The U.S. Department of Health and Human Services (HHS) recently announced a reduction in force (RIF) of around 20,000 employees. About 10,000 accepted “early-out retirements” or “early separation agreements” while the remaining employees are being laid off. Caught in the crosshairs of those layoffs are many NIOSH employees, many of whom provide direct services impacting the fire service.
This latest government agency RIF appears to be consistent with the Trump administration’s goal to reduce the size of the federal government. Through the Department of Government Efficiency, the government purports to be “rooting out waste, fraud, and abuse” in government operations and spending.
[Read next: The big picture: FEMA, DOGE and your local fire department]
I find it extremely difficult to identify waste, fraud, or abuse in any of the closures or layoffs that have thus far affected the fire service. Furthermore, the administration has not articulated waste, fraud or abuse in the RIF notices; they have instead defaulted to statements about “efficiency.” And when pressed for an explanation of efficiencies, DOGE usually states that agency directors were directed to eliminate those programs and people that were not deemed as “mission-critical,” despite the fact that some of those impacted programs are congressionally mandated. (We’ll address this conundrum below.)
As we identify some of these supposedly “non-mission-critical” programs and people below, we’ll start at the top of the federal structure and work our way into the firefighter-focused programs.
Centers for Disease Control and Prevention (CDC)
Nested under HHS, the CDC operates the following national entities (in addition to numerous internal offices/divisions) – emphasis to the first in the list:
- National Institute for Occupational Safety and Health (NIOSH)
- National Center on Birth Defects and Developmental Disabilities (NCBDDD)
- National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP)
- National Center for Emerging and Zoonotic Infectious Diseases (NCEZID)
- National Center for Environmental Health (NCEH)
- National Center for HIV, Viral Hepatitis, STD, and TB Prevention (NCHHSTP)
- National Center for Immunization and Respiratory Diseases (NCIRD)
- National Center for Injury Prevention and Control (NCIPC)
- National Center for State, Tribal, Local, and Territorial Public Health Infrastructure and Workforce (NCSTLTPHIW)
- National Center for Health Statistics (NCHS)
- Global Health Center (GHC)
With this many divisions, it’s almost hard to imagine the depth of the programs and services, not to mention the many individuals, affected by the recent reductions. Now, let’s turn to the fire service impact.
The National Institute of Occupational Safety and Health (NIOSH)
Many great researchers, scientists, and fire service colleagues and friends have spent years, if not decades, focused on firefighter health and safety. NIOSH, NIST and UL’s Fire Safety Research Institute have become significant partners for safety and tactical considerations at all levels of the fire service.
NIOSH specifically has decades of experience conducting investigations and research on firefighter safety and health across a variety of topics – cancer, PFAS, public health threats and more. The NIOSH Center for Firefighter Safety, Health, and Well-being provides a central point for engaging with fire service research groups and coordinating the many great NIOSH programs that have been long underway to serve firefighters. A snapshot of these programs:
- The National Firefighter Registry for Cancer (NFR)
- The Fire Fighter Fatality Investigation and Prevention Program (FFFIPP)
- The World Trade Center Health Program (WTCHP)
Each of the programs has been rocked by the recent federal reductions. Some affected NIOSH staffers and researchers had previously been let go, then rehired, only to receive RIF notices or RIF intent notices again on April 1. The roller coaster has been anything but smooth or efficient for sure.
The National Firefighter Registry (NFR)
Years of work went into the development and implementation of the NFR. There was strong bi-partisan and fire service partner support for the creation of the Registry, which President Trump signed into law in 2018. To date, approximately 23,000 firefighters (including myself) have registered, providing a never-before-available window into the world of toxic environment exposures and cancer causations.
Then Tuesday, just a few years after its official launch, many NIOSH senior leadership, researchers and staff I spoke with were swiftly and unceremoniously given the day to empty their desks and vacate their work sites, as part of a larger RIF. As part of this reduction, NFR was shut down. Firefighters can no longer register, and those of us who previously registered are unable to access our dashboard to track exposures. It takes staff and time to administer this site, and there simply aren’t enough employees left to do so.
The Fire Fighter Fatality Investigation and Prevention Program (FFFIPP)
The FFFIPP conducts independent investigations of firefighter line-of-duty deaths (LODDs) to formulate recommendations for preventing future deaths and injuries. The program does not seek to determine fault or place blame on fire departments or individual firefighters, but to learn from these tragic events and prevent future similar events. Not every firefighter LODD prompts an investigation; NIOSH must be requested. Recognizing that priorities change based on fatality data, investigations are prioritized using a flow chart. NIOSH also conducts investigations of selected non-fatal serious injury events.
