St. Louis Department of Health warns federal funding cuts could ‘devastate’ local programs; seeks corrections and targeted support for FY26

Dr. Matty Hlachwarya Davis, director of the St. Louis City Department of Health, told the Budget and Public Employees Committee on May 14 that the department already faces several confirmed federal grant terminations and that further cuts at the national level would deeply affect core public-health services and community partners.

Davis said the department is “55% federally funded” and that multiple funding streams are either already cut or at risk. She listed confirmed and proposed reductions including a terminated grant of $2,214,272 (07/2014 funding terminated by the federal government, notice dated March 24, 2025), $757,191 (grant ending 06/30/2025 and not being renewed), and other potential losses across HRSA, HUD/HOPWA and HIV/Ending the HIV Epidemic programs that support prevention, housing and treatment services.

“We are 55% federally funded,” Davis said in the committee hearing and asked the council to consider the human consequences if those streams were removed: “While it’s easy to see 1 word that represents an illness… the reason I chose infectious diseases as my subspecialty as a physician is because… they do not care your race, your gender… If we continue to… assault public health, it will come to all of our homes.”

Davis summarized three immediate priorities for FY26: (1) explore absorbing positions and programs that provide critical services if federal funding is cut; (2) examine options for an animal shelter that meets industry standards; (3) continue momentum on programs launched in FY25, including a behavioral-health bureau and public-health accreditation and quality-improvement work. She underscored continued oversight of jail medical care at the City Justice Center and cited a drop in in-custody deaths since oversight began — from six in 2019 and five in 2023 to two in 2024 — as evidence of the oversight’s impact.

Key budget corrections and requests

The department asked the committee to correct or re-examine several FY26 items after internal review of the city’s budget book:

- Removal of $2,214,272 in grant funding for grant 07/2014 (terminated by the federal government on March 24, 2025). - Removal of $757,191 in another grant that ends on 06/30/2025 and is not being renewed. - Revisit transfer of $400,000 from the inmate medical budget to the Health Care Trust fund; the department says its role at CJC is oversight and monitoring and that direct clinical fiscal responsibility was expected to remain with the jail. The department requested the original arrangement be honored and that the $936,000 transfer item for the commissioner’s office be reconsidered in light of scope. - Animal Care and Control: the professional services allocation was reduced by $500,000 in the proposed budget; the department says that approved shelter services (Care STL contract) plus shelter cleaning require an additional $1,351,424 to maintain current contracted shelter operations (Care STL contract $1,350,024 plus $1,400 for cleaning, per the department submission).

Personnel adjustments and accreditation needs

Davis and Commissioner Victoria Nwory identified personnel corrections and swaps intended to preserve core functions without increasing net city cost. Requests included restoring a filled community health worker line that the budget book showed as deleted, restoring a public-information officer position, adding a program manager 2 for the behavioral-health bureau and creating a health-marketing administrator tied to public-health accreditation needs. Davis said those changes reflect a “maintenance” phase for the department after substantial growth in prior years.

Federal funding risks and human impacts

Davis warned that cuts to HRSA (including Ryan White/ HIV care), HUD/HOPWA housing support and emergency preparedness would not only scale back city programs but reduce funds for community-based partners whose employees and services rely on those grants. She asked the committee and administration for flexibility to respond to confirmed federal actions and described a cost-neutral plan previously submitted to absorb some contracts and preserve core services without immediate layoffs.

Committee response and next steps

President Tishaura O. Jones’ office and the committee asked for the department’s slides, the cost-neutral plan and the transition documents Davis referenced. Commissioner Nwory and fiscal manager Emmanuel Kani offered to provide the requested spreadsheets and supplemental corrections for the committee’s review. Committee members — including Chair Aldridge, President Tishaura Jones and several aldermen — thanked Davis for her leadership and asked staff to continue coordinating with the administration and ENA (capital/budget review) staff on possible amendments, supplemental requests and the city’s use of COVID/ARPA or Grama (GOB) funds for public-health priorities.

Ending

Davis concluded by stressing the need for urgency and flexibility amid a shifting federal landscape and requested that the committee and administration consider targeted corrections and small, strategic investments — including possible Grama/RAM funds — to keep core public-health services stable while longer-term solutions are developed.