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Alliance Alert:

• Among mounting criticisms and legal challenges, the Trump Administration is continuing its policies to eliminate agencies and fire federal workers.
• We are still learning about the impact of these actions on SAMHSA and will provide details as we know them.
• Patty Murray, who chaired the House Health, Education, Labor and Pensions committee when the House was led by Democrats, issued the scathing statement below on the impact of the firings.
• New Secretary for Human Services Robert F. Kennedy Jr. “addressed HHS workers for the first time in a speech Feb. 18. Without addressing the fact the agency has fired thousands of workers, he tried to thread the line between acknowledging most federal workers as “competent, ethical, caring and idealistic” while decrying the “corrosive power of money” in government institutions. He said he hoped workers would not pre-judge based on past comments they’ve seen, and allow him to turn over stones, with no topic out-of-bounds, in the name of reversing chronic disease. Further, he said the DOGE team has already uncovered “vast amounts of waste and fraud” and its tech could be applied to HHS to a greater extent.”
• A group of mental health advocates that met last night to discuss responses: look for a statement in the coming days.

Mass Firings At HHS: Biden Admin Dept. Heads Denounce Federal Health Agency Firings (excerpts)
By Noah Tong Fierce Healthcare February 18, 2025

The nation’s most distinguished health agencies fired thousands of probationary workers, starting Feb. 13 and extending into the holiday weekend, in what is becoming informally known among federal workers as the Valentine’s Day Massacre.

The firings began at the Department of Veterans’ Affairs, before extending throughout virtually all of the Department of Health and Human Services (HHS) divisions by the end of the weekend, reported numerous media outlets. Impacted workers took to social media to confirm the news.

Eight former HHS subagency leaders in the Biden administration condemned the decision to unceremoniously fire workers across HHS in a statement released Feb. 17.  Among the signees was the former heads of the Centers for Disease Control and Prevention (CDC), the Centers for Medicare & Medicaid Services (CMS), the Food and Drug Administration (FDA) and the National Institutes of Health (NIH).

“The work of the members of the HHS team is not just important to the health of this country, it is also vital to the economic security of our nation,”  the Biden officials. “These individuals are not numbers on a spreadsheet. They are dedicated and passionate public servants who have committed their careers to working on behalf of the American people. We owe them a debt of gratitude, not a pink slip.”

President Trump, HHS Secretary Robert F. Kennedy Jr. and Department of Government Efficiency (DOGE) leader Elon Musk have long promised to drastically reduce the workforce at federal health agencies in an effort to fundamentally reshape the federal government…

The CDC eliminated 1,300 probationary workers. Employees were given four weeks paid administrative leave and notified the morning of Feb. 14, as first  by the Associated Press. Thousands more were terminated in the initial round of firings on Friday at the National Institutes of Health. 

Up to 5,200 employees lost their jobs across HHS, initial reports indicated. They included employees at the CDC’s Epidemic Intelligence Service division,  and  reported. 

“They’re top doctors, veterinarians and other health professionals,”  Tom Frieden, M.D., the CDC director under President Obama, on X. “They sign up for a two-year training program to serve the country. Not only is terminating them bad for the country, it’s also a disgraceful violation of a commitment.”

…All told, the fired civil servants at each federal department were responsible for helping combat public health epidemics, research and administer national programs like the Affordable Care Act (ACA) and Head Start, and regulate medical devices and artificial intelligence technology, among many other functions. Some workers were fired on Saturday.

…The Trump administration is choosing to target probationary workers early in the process because they are easier to fire without violating civil service protections. These workers may be recently hired, or they could have been promoted or switched into a new role. That does not mean the employees are part time or on a performance improvement plan—some of those speaking to media shared performance evaluations showing that they were high-performing.

HHS expects to save more than $600 million as a result of the firings, the administration told Politico on Friday.

