Information on U.S. Department of Health and Human Services Reorganization and Current Funding

Yesterday, the U.S. Department of Health and Human Services (HHS) announced a restructuring in accordance with President Trump’s Executive Order, “Implementing the President’s ‘Department of Government Efficiency’ Workforce Optimization Initiative.”

The plan combines personnel cuts, centralization of functions, and consolidation of HHS divisions. The current 82,000 full-time employees will be reduced to 62,000. It will go into effect in 60 days.

Impacts to ACL

The critical programs within the Administration for Community Living (ACL) that support older adults and people of all ages with disabilities will be split across the Administration for Children and Families (ACF), Assistant Secretary for Planning and Evaluation (ASPE), and Centers for Medicare and Medicaid Services (CMS).

We do not know at this time which agency will manage the TBI State Partnership Program grants and whether or not program staff will be transferred to other agencies, but it is expected that most disability programs will be moved to the Administration for Children and Families. Earlier this month, both the House and Senate passed, and the President signed, a Continuing Resolution that ensures level funding for most federal programs, including those under the Administration for Community Living (ACL). This means that regardless of program location, the Traumatic Brain Injury (TBI) State Partnership Program Grant should remain in place through September 30, 2025.

Impacts to the Centers for Disease Control and Prevention

The CDC will decrease its workforce by approximately 2,400 employees, with a focus on returning to its core mission of preparing for and responding to epidemics and outbreaks. NOTE: The “CDC” decrease would only be 1,400 if you included the individuals coming over from ASPR (approx. 1,000 individuals).

It is unclear what this reorganization will mean for the National Center for Injury Prevention and Control, which manages the brain injury data collection programs and supports coaches and other professionals with resources for children with concussion, among other activities. While the program and staff may be eliminated, the CR ensures level funding for most federal programs, including the Centers for Disease Control (CDC), so brain injury activities should move forward until September 30, 2025, regardless of whether the program is moved elsewhere.

Impacts on Other Programs

• A new Administration for a Healthy America (AHA) will consolidate the Office of the Assistant Secretary for Health, Health Resources Services Agency, Substance Abuse and Mental Health Services Act, and other agencies.
• The NIH will decrease its workforce by approximately 1,200 employees by centralizing procurement, human resources, and communications across its 27 institutes and centers.
• CMS will decrease its workforce by approximately 300 employees, with a focus on reducing minor duplication across the agency. This reorganization will not impact Medicare and Medicaid services.

Unfortunately, we do not have additional details on the expected changes, but we will share information as we have it.

Next Steps for Advocacy

BIAA and NASHIA appreciate the Administration’s recognition that disability programs are critical. However, we support the Administration of Community Living remaining in place to administer disability programs. The agency was initially organized to streamline and coordinate disability activities, and research has shown the effectiveness of the agency and its programs in supporting community living.

We will share a Fact Sheet in the coming 24 hours, along with instructions to contact your Members of Congress and Governors to express support for the Administration for Community Living and ask that they advocate for it to remain in place.

Additionally, Congress is beginning to work on funding bills for Fiscal Year 2026, which will provide funding for federal programs, including the TBI State Partnership Program Grant, from October 1, 2025, through September 30, 2026. Reps. DeLuzio and Luttrell are leading a Congressional sign-on letter to urge the appropriations committees to continue (and ideally increase) funding for the ACL TBI State Partnership Program, the CDC, and other related initiatives. We appreciate those of you who helped by asking your members of Congress to sign the letter during Brain Injury Awareness Day. It is very important that this letter be supported by many Members of Congress to show strong support for the programs.

As we approach the appropriations deadline, we will send out an updated Action Alert to ask you to remind your Representatives to support continued funding for these crucial programs. In the reorganization, maintaining funding is essential to ensure that these vital programs can continue.

We encourage everyone to stay engaged and take action as we work together to protect and expand these essential services.