Ongoing federal funding support for local governments to combat the COVID-19 pandemic dried up Friday, prompting some Bay Area counties to modify how they will respond to future surges and variants.
Federal legislators have not approved a standalone funding bill since 2021’s American Rescue Plan Act for response efforts to the pandemic like staffing testing and vaccination clinics.
Earlier this year, the White House had requested some $22.5 billion to be included in the annual federal budget to support pandemic response both domestic and globally.
White House officials argued that a lack of funding would force the closure of programs like the U.S. Health Resources and Services Administration’s reimbursement system for health care providers that offer COVID testing and vaccination services to uninsured people.
That program ended April 5, but other parts of the federal government’s pandemic response like nationwide National Guard deployment and a U.S. Federal Emergency Management Agency reimbursement program for local governments ended Friday, when the state and local fiscal years begin, after federal lawmakers recently removed the proposed $22.5 billion during budget negotiations.
As a result, Sonoma County said this week that it will contract its COVID response unit within the Department of Health Services by one-third from 60 to 40 staff members.
Health officials also said the county will change its COVID strategy from an emergency response to a long-term effort to mitigate the virus’s worst outcomes, particularly among vulnerable populations like older residents and those with chronic health conditions.
“Part of our key strategy will involve protecting those populations, and also to think about who could potentially slip through the cracks of the medical system,” said Gabriel Kaplan, the public health division director within the Sonoma County Department of Health Services.
The county also lost a handful of contracted consultants as a result of the funding lapse, including Vaccine Chief Dr. Urmila Shende, COVID Section Deputy Health Officer Dr. Leslie Kimura and disease control medical contractor Dr. Mark Lobato.
Other Bay Area counties said they would be able to extend the runway of their emergency-level COVID response with leftover funding from federal COVID packages like ARPA.
A spokesman for Contra Costa Health Services said Contra Costa County would not make any changes Friday related to the end of federal funding support, but said that the nature of the county’s COVID mitigation efforts could eventually change regardless.
“We are constantly evaluating our response given the changing nature of the landscape — for instance, new vaccines, new age groups for vaccine, new variants — and also the fact that residents can now get these services from their health care providers,” CCHS spokesman Will Harper said.
Public health officials in the Bay Area have urged health care providers in recent months to take on more of the COVID testing and vaccination burden, arguing that those services are most frequently available through a provider like Kaiser Permanente, and that local health departments are often only equipped to serve those without insurance.
Counties across the state expect to receive an undetermined amount of funding from the state budget, approved Thursday, to maintain vaccination and testing programs and other pandemic-era services.
Gov. Gavin Newsom also touted that the budget, which includes $1.8 billion specifically for COVID mitigation, earmarked $300 million in dedicated funding for local public health departments.
Kaplan said Sonoma County has budgeted conservatively while it waits to find out the amount of funding it will receive from the state.
He estimated that the county’s COVID response for the fiscal year that ended Thursday cost between $5 million and $7 million.
“We have a plan as more money becomes available, if it comes forth from the federal government, to expand our operations as resources come online,” he said.