The White House is proposing to reduce by nearly 40 percent the uniformed public health professionals who deploy during disasters and disease outbreaks, monitor drug safety and provide health care in some of the nation’s most remote and disadvantaged areas.
The proposal is part of a plan announced last week by the Office of Management and Budget to overhaul the federal government. It would cut the size of the U.S. Public Health Service Commissioned Corps from its current 6,500 officers to “no more than 4,000 officers.” Administration officials, who have said the officers are “more expensive” than equivalent civilians, want “a leaner and more efficient organization” better prepared to respond to public health emergencies. They have not offered projections on how much might be saved.
All Corps members are officers who work as doctors, nurses, engineers and other public health professionals across the federal government.
The proposal would also create a Reserve Corps of government employees and private citizens, similar to that used by other uniformed services, to be mobilized in a public health emergency or to back-fill critical positions left vacant during regular Corps deployment.
Jim Currie, executive director of the Commissioned Officers Association of the U.S. Public Health Service, said the reductions would greatly affect the Corps’ ability to respond to disaster sites as it routinely does now.
“I don’t quite understand the animosity toward the Commissioned Corps,” he said. “These folks are doing day jobs” — at the Centers for Disease Control and Prevention, National Institutes of Health and elsewhere within the government — “and when they’re needed, they go and deploy and work their butts off for 12 to 14 hours a day.”
The little-known U.S. Public Health Service Commissioned Corps, which dates back over two centuries, is part of the Department of Health and Human Services. It is one of the seven uniformed services; members receive military pay and benefits but are unarmed. They wear uniforms that look like those of the Navy and Coast Guard except for the insignia. The service’s officers fought yellow fever, cholera and plague in the early years of the 20th century and examined immigrants at Ellis Island.
The Corps has deployed to natural disasters, disease outbreaks and humanitarian crises. More than 1,460 officers were sent to respond to hurricanes Harvey, Irma and Maria, including more than 350 who deployed twice, said Kate Migliaccio Grabill, a commander and USPHS spokeswoman. Nearly 300 officers were sent to staff a U.S. field hospital in Liberia during the 2014 Ebola epidemic.
When thousands of unaccompanied minors crossed into the United States from Mexico in 2014, triggering a humanitarian crisis, more than 350 officers were sent to the Southwest to provide a variety of services, including medical screenings and behavioral health support. During this current crisis involving migrant children separated from their parents at the border, the service is also being tapped to help, HHS Secretary Alex Azar said Tuesday.
The largest number of officers — 1,887 — is assigned to the Indian Health Service. More than 1,100 work at the Food and Drug Administration and nearly 800 at the federal Bureau of Prisons. Many CDC leaders are Corps officers, including Anne Schuchat, a two-star rear admiral with nearly three decades of experience at the agency.
Some OMB recommendations announced last week involve merging entire federal departments, which would require approval from Congress. But reductions in force could be achieved through the budget process without going through Congress, Trump administration officials have said.
The two-page proposal on the public health service’s cuts said HHS would “civilianize officers who do not provide critical public health services or support in public health emergencies.” It would require Corps officers to work first in hard-to-fill areas — currently, individuals who join have the option — and continue to serve there or to deploy as needed in a public health emergency at least once every three years.
The plan says “only a small percentage” of Corps officers now deploy for public health emergencies but take up slots that could be filled by civilians. The only report it cites is a 22-year-old Government Accountability Office study that raised questions about the need for Corps officers in some positions.
A 2013 University of Maryland study noted that while some budget analysts consider commissioned officers to be more expensive than civil servants, that comparison fails to properly take into account the overtime hours for which Corps officers are not compensated. The federal government paid civil servants nearly 3 million hours in overtime, totaling $124 million, for work last year during hurricanes Harvey, Irma and Maria, according to information Currie received from FEMA.
Moving forward, the proposal says, agencies employing Corps officers would be required to pay their retirement costs. That is not the case now.
A former commander who now works in the private sector said the Corps has always been marginalized among the services. When a new Department of Veterans Affairs program was launched this year for online identification card applications, the USPHS Commissioned Corps and commissioned members of the National Oceanic and Atmospheric Administration, both considered veterans by law, were initially excluded.
The Corps has been a target of criticism because its members receive military benefits, “but we’re not in the line of fire, so it’s seen as a sweet gig,” said the former commander, who spoke on the condition of anonymity because he wasn’t authorized to talk publicly. “People in the Corps are feeling very upset,” he said. “They made a commitment in serving the public, and now we’re talking about basically getting rid of them, and these are the people who chose the public sector over the private, which generally means they took a pay cut for these jobs.”