Boulder County’s public health system is facing uncertainty after a sudden freeze — and unfreeze — of $267,000 in federal funds for immunizations and disease prevention programs. The money supports free flu and measles vaccines, shots for uninsured families and the infrastructure to track outbreaks and respond to future pandemics.
The funds were initially blocked in late March following a sweeping move by the Trump administration’s Department of Health and Human Services (HHS) to rescind more than $11 billion in pandemic-era public health funding. Colorado alone was slated to lose $250 million, with most of that intended for local governments and tribal communities.
Alexandra Nolen, executive director of Boulder County Public Health, called the move unprecedented.
“That certainly hasn’t happened as long as I’ve been in public health, to have committed funds ripped back that way,” said Nolen, who has worked in the field for 26 years.
HHS announced the cuts on March 24. A week later, on April 1, 22 states — including Colorado — and Washington, D.C., filed a lawsuit, arguing the move would cause “serious harm to public health” and “triggered chaos” at state and local levels. A federal judge has temporarily blocked the funding terminations while the case proceeds. The next hearing is scheduled for April 16.
Still, Boulder County Public Health is preparing for the possibility that the funds may be terminated for good. If that happens, Nolen said the county would likely have to cut vaccine clinics, delay investments in outbreak response tools and potentially lay off staff.
The department is also making plans in case the administration announces additional cuts. Over 25% of Boulder County’s public health budget, about $5 million, comes from federal funding.
“A lot of our federal funding is at risk because the federal administration is a little bit unpredictable right now,” Nolen said.
The risks extend beyond infectious disease. Federal funds also support local behavioral health services, emergency preparedness, environmental health, substance use prevention and maternal and child health programs, including services for children with special needs — all of which could be affected by future cuts or instability in Washington.
Since April 1, HHS, now led by Robert F. Kennedy Jr., has fired about 10,000 employees — more than 12% of the agency.
“We’re kind of waiting to see what else is going to come,” Nolen said.
Compounding the threat, Colorado faces a $1.2 billion budget deficit this year. Recent state budget proposals have included cutting mental and behavioral health funding. Nolen estimates Boulder County Public Health could lose another $150,000 in the coming year. She is also concerned about ripple effects from potential cuts to Medicaid, housing and food assistance on other agencies and nonprofits.
“Public health often is needed to pick up the pieces when things go wrong,” she said. “We have this perfect storm of budget reductions along with increased threats to the health of the community.”
She cited the rising number of measles cases as a growing concern. Measles was declared eliminated in the U.S. in 2000, but as vaccine hesitancy has risen, so has the number of measles cases. More than 600 cases have already been reported nationwide this year, including two deaths in Texas. That’s more than double the number of cases in all of 2024.
Two cases have been documented in Colorado this year, but Nolen warned that may be an undercount. Reporting is usually a few weeks behind, she said, and the agency is preparing for cases to hit Boulder County “sooner or later.”
Cuts to the county’s immunization and disease tracking programs would make that work harder.
Public health cuts “hurt the agency in terms of our ability to serve the community,” Nolen said. “There may be programs that we can no longer support because we simply don’t have the funding for it — and that’s a shame, because usually public health funding is some of the best invested in terms of return on investment for community health.”