Trump cuts trigger layoffs at KC area health department. ‘A lot of fear’
Jackson County Assistant Health Director Ray Dlugolecki sounded deflated.
When the Health and Human Services Administration abruptly cancelled billions in public health grants last month, Jackson County Public Health wasn’t spared. The agency, which serves hundreds of thousands of residents in areas of the county outside Kansas City and Independence, said it lost about $1.1 million.
A team of three focused on detecting and intervening to stop communicable diseases lost their jobs. When their funding was cut, they had been working to expand wastewater monitoring and set up dashboards that would better help medical professionals, schools and nursing homes understand the spread of disease.
“It’s incredibly frustrating and there’s a lot of fear and unknown,” Dlugolecki told The Star on Tuesday during an interview at Jackson County Public Health’s headquarters in Lee’s Summit.
Coming out of the pandemic, the public health field engaged in serious reflection and “visioning” on what needed to change and improve, said Dlugolecki, who has spent about a decade at the agency. Significant time, energy and passion were spent reimagining what the public health system could look like.
“To see it decimated across a wide range of different topic areas, it doesn’t leave a lot of hope for the future because there hasn’t necessarily been an accompanying plan for where we go as a community and where we go as a country,” Dlugolecki said. “If we don’t have a plan of action and we’re just randomly cutting, then it’s not action. It’s inaction. It’s decimation.”
Health and Human Services announced a wave of grant cancellations on March 24. They came as Robert F. Kennedy Jr., who has undercut confidence in vaccines, moves to assert control as the agency’s new secretary under President Donald Trump’s administration.
Termination notices sent to Kansas City-area health departments and nonprofits included boilerplate explanations that cited the end of the COVID-19 pandemic. And while public health leaders were using some of the funding specifically for COVID-19 vaccinations, the dollars were often supporting broader public health activities.
Several Kansas City-area health departments said they had lost grant funding. The Clay County Public Health Center lost over $204,000. The Platte County Health Department lost about $188,000, though officials cautioned the agency likely wouldn’t have spent the remainder before its contract ended in June. The Johnson County Department of Health and Environment had about $245,000 left.
As the Trump administration began issuing executive orders, Clay County Public Health Director Darrell Meinke said his agency had put together a team to monitor what changes were coming. But in the case of the grant cuts, “I think the entire state was caught off guard,” he said.
“You can plan for stuff and just be proactive but any time something like that happens, it’s a challenge,” Meinke said.
The state of Missouri also faces steep cuts. The Missouri Department of Health and Senior Services said the Centers for Disease Control and Prevention informed the agency that funding streams totaling $255 million were being terminated, including $135 million in current projects to support the state’s public health system.
Jackson County layoffs
The lost funding comes at a crossroads moment for the public health field.
The pandemic strained the resources and resilience of agencies locally and nationally as public health officials tried to limit the spread of the virus amid resistance to masks and, later, skepticism and opposition to the COVID-19 vaccine. Agencies are now recovering and in some cases trying to emerge stronger.
Before the pandemic, Jackson County Public Health had about 30 employees, but swelled to about 120 during the crisis. Today, Dlugolecki said about 60 people work for the agency – a new baseline.
For a long time, Jackson County couldn’t meet basic, foundational public health needs, Dlugolecki said, but local leaders have helped infuse additional resources into the agency. Before the pandemic, the agency was oriented around responding to crises in the moment, he said. Now it better plans and identifies issues; in other words, a more proactive approach.
But federal funding continues to play an important role.
Jackson County Public Health lost three federal grants. One supported epidemiology and laboratory capacity improvement. Another focused on health disparities. A third helped fund adult vaccination efforts.
The epidemiology and lab capacity grant represented about 75% of the lost funds and was helping the agency maintain a monitoring and research team within its communicable diseases and epidemiology program. Before it was cut, the team had several research projects, including on tick-borne diseases in the area, in addition to work on wastewater monitoring and other tasks.
“It was a huge, huge swath of different activities they were doing,” Dlugolecki said.
Before Jackson County Public Health – and many other agencies – received an email on March 24 about the grant terminations, Dlugolecki said they had heard rumblings that something might be coming. When the notice did arrive, agency officials immediately confronted a set of difficult choices.
Agency leaders had to weigh what to strategically eliminate so that, overall, foundational public health services would continue. They conducted what he called an exhaustive review of funding sources to see what portions of grant-funded services could continue. For now, they’re holding open a handful of positions to save money. Two Jackson County Public Health epidemiologists are absorbing a fraction of the eliminated team’s work.
Kansas is responding to a measles outbreak in the southwest part of the state that’s infected at least two dozen people. While no cases have been reported in the Kansas City metro, health officials are steeling themselves for the possibility the disease will emerge in the area.
But the federal grant cuts have reduced Jackson County Public Health’s capacity to detect and monitor disease spread.
“That team was working to rebuild structures or reimagine structures so that we can better detect and better identify pathogens, especially in high-risk settings” like schools and nursing homes, Dlugolecki said. “As of right now, that will not be realized. Without additional funding, without additional investment, we’re stuck with systems we had before COVID.”
Across the country, local health officials are weighing whether they want to partner with the federal government in the future in the aftermath of the grant cuts, said Adriane Casalotti, chief of government and public affairs at the National Association of County and City Health Officials.
If health officials don’t have confidence the federal government will honor contracts, they may be more reluctant to enter into them. That’s partly because local health departments can place themselves at risk financially if federal grants are suddenly withdrawn without warning.
Many of the cancelled grants were reimbursable, meaning public health agencies incur costs first before the federal government provides funds to pay them, often in regular installments. In some instances, organizations with terminated grants have had to absorb costs themselves.
In other cases, the grants were originally awarded to states, cities or counties themselves, which then provide them to health departments.
“It’s not necessarily even just the health department that’s thinking this way. It’s also that they’re going to have to work with their political entities about whether or not to go into some of these future contracts,” Casalotti said.
Public health funding ‘critical’
In Clay County, Meinke said his department had focused most of its grant spending on capital-type projects, so no layoffs were necessary. Still, any funding is “critical.”
Missouri ranks 41st among states in public health funding, at $92 per person, according to a two-year estimate compiled by America’s Health Rankings, an initiative of United Health Foundation. Kansas ranks 38th at $95.
“To have funding taken away for opportunities to build our infrastructure for our public health system in Missouri is really a challenge,” Meinke said.
Jackson County Public Health takes pride in a mobile unit – basically a cross between an ambulance and an RV – that helps provide services around the area. The agency has used it for COVID-19 vaccinations and other services.
Federal grants had been helping pay for gas, maintenance and staff time. The agency now spends other dollars to keep the vehicle in operation.
“But again, we’re having to take from other places to be able to carry on those activities,” Dlugolecki said.
The United States in the past has undergone periods where the country reassessed how money is spent and resources reallocated, Dlugolecki said. But those times have come with plans of action.
By contrast, these current cuts appear arbitrary.
“That’s not necessarily a vision or a strategy,” Dlugolecki said. “And honestly, this country deserves really a vision and a strategy for how we rebuild this public health system.”
This story was originally published April 9, 2025 at 5:30 AM.
