On April 7, 2025, the Health Resources and Services Administration’s (HRSA) HIV/AIDS Bureau (HAB) shared an update with the Ryan White HIV/AIDS Program (RWHAP) and HAB Ending the HIV Epidemic in the U.S. (EHE) recipients, subrecipients, stakeholders, national partners, and federal colleagues.

On March 27, the U.S. Department of Health and Human Services (HHS) announced a dramatic restructuring in accordance with President Trump’s Executive Order, “Implementing the President’s ‘Department of Government Efficiency’ Workforce Optimization Initiative.” Reductions in Force (RIFs) started last Friday March 28. Here is some information that has been gleaned from media reports and interactions with current and former HHS staff:

·       Total RIFs at large agencies: HHS did announce that it planned to reduce:

o  2,400 full-time jobs at the CDC,

o  3,500 jobs at the FDA,

o  1,200 at the NIH, and

o  300 at the CMS. This included the entire staff of the Office of Equal Opportunity and Civil Rights.

No details were announced about what functions would be impacted by these RIFs. Also, these figures suggest that roughly 2,600 FTEs were let go at smaller agencies such as HRSA, SAMHSA, and AHRQ.

·       Reports suggest that up to one third of HRSA staff were let go. According to Politico, as many as 500 to 600 people from HRSA were let go. Trade publication Government Executive also reported that about a third of HRSA staff got RIF notices. In 2024, HRSA reported having 2,749 FTEs.

·       Two offices within BPHC were eliminated entirely. All staff from the following BPHC offices were let go:

o      The Office of Strategic Business Operations (OSBO), which supports BPHC operations around internal/external communications, including the BPHC Contact Form, the HRSA GeoCareNavigator, IT, strategic planning, professional development, EHB, BPHC website, etc.

o      The Office of Health Center Investment Oversight (OHCIO), which oversees all “supplemental” CHC funding.

·       Five HHS Regional Offices were eliminated in their entirety. All staff at the Boston, New York, Chicago, San Francisco, and Seattle offices received RIF notices this week. While the regional offices in Philadelphia, Atlanta, Dallas, Kansas City, and Denver will remain open, it is not yet clear what states they will each work with.

We will continue to update members about the changes at HHS, HRSA, and BPHC as we become aware of them. If you have questions or learn information, contact Eric Kiehl, PACHC Director of Policy and Partnership.

Congress paved the way for deep cuts in healthcare spending as part of an effort to extend expiring tax cuts on Thursday. The House voted 216-214 to adopt the final version of the fiscal 2026 budget resolution, with GOP Reps. Thomas Massie (Ky.) and Victoria Spartz (Ind.) joining the Democratic minority in opposition. This followed a Senate vote to approve the budget on Monday and a House vote in February on the lower chamber’s first draft of the measure.

In an op-ed, state Rep. Tarik Khan explains how Democrats in Harrisburg are working to protect access to health care. Rep. Khan is a nurse practitioner with a Ph.D. in nursing research from the University of Pennsylvania and works for Family Practice and Counseling Network, a CHC in Philadelphia.

Congressman Brendan Boyle (PA-02) held a press conference this week to sound the alarm about the catastrophic consequences that the proposed Medicaid cuts would have in Philadelphia. He was joined by Susan Post, Chief Executive Officer of Esperanza Health Center, and Suzanne O’Grady Laurito, Director of Catholic Housing and Community Services at the Archdiocese of Philadelphia. “In the geographical area that Esperanza takes care of, which is about a three-mile radius from here, we have a population that’s almost 400,000 people. And of those 400,000, almost 200,000 of them rely on Medicaid insurance for all of their health care needs,” said Susan Post, Chief Executive Officer of Esperanza Health Center. Learn more.

In collaboration with the Rural Health Information Hub (RHIhub), the Federal Office of Rural Health Policy(FORHP)  has released a new tool to help rural hospitals and rural health clinics identify FORHP programs that provide free technical assistance to improve financial and operational performance, quality, and transition to value-based care.

Check out the new FORHP Rural Hospital Technical Assistance Finder at https://www.ruralhealthinfo.org/hospital-ta or on the RHIhub homepage.

