Federal cuts to disaster preparedness funds jeopardize hospitals

Modern Healthcare – Monday, May 5, 2025
By Alex Kacik

The federal government’s cuts to disaster preparedness grant funding will cost providers millions of dollars and potentially jeopardize patient care.

President Donald Trump’s administration last month eliminated roughly $3.3 billion in annual federal grants when the Federal Emergency Management Agency ended the 2025 Building Resilient Infrastructure and Communities and Flood Mitigation Assistance programs. The program reductions are part of the administration’s crackdown on federal preparedness funding, which health system executives and experts say are vital to combat the growing threat of wildfires, hurricanes, floods and other disasters.

The administration also teed up the possibility of additional cuts in its May 2 budget proposal. The proposal included eliminating $240 million in annual federal funding linked to the Administration for Strategic Preparedness and Response Hospital Preparedness Program.

Hospitals and experts said disaster preparedness projects are crucial.

“We know from Hurricane Milton how a breach of potable water and wastewater systems can impact a community and a hospital,” a spokesperson for BayCare Health System said.

The Clearwater, Florida-based nonprofit health system was hit by Hurricane Milton on Oct. 9. A water main broke that night, cutting off St. Anthony’s Hospital’s water source. Staff relied on bottles of water, as well as portable commode liners and bathing wipes, to help maintain essential operations.

The Building Resilient Infrastructure and Communities and Flood Mitigation Assistance funds helped West Central Florida’s local governments draft plans to bolster potable water and wastewater systems, the BayCare spokesperson said. Despite the grant funding interruption, BayCare hopes these plans will continue, the spokesperson said. Florida water districts and local jurisdictions did not respond to requests for comment.

The FEMA grant programs fund mitigation projects aimed at reducing the long-term risk of natural disasters. For instance, health systems, local jurisdictions and states could use grants to retrofit culverts, elevate buildings above flood levels and develop emergency evacuation centers. FEMA would typically fund up to 75% of Building Resilient Infrastructure and Communities grants and the state would pay the remainder.

FEMA awarded Columbia Memorial Hospital a $14 million Building Resilient Infrastructure and Communities grant in 2023 to build a shelter where patients could get care during a disaster. The hospital in Astoria, Oregon, also planned to use the grant to relocate generators and other critical infrastructure to the roof of its expanded hospital, slated to open in 2026. A spokesperson said the organization is disappointed the grant was canceled.

Without federal support, states and providers may have to shoulder more of the cost of disaster preparedness projects. Healthcare providers, along with states, counties and local governments, may be less willing to fund preventive measures as they could also face reduced federal support for Medicaid and National Institutes of Health-backed research grants, experts said.

The Building Resilient Infrastructure and Communities program was one of the few federal programs that invest in upstream disaster prevention and risk reduction projects, said Glen Mays, chair of health systems, management and policy at the University of Colorado School of Public Health.

“Canceling it has the potential to increase health system vulnerability to disasters,” he said. “Without these investments, communities are likely to experience increased economic losses from disasters as well as elevated morbidity and mortality because of disruptions in access to needed healthcare.”

Hospitals are facing other federal funding threats beyond the FEMA grant reductions.

The Trump administration last week outlined $163 billion in proposed budget cuts, including reductions to several hazard readiness programs such as the Administration for Strategic Preparedness and Response Hospital Preparedness Program. The program was established in 2002 to help facilitate public-private coalitions among healthcare, public health and emergency management organizations.

In Trump’s budget proposal, officials said the hospital preparedness program has been redundant and unfocused, and that states were better equipped to handle these initiatives.

“If funding mechanisms like these are no longer in place, ensuring an alternative pathway for communities to strengthen critical infrastructure will be essential,” said Julie Abrams, acting executive director of the nonprofit Healthcare Ready.

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