How DOGE Funding Cuts Are Impacting Nursing Outreach Programs Nationwide

The Department of Government Efficiency (DOGE) has implemented numerous healthcare grant terminations that affect community-based nursing programs. These cuts—part of broader federal austerity measures—if final, likely will dismantle critical public health infrastructure, leaving vulnerable populations without (or with reduced) access to preventive care, addiction treatment, and chronic disease management. While the extent of some of these cuts may still be unknown, below are examples of cuts from multiple states impacting nurses or nursing-related community services.

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Michigan: Significant Cuts to Public Health Grants

Michigan recently joined 23 other states to sue the U.S. Department of Health and Human Services and HHS Secretary Robert F. Kennedy, Jr. for terminating $11 billion in critical public health grants. Those cuts included $379.3 million in grant funding awarded to the State of Michigan for services including:

• Mental Health Services: Grants supporting care for individuals with serious mental illness and children with severe emotional disturbances, directly impacting nursing staff in crisis response and outreach roles.
• Substance Abuse Programs: Funding for substance use disorder services, including outreach to pregnant women, opioid users, and rural populations, reducing the ability of nurses to provide addiction treatment and harm reduction.
• Infectious Disease Control: CDC grants for laboratory upgrades and disease surveillance were canceled, undermining the capacity of nurses to respond to outbreaks in healthcare facilities.
• Immunization and Vaccination: $49 million in CDC grants for vaccine clinics, storage, and translation services, threatening routine and seasonal immunizations for children, adults, and underserved populations—services often delivered by public health nurses.
• Local Health Departments: All 45 local health departments and 46 community mental health service programs in Michigan were impacted, with more than $80 million in direct-care funding lost.

California: Cuts to Street Medicine and Disease Surveillance

• Tenderloin Roving Nurse Program (San Francisco): Federal funding cuts ended this street-based nursing initiative, which provided wound care, overdose prevention, and chronic disease management to unhoused residents.
• LA County Public Health: Over $45 million in grants for epidemiology and laboratory capacity were rescinded, slashing nurse-staffed disease surveillance and outbreak response teams.

Louisiana: Cuts to Mental Health Crisis Services

DOGE cut $55 million from mental health and substance use grants, including:

• Crisis intervention teams (often nurse-led) for opioid overdoses.
• Mobile psychiatric units serving rural areas.

State officials warn these reductions likely will force ERs to absorb behavioral health cases.

New York: Maternal Health and Infectious Disease Cuts

• NYC Health Department: $100 million cut for infectious disease prevention, including nurse-staffed vaccination education programs.
• Maternal Health Equity Partnerships: Federally funded programs connecting high-risk pregnant patients to nurse midwives were defunded.

Connecticut: Public Health Layoffs and Clinic Closures

• 48 contracts terminated for immunization services, including school nursing partnerships.
• $150 million cut from COVID-19 response grants, dismantling community health worker programs (often supervised by RNs).

North Carolina: Substance Use and Immunization Cuts

80 health department layoffs due to grant terminations, including nurses supporting:

• Statewide immunization registries.
• Medication-assisted treatment for opioid addiction.
• Rural harm-reduction clinics, which rely on nurse practitioners, face closure.

Minnesota: Vaccine Clinics Closed

$226 million cut (25% of state health budget), forcing:

• Closure of five vaccine clinics staffed by public health nurses.
• Layoffs of 150–200 employees, including nurses managing tuberculosis and STD programs.

Broader Implications for Nurses

Nursing outreach programs are often the frontline of care for marginalized and high-need populations. The loss of federal support has led to some layoffs, service disruptions, and increased health risks or disease outbreaks within communities already facing significant barriers to care. Without intervention, experts warn of increased ER visits, untreated chronic conditions, and preventable deaths.

Hospitals, clinics, and community organizations are scrambling to fill the gaps, often turning to outsourcing and telehealth to maintain basic services. However, these solutions cannot fully replace the hands-on, relationship-based care that nurses provide in local communities.

State and local agencies are appealing the cuts and seeking alternative funding, but the immediate impact is a reduction in the capacity to deliver essential health services where they are needed most.

As the healthcare system absorbs these shocks, the long-term effects on public health, health equity, and the nursing workforce remain uncertain. What is clear is that the loss of nursing outreach programs will likely be felt most acutely by those with the fewest resources and the greatest need.

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