It is important to understand that the NIOSH LODD investigations are not after-action reviews (AARs) or safety investigations. AARs and safety investigations are the responsibility of the authority having jurisdiction.
As part of the April 1 RIF, staff and investigators for the FFFIPP were let go.
The World Trade Center Health Program
The World Trade Center Health Program provides monitoring and treatment for certified WTC-related health conditions for eligible first responders to the September 11, 2001, attacks in New York City, the Pentagon in Arlington, Virginia, and the crash site in Shanksville, Pennsylvania. The program also provides benefits to eligible survivors in the New York disaster area in the days after 9/11, and those who were caught in the dust or dust cloud on 9/11. In addition, the program conducts research to better identify, diagnose, and treat physical and mental health conditions related to 9/11 exposures. Over 90,000 responders and nearly 50,000 survivors are currently registered with and supported by the WTC Health Program.
As part of the larger NIOSH reduction, Dr. John Howard, the head of NIOSH and the administrator of the 9/11 first responders health treatment and monitoring program, was removed. According to one report, “No other WTC Health Program employees have been fired, but the program relies on doctors, epidemiologists and administrative staffers who work for the broader agency, so the NIOSH firings pose a threat, survivor advocates claim.”
Benjamin Chevat, executive director of Citizens for the Extension of the James Zadroga Act, shared the following: “These cuts to NIOSH will be devastating to the World Trade Center Health Program and must be stopped. The first step must be restoring Dr. Howard as NIOSH Director immediately.” Read Chevat’s full statement.
Not “mission-critical”?
So where do we categorize the National Firefighter Registry, the Fire Fighter Fatality Investigation and Prevention Program, and the World Trade Center Health Programs? Waste? Haven’t seen any evidence of that. Fraud? Haven’t seen any evidence of that. Abuse? Haven’t seen any evidence of that.
The RIF letters NIOSH staff received state the following: “your duties have been identified as either unnecessary or virtually identical to duties being performed elsewhere in the agency.” This sounds like the “inefficiency” talking points we’ve heard.
There are probably some inefficiencies that could be addressed – there almost always are in any organization or company, public or private – but it’s hard to imagine how that could result in this level of disruption and program closures. More importantly, I’m not aware of anyone else administering the cancer registry, investigating firefighter deaths and serious injuries, or administering the 9/11 health program. NIOSH is the only agency with these firefighter-focused programs.
So, if there’s no fraud, waste, abuse or inefficiency, that leaves one word from the RIF notice – “unnecessary.” The programs have been deemed not “mission-critical” in the eyes of the Department of Health and Human Services.
Think about that for just a minute. HHS is silently communicating that our programs to prevent and track firefighter cancers, to improve firefighter safety, to investigate our LODDs, and to support the responders and families suffering 9/11 illnesses are not “mission-critical” to them. I guess that fits with the communication we’ve been sent that the National Fire Academy isn’t mission-critical either. Prove me wrong.
What’s next?
We must advocate for the administration to rehire the staff and restore these programs. Anything less is unacceptable for the men and women who are working to manage the chaos and restore order within the communities they serve. Additionally, we must do everything we can to support our firefighters and support their health and well-being. We must also find ways to maintain the public trust and public safety for the communities we are sworn to serve.
While the axes continue to swing and the chainsaws continue to cut in the halls of the federal government, I will reiterate the call to prioritize the U.S. Fire Service and our allied agencies into a single more-efficient Department of Emergency Services. Time is of the essence to take action and find paths forward, even reaching across the political aisles.
The IAFF is reportedly taking the lead here to advocate for restoring these programs. IAFF President Ed Kelly shared these comments on X, highlighting some hope for what’s ahead: “I spoke with the White House yesterday to express our concerns about HHS’s actions this week and urged the Administration to fully restore these vital programs. The call was productive, and they assured me that efforts are underway to reverse these cuts. I appreciate the Administration’s willingness to engage in this important conversation.”
Like IAFF President Kelly, I appreciate that the administration is willing to consider reinstating these programs. I am also hopeful that, going forward, we can have the conversations in advance, minimizing the industry and personal chaos involved.
It’s time to join the chorus. What will you be willing to give up? How much are you willing to cut? How many of your friends, brothers and sisters in arms are you willing to lose while you sit idly by and quietly allow this all to take place? Tick tock, tick tock.
WATCH | ‘Restore classes immediately’: Fire service leaders urge action after NFA training cancellations
Dr. Lori Moore-Merrell, Chief Josh Waldo and Chief Marc Bashoor offer potential solutions that would accommodate both training and program reviews.