RFK Jr. addressed HHS workers for the first time in a speech Feb. 18. Without addressing the fact the agency has fired thousands of workers, he tried to thread the line between acknowledging most federal workers as “competent, ethical, caring and idealistic” while decrying the “corrosive power of money” in government institutions. 

He said he hoped workers would not pre-judge based on past comments they’ve seen, and allow him to turn over stones, with no topic out-of-bounds, in the name of reversing chronic disease. Further, he said the DOGE team has already uncovered “vast amounts of waste and fraud” and its tech could be applied to HHS to a greater extent.

A Feb. 11  gave details on how DOGE would alter the federal workforce. It requires every federal agency to hire “no more than one employee for every four employees that depart.”

Explicitly mentioned in the executive order are offices that include diversity, equity and inclusion initiatives, which will be prioritized for any waves of firings.

“Staffing cuts of the level described in the President’s executive order will bring about a cascade of consequences for Medicare, Medicaid and other publicly-supported coverage programs—placing at risk the people who rely on those programs for coverage, including children, families, seniors, veterans and people with disabilities,” said Margaret Murray, CEO for the Association for Community Affiliated Plans (ACAP).

…As with other executive orders from the administration, the firings are likely to trigger lawsuits from those affected. One group, Democracy Forward, has already taken action.

“The administration’s mass termination of employees in their first or second year on the job is an unprecedented and grossly unfair circumvention of the merit principles upon which our civil service is based,” said Michelle Bercovici, a partner with the Alden Law Group, in a statement. ”These hard-working employees should have the opportunity to let their work speak for itself.”

A coalition of state attorneys general  (PDF) Musk for his role at DOGE and inside federal agencies, equating the tech billionaire to a monarch through “virtually unchecked authority” via his access to  at the Treasury Department, U.S. Agency for International Development (USAID), HHS and other agencies. That argument was rejected Feb. 18, when a judge denied a temporary restraining order (TRO) request, partially because of the reliance on media reports as evidence of harm.

“Plaintiffs legitimately call into question what appears to be the unchecked authority of an unelected individual and an entity that was not created by Congress and over which it has no oversight,” the judge said. “In these circumstances, it must be indisputable that this court acts within the bounds of its authority. Accordingly, it cannot issue a TRO, especially one as wide-ranging as plaintiffs request, without clear evidence of imminent, irreparable harm to these plaintiffs.”

One  (PDF) by anonymous USAID employees outlined Musk’s “slash-and-burn” strategy at agencies to “identify personnel for termination and contracts for freezing” before overhauling whole departments. Earlier this month, the government enacted a , which was later temporarily halted by the courts. 

Another challenge to the firings and appeal for a temporary restraining order was argued in front of a district judge on Feb. 18, this one brought by federal worker unions against the Trump administration.

Judge Christopher R. Cooper questioned both sides on whether the district court was the appropriate forum for the unions’ alleged injury of halted member dues. The unions argued, to some skepticism, that the scale of the firings meant they could not go through administrative channels like the Federal Labor Relations Authority, but seemed to find success in painting widespread cuts as incompatible with Congress’ intent when appropriating funds to federal agencies. The judge also criticized the administration’s position that it has the authority to fire so many employees outside of Congress’ reduction in force protocol.

Cooper is now considering the plaintiffs’ request for a temporary hold on the firings, which plaintiffs argued should apply government wide but the administration countered should, if granted, be limited to the plaintiff unions’ members. 

Federal contracts dealt out by HHS have also been eliminated over recent weeks, Musk has repeatedly posted on X. The DOGE team updated its  website Feb. 17, which includes cancelled contracts at HHS and other departments.

This is a developing story.

Murray Blasts Trump and Musk Decimating HHS, Risking Americans’ Health and Livelihoods
February 19, 2025

Washington, D.C. – Today, U.S. Senator Patty Murray (D-WA), Vice Chair of the Senate Appropriations Committee and a senior member and former chair of the Senate Committee on Health, Education, Labor, and Pensions (HELP), responded to the Trump administration’s mass firings of dedicated workers across the Department of Health and Human Services (HHS) and its many subagencies. Thousands of HHS employees on their “probationary” period–i.e. those hired or promoted within the last 1-2 years–have already been fired, and more are expected to be in the coming days and weeks.

