HRSA Cuts Put FQHCs at Risk: What You Need to Know and Do Now
A recent KFF Health News article highlights how deep staffing cuts at the Health Resources and Services Administration (HRSA) under the Trump administration are jeopardizing the agency’s ability to manage and distribute the $12 billion in grants it oversees.
In a time when access to healthcare is more critical than ever, sweeping federal cuts are placing significant pressure on the very programs designed to support underserved communities. The Health Resources and Services Administration (HRSA), which oversees funding for nearly 1,400 community health centers nationwide, is facing dramatic staff reductions and stalled initiatives. For Federally Qualified Health Centers (FQHCs), the implications are clear: it’s time to prepare, adapt, and act.
What’s Happening at HRSA?
Massive Staff Reductions: Roughly one-third of HRSA staff have been cut, including those in the Bureau of Primary Health Care—HRSA’s branch that supports FQHCs.
Technology Modernization Stalled: A multi-year effort to modernize data systems and streamline reporting for health centers has been halted due to staffing shortages.
Grant Funding Disruptions: Health centers across the country are experiencing delays and freezes in federal grant disbursements, putting essential services at risk.
These changes are part of a broader restructuring within the U.S. Department of Health and Human Services (HHS), including consolidations and layoffs across the CDC, NIH, and FDA. Tens of thousands of jobs have been cut already.
Why This Matters to FQHCs
FQHCs rely on HRSA grants not only for operations but for compliance, workforce development, and care delivery enhancements. Without steady support:
Service capacity may shrink
Staffing becomes more fragile
Compliance risks increase
Strategic growth stalls
Patients who rely on FQHCs may not get the care they need
Health centers in multiple states have already reported hiring freezes, service cutbacks, and fears of closure due to the uncertainty of funding and delays in being able to access funds.
We’ve also heard from clients that HRSA communication has slowed drastically. Previously, FQHC leaders could expect a response from their Project Officer or Grant Manager within a day or two. Now, it may take weeks—or longer—to get answers.
What FQHCs Can Do Now
In light of the recent HRSA staffing cuts and the resulting disruptions, FQHCs must take proactive measures to ensure their stability and continued service to their communities. The following actionable steps are designed to help FQHCs navigate these challenges, maintain compliance, and advocate for necessary support. By implementing these strategies, FQHCs can better prepare for the uncertainties ahead and continue to provide essential healthcare services to those in need.
1. Stabilize Your Financial Foundation
Reassess cash flow and prepare for drawdown delays
Evaluate the organization’s reliance on federal grants
Build contingency budgets for the next 6–12 months
Explore alternative funding streams (e.g., state or philanthropic sources)
2. Protect and Prioritize Critical Services
Identify essential services linked to compliance and patient access
Support core staff roles and prioritize retention
3. Enhance Operational Efficiency
Invest in low-cost tech tools to continue modernizing your workflow
Optimize EHR use, scheduling systems, and data reporting manually if needed
4. Maintain Compliance
Stay current with all reporting requirements
File audits and reports on time
Monitor and adapt to Notice of Award (NOA) and Executive Orders changes
5. Lead in Advocacy and Storytelling
Collaborate with your PCA or HCCN to elevate stories and data
Contact local legislators to share the impact of HRSA delays
Equip your board and leadership with talking points
Anticipate higher demand from uninsured or Medicaid-transitioning populations
Monitor shifts in your payer mix and service demand
Strengthen your partnerships for food, housing, and behavioral health
Your Voice Is More Important Than Ever
The federal restructuring is reshaping the future of public health support. FQHCs must act swiftly—not only to protect funding and operations—but to ensure community voices are heard. These changes will disproportionately affect those who already face barriers to care. The time to plan, protect, and advocate is now.
At Community Link Consulting, we understand the challenges FQHCs face during these uncertain times. Our team of experts is here to help you navigate HRSA changes, strengthen your financial foundation, ensure compliance, and maintain the vital services your community depends on. Whether you need immediate support with cash flow planning, compliance guidance, or strategic planning for the road ahead, we're ready to partner with you. Contact us today to discuss how we can help your health center thrive despite these challenges.
Phone: 509-226-1393
Email: info@communitylinkconsulting.com
Authors:
Karen Creveling-Hughes, CEO & Visionary, Community Link Consulting - Karen brings 30 years of accounting and leadership experience to healthcare consulting, specializing in organizational effectiveness and strategic development for FQHCs nationwide.
Amy Brisson, Chief Strategy Officer, Community Link Consulting - Amy combines over 15 years of progressive financial leadership experience with 11 years of specialized FQHC industry expertise to drive strategic initiatives and deliver solutions for community health centers.
