarding, and managing contracts that are critical to the response effort.

The Indian Health Service (IHS) received advance appropriations for FY24. Therefore, the majority of IHS-funded programs will remain funded and operational in the event of a lapse of appropriation. Specifically, advance appropriations, third party collections, and carryover balances, including from supplemental COVID-19 appropriations, will continue to fund the provision of care by IHS, Tribal Health Programs, and Urban Indian Organizations. Facilities construction projects supported with previously-appropriated funds will also continue.

FDA will continue activities that can be carried out with COVID-19 supplemental funding include work on emergency use authorizations to respond to the COVID-19 pandemic, mitigation efforts related to potential drug and medical product shortages and other supply chain disruptions, medical device infection control, work on enforcement actions for fraudulent, counterfeit and misbranded products related to COVID-19, and work on medical countermeasures, therapies, and vaccines and important generic and biosimilar treatment options.

SAMHSA will continue substance abuse and mental health programs, including those that provide critical behavioral health resources in the event of a natural or human-caused disaster such as Disaster Behavioral Health response teams, the 24/7 365 day-a-year Disaster Distress Helpline that provides crisis counseling to people experiencing emotional distress after a disaster, and the 988/Suicide Lifeline to connect people in crisis with life-saving resources.