Major Staff Reductions at Unfamiliar Federal Agency Threaten Local Health Initiatives

The Struggle of a Vital Federal Agency

A little-known federal agency, the Health Resources and Services Administration (HRSA), plays a critical role in supporting some of the most vulnerable populations in the United States. It distributes over $12 billion annually to fund community health centers, addiction treatment services, and workforce initiatives. However, this essential agency has faced significant challenges due to staffing cuts implemented during the Trump administration.

Carole Johnson, who previously led HRSA, described the impact of these staff reductions as “just a little astonishing.” She left the agency in January following the change in administration and expressed concern about how these cuts threaten the agency’s ability to distribute billions in grants to hospitals, clinics, nonprofits, and other organizations across the country.

Since February, approximately a quarter of HRSA workers have left the agency. This includes analysts, auditors, scientists, grant managers, and nursing consultants. According to a KFF Health News analysis, about 700 employees were either fired or chose to leave between February and June. The data comes from the HHS employee directory, which may not include all workers, as some may have opted out of being listed.

HRSA, headquartered in Rockville, Maryland, employed around 2,700 people in early 2025. These employees managed and monitored thousands of projects nationwide that funded primary health providers, HIV/AIDS treatment and prevention, maternal and child care programs, rural hospitals, and workforce training.

On the ground, HRSA's grants have made a tangible difference. For instance, they helped create telehealth initiatives for mothers in rural New Mexico, funded workforce training for Indigenous nurses in South Dakota, and supported Healthy Start programs for expectant mothers and babies in places like rural Georgia.

Ryan Alcorn, co-founder and CEO of GrantExec, a company that helps organizations secure funding, said every American benefits from HRSA’s programs: “When the safety net fails, hospitals become overwhelmed, unpaid costs rise, and premiums go up for everyone.”

Former HRSA leaders and employees confirmed the magnitude of the cuts estimated by KFF Health News. Johnson believes the actual number of workers lost is even higher. The reduction in staff has raised concerns about the potential elimination of specific programs and the impact on ongoing program oversight.

The agency’s workforce ethos, according to Johnson, is one where “if there were two people left at HRSA, they would work around the clock to try to get the money out.” However, recent events suggest otherwise.

During a tense moment on Capitol Hill in July, it was revealed that funding for the Scholarship for Disadvantaged Students program had stopped flowing to colleges and universities. This program, established through congressional legislation, helped schools pay for students to train as dentists, physician assistants, midwives, and nurses—professionals in short supply in rural and urban areas.

Candice Chen, acting associate administrator of HRSA’s health workforce bureau, confirmed that some competitions were canceled. When asked if the Trump administration was responsible, Chen paused before responding: “Well, the funding decisions were made across the administration.”

U.S. Rep. Diana DeGette (D-Colo.) and other lawmakers have criticized the situation. Sen. Angela Alsobrooks (D-Md.) called for the resignation of Health and Human Services Secretary Robert F. Kennedy Jr., saying there was “no defensible answer” to eliminating thousands of workers across federal agencies.

In April, nearly a dozen Democratic senators sent a letter to Kennedy demanding answers about the mass firings, noting HRSA is the “primary agency tasked with improving access to health care for vulnerable populations.” HHS did not respond to the letter, and officials refused to address questions about the firings.

President Donald Trump’s proposed fiscal 2026 budget eliminates HRSA and some of its programs, including grants to rural hospitals, workforce training, Ryan White HIV/AIDS programs, and emergency medical services for children. HRSA spokesperson Andrea Takash stated that HHS is “undertaking organizational changes that support multiple goals while ensuring continuity of essential services.”

Despite the challenges, HRSA continues to process new funding announcements and awards for health centers, workforce programs, child and maternal health initiatives, and other critical programs. The agency’s largest bureau supports thousands of community health centers that serve over 31 million people nationwide.

Cuts to health centers could face increased scrutiny because their funding has “a lot of bipartisan” support, according to Celli Horstman, a senior research associate at the Commonwealth Fund. HRSA’s Section 330 grants help keep federally qualified health centers open, and an additional 42% of health center funding comes from Medicaid, a federal and state insurance program covering low-income individuals and those with disabilities.

Congress recently voted to reduce Medicaid funding, forcing health centers to rethink their operations. Joe Stevens, spokesperson for the Virginia Community Healthcare Association, noted that health centers are now required to provide itemized lists of how funds are used after grants are approved. This added administrative burden is challenging for understaffed clinics.

HRSA staff have continued processing grants despite an executive order that froze federal funding and a March announcement that HHS would lay off 10,000 workers and shut down entire agencies, including HRSA. One former employee said, “All we’re doing now is keeping the lights on.”

Michael Warren, who left HRSA in June, described the staffing cuts in his bureau as “substantial.” He highlighted the importance of the Maternal and Child Health Bureau, which awarded over $628 million in grants between October 2024 and July 2025. Warren, now chief medical and health officer for the March of Dimes, emphasized the crisis in maternal health, noting that the U.S. is one of the most dangerous places in the world to give birth among high-income countries.

With tears in his eyes, Warren said his former employees “wake up every morning, they work all day, and they go to sleep every night thinking about what they can do for mothers, children, and families.”