On April 8, 2025, the Center for Rural Pennsylvania Board of Directors held a public hearing at the Capitol Building in Harrisburg to advance awareness and support for rural mental health. The hearing brought together lawmakers, mental healthcare professionals, and community leaders to discuss ongoing challenges and potential solutions related to mental health care in rural Pennsylvania.

“We know rural Pennsylvania faces a unique set of challenges when it comes to mental health care,” said Senator Gene Yaw, Chairman of the Center for Rural Pennsylvania Board of Directors. “Limited access to providers, long distances to travel for treatment, and a shortage of specialized resources all contribute to a system facing significant barriers. The Center for Rural Pennsylvania is working to find innovative solutions to address these challenges. This hearing was an important step towards building a more accessible and supportive mental health system for all Pennsylvanians, no matter where they live.”

“The testimony shared at this hearing highlights the urgent need for ongoing collaboration and solutions to address the mental health challenges facing rural Pennsylvania,” said Representative Eddie Day Pashinski, Vice Chairman of the Center’s Board. “This effort includes expanding access to services, tackling workforce shortages, and reducing stigma.”

“We want Pennsylvania to be a place where mental health services are accessible and effective, no matter where you live,” said Senator Judy Schwank, member of the Center’s Board. “But in our rural communities, people often face a unique set of challenges when it comes to getting the care they need. This hearing is an opportunity to explore some of the most common barriers to mental health care in rural Pennsylvania and begin identifying solutions.”

“I was grateful for the insight provided by mental health professionals, judges, and other officials who testified concerning the unique challenges that exist in rural communities, including homelessness,” said Representative Dan Moul, member of the Center’s Board. “Homelessness is a far more complex problem than I imagined, particularly for those with mental health and substance abuse challenges. Clearly, there is no easy fix, but as we examine this issue, I am hopeful solutions can be found that will build on the resources available.”

“The mental health struggles in our rural communities are not just data points—they’re daily realities for countless Pennsylvanians,” said Dr. Kyle C. Kopko, Executive Director of the Center. “This hearing shed vital light on the challenges and, more importantly, the opportunities to expand care, break down barriers, and ensure no one is left to face these issues alone.”

Testifiers included:

• The Honorable Judge Tiffany L. Cummings, Magisterial District Court 04-3-03, Tioga County
• Annette (Annie) L. Strite, M.A., M.H./I.D.D. Administrator and Mental Health Director
• Andrea B. Kepler, L.C.S.W., Administrator, Dauphin County Mental Health, Autism and Developmental Programs
• Chris Santarsiero, Vice President of Government Affairs, Connections Health Solutions
• Kimberly Jones, M.S., L.P.C.S., Vice President of Clinical Operations, Connections Health Solutions
• Brittney McCarthy, Strategic Account Manager, Connections Health Solutions
• Dr. Jamie Zelazny, Assistant Professor of Nursing and Psychiatry and Co-Director of the Digital Health Hub, University of Pittsburgh
• Dr. Brayden N. Kameg, Assistant Professor of Nursing, University of Pittsburgh; Director of the Mental Health Nurse Practitioner Residency Program, VA Pittsburgh Healthcare System
• Dr. Brian Schurr, Central Keystone Counseling

To access the hearing recording and testimony, visit the Center’s website at www.rural.pa.gov.

The Substance Abuse and Mental Health Services Administration (SAMHSA) administers relief grants to states, territories, and tribes to address behavioral health needs post-disaster through community-based outreach, crisis counseling, public education, and other supportive services.  The Federal Emergency Management Agency (FEMA) funds the program as support for mental health assistance and training. Learn more about how a disaster gets declared at the federal level and search FEMA’s list of disasters and other declarations.

Rural Development at the U.S. Department of Agriculture (USDA) has a series of loans and grants for community facilities, businesses, water and infrastructure, and housing.

Starting January 1, 2025, eligible providers may use a new payment bundle for Advanced Primary Care Management (ACPM) that reflects the essential elements of advanced primary care, including principal care management, transitional care management and chronic care management.  ACPM services combine elements of several existing care management and communication technology-based services