Attorney General Neronha co-leads lawsuit against HHS Secretary Kennedy for public health grant cuts
"This attack on the health of Americans is a lot of things, but it’s mostly just plain cruel, and we will do everything we can to stop it.”
From press releases and reporting:
Rhode Island Attorney General Peter Neronha co-led a coalition of 24 attorneys general in filing a lawsuit in United State District Court in Rhode Island against the United States Department of Health and Human Services and HHS Secretary Robert F. Kennedy, Jr., for abruptly and illegally terminating nearly $11 billion in critical public health grants to the states.
The grant terminations, which came with no warning or legally valid explanation, have quickly caused chaos for state health agencies that continue to rely on these critical funds for a wide range of urgent public health needs such as infectious disease management, fortifying emergency preparedness, providing mental health and substance abuse services, and modernizing public health infrastructure.
“For Rhode Islanders who think that the public health interests don’t matter to them, remember that this work has to get done,” said Attorney General Neronha. “If these funds are not restored, that’s 30 million more dollars that the state has to find in its budget to do this work - because this work has to get done. So the president, with one hand giveth the $220 million for the bridge, and with this hand, he takes it away. That is chaotic government. It is government by whim, and that’s why attorneys general are fighting back as aggressively and frankly successfully as we are.
“This massive and egregiously irresponsible cut of public health funding should put everyone on high alert to the depths this Administration is willing to go. First and foremost, Americans expect their government to protect them from harm. By eliminating billions in critical funding for essential public health initiatives, the Administration is effectively telling the American people to fend for themselves. Here in Rhode Island, these cuts will defund programs which ensure our children are properly vaccinated and immunized from preventable disease, and which address health disparities in low-income communities, among others.”
“There is nothing more sobering than a health scare, whether it be your own or that of a loved one. We all have either experienced or know someone who has experienced the physical and emotional pain caused by health problems. This attack on the health of Americans is a lot of things, but it’s mostly just plain cruel, and we will do everything we can to stop it.”
Last week, the Rhode Island Department of Health (RIDOH) received notice of the termination of four grants from the Centers for Disease Control and Prevention (CDC) that represented roughly $31 million in public health funding. These grants originally came to RIDOH during the COVID-19 pandemic. However, as they were renewed over time, their scopes were expanded by the CDC to prepare Rhode Island for future pandemics and strengthen the public health system in Rhode Island. For example, these grants support:
Surveillance, outbreak response, engagement in care, and other infectious disease prevention and control activities decrease the rates of infectious diseases in Rhode Island, including respiratory pathogens, foodborne illnesses, HIV, hepatitis C, congenital syphilis, gonorrhea, chlamydia, and tuberculosis. It also helps prevent disease clusters and outbreaks.
Occupational health, biosafety risk activities, biosafety training, and other functions. This funding also supports some core laboratory functions and administration, as well as the replacement of obsolete laboratory equipment and systems (for example, a modernized Laboratory Information Management System).
The public health infrastructure that surrounds vaccination in Rhode Island. This includes vaccination clinics, partnerships with community organizations to promote vaccination and increase vaccine confidence, proper vaccine storage, and upgrading our immunization registry. This work and these systems help Rhode Island maintain some of the highest vaccination rates in the country across all vaccine-preventable diseases (e.g., measles and other childhood vaccines, as well as seasonal vaccinations). Rhode Island stands to lose more than $31 million from these cancellations by HHS. If the funding is not restored, important state public health programs and initiatives will have to be dissolved or disbanded, including those that focus on childhood vaccination and immunization, health disparities among high-risk and underserved populations, and laboratory testing capacity.
“In January, we had a vivid illustration of how public health works,” said Rhode Island Director of Health Jerry Larkin, MD. “A person traveled from Rhode Island to a part of the world where measles is common, and that person was unvaccinated and not immune, and so acquired the infection. Measles is one of the most infectious, if not the most infectious pathogen known to medical science. If a person who is not immune comes into contact with someone with measles, they have a 90% chance of acquiring the disease. That person returned to Rhode Island. They exposed many people. However, their diagnosis was made in a timely fashion. An appropriate response was put in place by our healthcare providers and the Department of Health.
