Durham County Public Health warns of federal grant cuts, requests $27.97 million for 2025–26

Durham County Public Health Director Rod Jenkins told the county’s Board of Commissioners on Tuesday that the department is requesting $27,967,434 for fiscal year 2025–26, an increase reflecting personnel and operating cost growth and the winding down of pandemic-era grants.

Jenkins outlined both recurring needs and short-term revenue shifts, and he cautioned that recent federal and state actions and proposed cuts could force reductions in core public-health services. "We strive to spend, no less than 90% of our county funding, year over year," Jenkins said as he described how federal COVID-era grants had temporarily inflated program capacity and how those funds are sunsetting.

Public health leaders identified about $3.15 million in net changes to their budget request, including roughly $1.9 million in personnel costs and $1.2 million in operating increases. Jenkins said the department expects growth in Medicaid-reimbursable laboratory revenue but also described a series of recent federal funding curbs and stop-work orders that have already affected local programs — notably an interrupted NACCHO (National Association of County and City Health Officials) grant intended to expand pediatric vaccination outreach.

Jenkins and his team drew special attention to the county’s contracted health services at the detention center (the Wellpath contract), noting a proposed increase to cover staffing, expanded youth-home costs and rising pharmacy expenses. Pharmacy costs for certain widely used medications, including HIV treatments, have risen sharply, Jenkins said; the department reported medication and pharmacy costs at the jail that have climbed year over year. Jenkins also highlighted the public health laboratory’s new capabilities and noted the department has begun billing Medicaid for additional tests such as hemoglobin A1C, which will generate additional revenue.

Commissioners pressed Jenkins on outreach to immigrant communities, vaccination supply and the department’s capacity to absorb grant reductions. Jenkins said the department’s lab performs services for neighboring counties and that public-health staff are pursuing revenue-cycle improvements. He also asked for continued advocacy to state and federal officials about the impact of proposed cuts.

Jenkins warned that program areas at risk include HIV/STI testing and tobacco prevention (both cited as having stop-work orders or funding reductions), and he described the local nutrition education program (DINE) as particularly vulnerable to reduced federal support. "It would be devastating to the 13 full-time employees," he said, noting the program’s reach into schools, preschools and community sites.

Commissioners and public-health staff discussed next steps, including more detailed briefings on aging initiatives, detention-center health services and potential contingency plans. Jenkins told the board the department will continue to pursue revenue improvements, such as better billing and credentialing, but said the department expects a tight and uncertain fiscal outlook as pandemic-era federal supports disappear.

Ending: Public health officials asked the board to consider the department’s requested increase and continued efforts to protect services amid federal and state funding uncertainties; commissioners said they would consider the request alongside other county priorities.