Austin Public Health outlines uncertainty as several federal grants pause or end

Austin Public Health officials told the City Council Public Health Committee on Sept. 3 that multiple federal grants that support local services have been paused, reduced or ended, producing uncertainty about service continuity and staffing.

"I think the conversation now is less about cuts and more about uncertainty and instability," Austin Public Health Director Adrienne Stirrup told the committee as she reviewed grants the department considers at risk. Stirrup and Deputy Director Cassandra De Leon outlined specific programs affected and short-term measures the department is pursuing.

Stirrup said the refugee medical services subcontract (APH is a subcontractor to USCRI) had a funded contract ending Sept. 30, 2025; USCRI issued a no-cost extension through Dec. 31, 2025, and APH has proposed a shoestring budget to the city manager's office to keep staffing and services running through that extension. APH staff said the clinic historically operated on variable funding tied to the number of resettled refugees; current funding cited in the briefing was $5 million, though staff noted the clinic has at times operated on less than $1 million.

BioWatch/air-monitoring support received a no-cost extension through Oct. 31, 2025, APH said; the program previously employed three staff who checked monitoring equipment, but staffing reductions have left one employee reassigned and two positions scheduled to end Sept. 19, 2025. APH said it is assessing remaining contract spending and will make a recommendation to city management about accepting the extension.

Stirrup listed previous abrupt endings or reductions in federal funding that already affected APH operations, including an $8 million mobile vaccination (MOV) contract that ran across five years and averaged about $1.7 million per year but was abruptly canceled in March 2025, and a COVID-19 epidemiology and lab-capacity grant that ended in March 2025 although it had been slated to run to July 2026. APH said those changes reduced mobile outreach capacity and data modernization staff for disease reporting.

Other grants cited as ended, reduced or not awarded for fiscal year 2025 included tobacco control funding (targeting tobacco cessation outreach to LGBTQIA+ communities), an HIV prevention grant that was not awarded for FY25, and substance-use disorder outreach funding that previously supported Narcan distribution and community training. APH said settlement dollars and other city resources have helped sustain some work, but capacity is down and community partners face strains as well.

Stirrup emphasized the public-health infrastructure grant as particularly consequential because of its flexible nature; she said APH is working with its project officer to meet new requirements but characterized the grant as uncertain. APH is coordinating with the Texas state health department, regional peers and national coalitions while asking staff to prepare contingency budgets.

Committee members asked for clarifications on contract totals and wait-list numbers. APH said it currently has a small refugee clinic wait list — under 50 referrals — and that demand has decreased compared with earlier in the year. Deputy Director De Leon said a policy change at the federal level reduced the special refugee insurance window from 12 months to four months for arrivals beginning in May, which complicates access and scheduling of care.

Stirrup told the committee the department believes it can still mobilize for a future public-health incident but that its reach would be reduced because of staff losses and the time needed to recruit and train replacements. "We need to become a department of Swiss army knives," she said, explaining APH must rely on more cross-trained staff to respond with fewer specialized positions.

Ending: APH said it will continue contingency planning and provide updated financial details to the city manager’s office. The committee asked APH to follow up with corrected grant totals and additional detail on the HOPWA and other multi-part grants.