Public health advocates in Georgia have canceled a major annual conference, more than 100 public health workers have been let go and state agencies are now limiting other spending as the Trump administration last week abruptly canceled pandemic health grant money that was awarded but not yet spent.

Georgia agencies dealing with public health, addiction and disabilities said their total rescinded by Washington is still being counted but already surpasses $300 million.

A federal judge on Thursday temporarily blocked the Trump administration’s clawback. But that changed nothing in Georgia, where state agencies said they would not resume spending the money as they had not heard anything different from the Trump administration itself.

The suit was filed in Rhode Island by Democratic-led states. Georgia Attorney General Chris Carr has not joined the legal challenge.

The money was awarded with the understanding it would be spent over years, with some grants running to 2027. It was part of billions awarded nationwide by the Biden administration under COVID-19 emergency spending bills, to fund the pandemic response and prop up the nation’s gap-filled public health infrastructure.

President Donald Trump and his Department of Government Efficiency leader Elon Musk have said they are trying to reduce fraud, waste and abuse in federal spending and get the debt-laden budget back on track.

The news of the massive clawback was sudden.

The Georgia Department of Public Health said it learned only March 25 that the White House had set a March 24 deadline to use the grants. There are some projects that were not finished but that the sate health department will still try to accomplish, either with funds it already has or by trying to raise more. One example is upgrading Georgia’s decades-old computer system for disease surveillance.

DPH says that out of $877 million it was originally awarded in COVID-19 grants, the majority has already been expensed. But it estimates it will have to give up some $334 million. Some of that is under negotiation depending on work that was currently underway but not yet billed.

Separately, the Georgia Department of Behavioral Health and Developmental Disabilities said it is still counting through what was spent as of March 24 and what wasn’t. The agency said it has 90 days to provide invoices to Washington showing that there are sums it should be able to keep.

“We are still examining the impacts across our service delivery areas,” said spokeswoman Camille Taylor.

Department of Public Health officials said the rescinded money will not affect “core” services.

The public health agency is losing about 180 workers. The vast majority of them — about 170 — were originally among the massive impromptu workforce hired at the height of the pandemic to perform work tracing and stopping COVID-19 spread. Most were let go over time, but those remaining had turned to epidemiology work beyond the pandemic and helped staff public health offices throughout the state.

“There will probably have to be some kind of a shift,” Nancy Nydam, a spokeswoman for the DPH, said of the workers. However, she said, “we did epidemiology work without them before.”

“Now, can we use more help? Everybody can always use more help, and we had the ability to keep those 170-some-odd on to do that,” Nydam said. “But now it shifts back to the epidemiologists.”

Services that will be reduced or eliminated include mobile vaccine deployments, for example. But local health departments will still perform their core function, including vaccinating people who can travel to them, DPH said.

While the notice last week was sudden, ever since the first weeks of the Trump administration DPH had braced for something dramatic. DPH Deputy Commissioner Chris Rustin had already told staff to stop all nonessential travel, including to trainings and meetings.

Rustin alerted staff Feb. 5 that DPH was postponing an annual spring convention on vaccinations and said it would not allow staff to attend the Georgia Public Health Association’s annual conference where public health workers and lay officials from Georgia’s 159 counties meet to educate, stay up to date and plan. Rustin called it a “tough decision.” The association canceled the conference as a result, one member said.

“Federal funds account for approximately 50% of our budget and impact key programs and services,” Rustin said in the email. “We must proceed cautiously.”

In Georgia, the overall direction of each county’s public health department is set by a county board staffed by locals, such as rural mayors or business people who may never have worked in medicine. They need education, and they usually get it at the annual conference that has just been canceled, said Jack Bernard, chairman of Fayette County’s board of health.

Bernard also serves with the Georgia Public Health Association and chairs the committee responsible for convening those local board members at the conference.

“I had to cancel my speakers who were coming from other states,” Bernard said. “That’s the main meeting where board of health members who don’t know much about public health are trained. And these are public health issues. So it’s not a junket.”

EDITOR’S NOTE: This story has been updated to include references to the legal challenge filed by Democratic-led states and Georgia agencies’ reaction to the latest ruling.

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