That person recovered. Nothing happened. What could have happened if our vaccination rates had not been sufficient to ensure herd immunity? The concept is that if enough people are immune, an epidemic is not propagated further. If our vaccination rates had not been high enough, I can assure everyone in this room and everyone in Rhode Island that we would be currently experiencing a measles epidemic similar to that which is occurring right now in Texas and New Mexico. As it happened, there were no secondary cases in Rhode Island. That is how public health works.
“Investments in public health make our communities healthier and safer, and they save lives. These grants support critical work to prevent deadly infectious diseases, ensure people are vaccinated, prevent outbreaks of foodborne illness, and modernize many of our core laboratory functions, Medical Examiner’s Office, and public health data systems, amongst other work. These are public health services that Rhode Islanders paid for and deserve. I want to thank the legal team and program staff at RIDOH and the Attorney General’s Office for all the work that went into today’s filing.”
Congress authorized and appropriated new and increased funding for these grants in COVID-19-related legislation to support critical public health needs. Many of these grants are from specific programs created by Congress, such as block grants to states for mental health and substance abuse and addiction services. Yet, with no legal authority or explanation, Secretary Kennedy’s HHS agencies arbitrarily terminated these grants “for cause” effective immediately on March 24, claiming that the pandemic is over and the grants are no longer necessary.
Steve Ahlquist: Part of this seems to be about targeting community organizations. A lot of those are BIPOC organizations that promote vaccines and healthcare in places where language might be a barrier. It seems in line with the anti-DEI policies of the present administration. How targeted do these attacks feel in those areas?
Attorney General Neronha: I think they affect those areas. We know that during Covid, some of the places that were the most difficult to get vaccines to were underserved communities. A lot of the build-out of our public health system was to serve those communities and the broader public.
There may be some who say, “Who cares about those communities?” I’m not one of those people, but I know how it works out there. Dr. Larkin alluded to herd immunity, which is what we heard all the time during covid. When you get a certain percentage of the population vaccinated, that’s how you end a pandemic - this is building out the infrastructure we need and maintaining the infrastructure we need to be ready for the next pandemic.
Director Larkin, MD: Are the grant terminations targeted? You’d have to ask the person doing the targeting to have the answer to that... I’ll invoke common sense - They certainly look targeted to me. I believe they are. But you’d have to ask the person doing the targeting why they are doing it.
In their lawsuit filed in United States District Court in Rhode Island, the coalition of attorneys general assert that the mass terminations violate federal law because the end of the pandemic is not a “for cause” basis for ending the grants, especially since none of the appropriated funds are tied to the end of the pandemic which occurred more than a year ago. HHS’s position, up until a few days ago, was that the end of the pandemic did not affect the availability of these grant funds. Moreover, for some of the grants, termination “for cause” is not a permissible basis for termination, yet the federal government unlawfully terminated them.
With this lawsuit, Attorney General Neronha and the coalition seek a temporary restraining order to invalidate Secretary Kennedy and HHS’s mass grant terminations in the suing states, arguing that the actions violate the Administrative Procedure Act. The states also ask the court to prevent HHS from maintaining or reinstating the terminations and any agency actions implementing them.
Attorney General Neronha co-leads this lawsuit with Attorney General Phil Weiser of Colorado, Attorney General Rob Bonta of California, Attorney General Keith Ellison of Minnesota, and Attorney General Nick Brown of Washington. They are joined by the attorneys general of Arizona, Connecticut, Delaware, the District of Columbia, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan, Nevada, New Jersey, New Mexico, New York, North Carolina, Oregon, and Wisconsin.
Here’s the press conference video:
Updated with the press conference video.
Yes! Just plain cruel!