ADMINISTRATION FOR CHILDREN AND FAMILIES (ACF)

ACF is responsible for administering a variety of programs to help children and families thrive–including the primary federal child care grant program, Head Start, and Low Income Energy Assistance Program (LIHEAP), among many others. 

Over the weekend, dozens of ACF staff were  fired–including roughly 20% of the staff at both the Office of Head Start and Office of Child Care, which process grants supporting communities across the country, conduct oversight of those grants, and provide technical assistance to grantees.

“It is outrageous that at the same time the child care crisis is holding back parents and hurting our entire economy, Trump is indiscriminately firing the workers who help child care and Head Start centers keep their doors open and ensure kids in their care are safe. You know what doesn’t help parents find and afford child care? Firing the people who help make sure there are more quality, affordable options in every part of the country,” said Senator Murray. “Trump and Elon are making child care more expensive and hard to get for working parents while they focus on passing massive tax cuts for themselves and other billionaires.”

ADMINISTRATION FOR STRATEGIC PREPAREDNESS AND RESPONSE (ASPR)

ASPR leads our country’s medical and public health preparedness for, response to, and recovery from disasters and public health emergencies–coordinating planning and response for when fires erupt, pathogens like COVID or bird flu emerge, and so much more.

After claiming that employees working in emergency preparedness would be exempt from mass firings,  Trump and Musk began firing employees at ASPR this weekend.

“We know all too well just how serious pandemic threats can get and what happens when we are not ready. It is painfully clear we need to be more prepared for public health threats, but Trump is undermining this agency and leaving us less prepared—even as the bird flu presents significant risks to our country. Firing ASPR staff puts our economy and our families in serious danger,” said Senator Murray.

CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC)

CDC is charged with protecting the American people from health threats.

Nonetheless, Trump and Musk have already fired hundreds of CDC employees, including staff responsible for monitoring public health threats and for addressing lab safety failures.

“CDC is the backbone of our public health system–and on the frontlines of outbreaks and health threats across the nation. Trump’s decision to fire hardworking public health experts will make our communities less safe and less prepared to respond quickly and effectively when diseases put lives in danger. We are seeing right now how threats like measles, tuberculosis, and bird flu can spread without strong, trusted public health agencies—and Trump is all but ensuring these challenges will get more dangerous and more deadly,” said Senator Murray.

CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS)

CMS helps ensure over 100 million Americans have access to health insurance by overseeing Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), and Affordable Care Act marketplaces. 

The agency has long been understaffed and under resourced–and Trump and Musk have already begun indiscriminate firings at CMS. This includes staff responsible for inspecting nursing homes to ensure that families can have peace of mind that their loved ones are appropriately cared for–and at least 80 employees reportedly cut from the agency’s Center for Consumer Information and Insurance Oversight, which oversees the Affordable Care Act and protects Americans from surprise medical bills. Staff have also been fired from the CMS Innovation Center working on improving maternal health outcomes and more. 

“Firing the people who help Americans get quality, affordable health care and who help ensure long-term care facilities are safe is as stupid as it is heartless. These firings aren’t some abstraction–they’ll hurt people who need help getting their kid covered or who should be able to trust the nursing home their mom lives in is safe,” said Senator Murray.

FOOD AND DRUG ADMINISTRATION (FDA)

The FDA is charged with protecting Americans’ health by ensuring the safety and effectiveness of medicines, biologics, and medical devices–and regulating food, cosmetics, tobacco products, and more. 

Hundreds of layoffs have been reported at the FDA, which will jeopardize the agency’s ability to fulfill its critical mission. These include layoffs of staff responsible for reviewing medical device products, which could delay new products hitting the market.

