By Dena Bunis, CQ HealthBeat Managing Editor
September 27, 2013 -- If the federal government shuts down, the Department of Health and Human Services’ contingency plan calls for furloughing more than half of its 78,198 employees.
Services such as the Centers for Disease Control and Prevention’s (CDC) flu program and the majority of the Food and Drug Administration’s food safety activities would be suspended, according to a plan the agency posted on its website late Friday.
According to the memo, the Centers for Medicare and Medicaid Services (CMS) "would continue large portions of Affordable Care Act (ACA) activities, including coordination between Medicaid and the Marketplace, as well as insurance rate reviews, and assessment of a portion of insurance premiums that are used on medical services."
The contingency plan "for agency operations in the absence of appropriations would lead to furloughing 40,512 staff and retaining 37,686 staff as of day two of a near-term funding hiatus," the document says.
"As in previous periods without enacted annual appropriations, the number of excepted staff would vary daily," the plan says, "depending on the amount of excepted work that needs to be done."
Some employees would be exempt from furlough because their jobs are funded through mandatory, carryover or user fee funds which wouldn’t be affected by a shutdown, the memo explained. Also exempted are staff whose activities are needed for the "safety of human life." The vast majority of those are employees in the Indian Health Service and the National Institutes of Health’s (NIH) Clinic Center that provide direct medical services. A number of presidential appointees also would be exempted from the furlough.
Here’s a look at some of the agency’s key divisions and what would and wouldn’t continue:
- Centers for Medicare and Medicaid Services. The memo says that "in the short term, the Medicare program will continue largely without disruption." Because of the way appropriations are made to the Medicaid and Children’s Health Insurance Program, states would continue to get their federal shares of those programs.
CMS would have to suspend its health care fraud and abuse strike force team operations. In addition, fewer recertifications and initial surveys for Medicare and Medicaid providers would be completed, "putting beneficiaries at risk of quality of care deficiencies," the memo says.
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National Institutes of Health. NIH would continue patient care for Clinical Center patients but would not admit new ones, "unless deemed medically necessary by the NIH Director," the plan says. Some veterinary services would be halted and NIH would not process any new grant applications or awards.
Employees would be available at NIH to protect the health of its animals.
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Centers for Disease Control and Prevention. Beyond suspending the seasonal influenza program, CDC would not be able to support outbreak detection and would not be able to assist states with infectious disease surveillance. The CDC would, the memo says, "continue minimal support to protect the health and well-being of U.S. citizens here and abroad through a significantly reduced capacity to respond to outbreak investigations, processing of laboratory samples and maintaining the agency’s 24/7 emergency operations center."
Because such programs as PEPFAR, CDC’s Global AIDS program and other similar programs are supported through mandatory funding, including from the World Health Organization, those efforts would continue.
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Food and Drug Administration. Because some of this agency’s funding comes through user fees, this agency would be able to continue some limited activities, the memo says, including in the Center for Tobacco Products. It would continue to handle "emergencies, high-risk recalls, civil and criminal investigations” and other similar activities." But the agency would have to "cease safety activities such as routine inspections, some compliance and enforcement activities, monitoring of imports" and the majority of laboratory research necessary to inform public health decision-making, the memo says.