“From inspecting food to ensuring drugs are safe and effective to preventing food shortages and so much more, Americans depend on the FDA’s work every time they sit down for a meal or pick up a prescription. Sweeping layoffs will materially undermine this important work, leaving babies at higher risk of consuming contaminated formula, leaving patients waiting longer for lifesaving drugs to be reviewed and approved, and leaving our entire food supply more exposed to shortages, contaminants, or worse,” said Senator Murray.

HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA)

HRSA is charged with improving access to care for vulnerable and underserved populations. The agency runs critical programs to bolster the nation’s health workforce, improve maternal and child health, support high-quality care in Community Health Centers and Ryan White HIV/AIDS clinics, address rural health needs, and more.

Trump’s layoffs severely impact HRSA’s ability to deliver on these critical health care programs for communities nationwide. The layoffs reportedly include significant cuts to the staff hired specifically to support the modernization of the nation’s organ transplant system. Congress has worked in a bipartisan manner to strengthen this initiative by providing additional funding to address longstanding system issues and ultimately ensure that more organs are available for transplant. These layoffs will set back this lifesaving work for the 100,000 Americans waiting on an organ transplant.

“HRSA builds the health workforce and helps connect people in every part of the country to the essential health services they need–from routine checkups to maternal care to HIV prevention and so much more. Indiscriminately firing these staff risks putting critical health services out of reach for so many Americans, and it is extremely troubling that staff charged with modernizing our nation’s organ transplant network, which has faced longstanding issues, have been fired,” said Senator Murray.

NATIONAL INSTITUTES OF HEALTH (NIH)

NIH is the nation’s premier medical research agency. Each year, NIH supports biomedical research that produces life-changing and, in many cases, lifesaving treatments and cures.

Over 1,100 NIH employees have already been fired by Trump and Musk, including more than 130 employees at the National Cancer Institute and nearly 20% of the workforce at the National Institute on Aging, which funds Alzheimer’s disease research. This includes the Acting Director of the Center for Alzheimer’s and Related Dementias (CARD), alongside a number of senior scientists and principal investigators at CARD—leaving early career scientists and trainees without principal investigators guiding their work. Additional senior leaders at NIH are expected to be fired soon.

 The Trump administration is also continuing to hold up NIH funding, and its illegal and indiscriminate indirect cost rate change would create a  for lifesaving research that patients and families are counting on. An estimated  in lifesaving research funding has already been prevented from going out the door to institutions in every state since January 20.

 “Trump isn’t just firing the scientists who put us on the cutting edge of biomedical research, he is taking the best hopes for patients desperately counting on new cures and treatments and throwing them in the shredder. Ousting top scientists and leaders at NIH–people who’ve spent decades gaining expertise and working to discover medical breakthroughs–does nothing to help patients searching for treatments that could save their lives. These firings create chaos–and dangerously set back NIH’s lifesaving work. Washington state is a hub for this work, and I’m already hearing from people in my state about how research into cancer, Alzheimer’s disease, diabetes, heart disease, and so many other deadly conditions will be upended by Trump’s NIH cuts and these reckless–and heartless–layoffs. This is not just going to delay research—it will halt clinical trials in their tracks, cut patients off from care, and hollow out our medical research enterprise in ways that will echo for years to come,” said Senator Murray.

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION (SAMHSA)

SAMHSA is charged with improving services and support available to people across the country for substance use disorder and mental health. The agency plays a leading role in tackling the fentanyl and opioid crisis, and it oversees the 988 Lifeline. Nonetheless, Trump and Musk have also begun laying off dozens of SAMHSA employees.

“After years of bipartisan work, we are just starting to make progress getting opioid overdose deaths to trend down nationally—and now Trump is jeopardizing that progress by firing employees at the agency responsible for much of this work. Trump’s decision to fire these workers undermines the work happening on the ground in our communities to improve and save lives,” said Senator Murray.