Each month, the Northern Oklahoma Regional Pediatric Clinic gives hundreds of doses of routine vaccinations to Kay County kids free of charge through a federal program. 

Vaccines for Children, a program that helps fund immunizations for low-income kids, is popular in Kay County, said Brandi Glaser, office manager for the Ponca City clinic. Kay County is rural, with about 16% of residents living in poverty and 13% lacking health insurance, according to the U.S. Census Bureau. The clinic ordered 620 doses of vaccines in May alone, which would have cost families $61,000, Glaser said. 

“It’s utilized all day, every day in our clinic,” Glaser said. 

During the coronavirus pandemic, the program received millions in supplemental funding to help roll out the COVID-19 vaccine, improve vaccination access, and more. 

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In March, the federal government terminated the state’s access to about $15 million in supplemental pandemic funds that hadn’t been used. And in April, Oklahoma’s own Division of Government Efficiency announced recommendations that the state returned $157 million in federal health care grants, including the $15 million for the vaccination program.

“A grant may dedicate millions for COVID-19 testing supplies, but the demand for those supplies is not there, and it would be irresponsible for us to spend that money when we know those supplies will sit on a shelf, expire and go to waste,” the Health Department wrote in a statement, explaining why some money wasn’t used. 

State and federal officials have targeted public health programs in efforts to trim what they call wasteful spending, focusing on pandemic-era funding that remained unused. But health care advocates have pushed back, pointing to Oklahoma’s low public health rankings and questioning why the state wasn’t able to find some use for the funds. 

Nationwide, the federal government pulled back $11 billion in COVID-era health care funding this spring, saying it would no longer “waste billions of taxpayer dollars responding to a non-existent pandemic that Americans moved on from years ago.”

For Oklahoma, this meant the end of extra funds for immunizations, epidemiology and public health lab services. Funding also ended for the Oklahoma Community Health Workforce Initiative, which put community health workers across the state where they worked to connect people to health care and social services, and the Oklahoma Initiative to Address COVID-19 Health Disparities, a program to expand health department capacity and prevent COVID-19 infections in high-risk and underserved populations. 

The federal government required the state to stop spending any money related to these grants, according to termination notices obtained by The Frontier. 

Lori Freeman, CEO of the National Association of County and City Health Officials, said money can almost always be used effectively on the local level. These grant terminations, combined with federal cuts to programs like Medicaid, will likely create ripple effects. 

“It’s a perfect storm coming together to really threaten our ability to provide what is needed to keep communities safe and healthy,” Freeman said. 

In April, Oklahoma’s Division of Government Efficiency identified what it called $157 million in wasteful federal grant spending, saying much of the money exceeded the state’s need and should be returned to the federal government. This included a recommendation to return $132 million meant for epidemiology and laboratory capacity services that provided diagnostic testing, staff training, wastewater surveillance, and modernizing data collection.

The Health Department said spending restrictions were strict and there was no demand to expand lab capacity for pandemic response. When DOGE-OK asked the health department where it could trim, the Health Department said it focused cuts on grants likely to be reduced federally. 

But former Oklahoma State Medical Association President George Monks said the money could have likely helped the state’s public health lab upgrade facilities or processes. “It’s a real head scratcher,” he said. “We have major deficiencies that need to be fixed.”

The Health Department did not respond to questions on whether the money could have been used this way. The lab struggled to meet federal standards when it moved to Stillwater in 2021, and still outsources tests for tuberculosis, measles, mumps, and cervical cancer screenings. A spokesperson for the Association of Public Health Laboratories said outsourcing is typical when state labs lack capabilities.

In early 2023, State Health Commissioner Keith Reed told lawmakers the agency wanted to bring some testing back to the lab. 

“I don’t want to rely on another public health lab to meet the needs I feel like we should be able to,” he said. The Health Department took back management of the lab that year.

The DOGE-OK report also recommended returning other federal money to combat diabetes, overdose data surveillance systems and newborn hearing screenings. 

Marc Nuttle, a longtime conservative political advisor and Stitt’s pick to lead DOGE-OK, said health care needed “the most help” during efficiency efforts. 

Stitt’s executive order establishing DOGE-OK directed the office to identify and eliminate wasteful spending to make Oklahoma a top-ten state for business. But Nuttle says he’s most focused on increasing efficiencies — not cutting any programs or staff — ahead of any possible funding losses as the federal government continues to trim spending on social programs. 

Oklahoma receives more federal dollars for programming than taxpayers send in, according to the Oklahoma Policy Institute, a local think tank. 

“If they cut those federal funds, what are we going to do?” Nuttle said. “So our goal was to prepare and provide options for the Legislature to consider.” 

Nuttle said the office only makes recommendations and would rely on action from executive agencies or the Legislature to finalize saving recommendations.

But legislative leaders say they have not worked closely with DOGE-OK since its creation. 

Rep. Preston Stinson, R-Edmond, chair of the House Appropriations and Budget Health subcommittee, said he’s glad the state was able to align with federal priorities so far without having deep cuts to programs. But the Legislature has had limited involvement with DOGE-OK’s work so far, he said. 

Sen. Paul Rosino, R-Oklahoma City, chair of the Senate Health and Human Services committee, said he hasn’t met with DOGE-OK but was informed of the grant reductions by the Health Department.

Rosino said he’s focused on other areas that are going to see federal funding cuts. He estimates that funding cuts in the latest federal budget bill will leave up to a $700 million to $1 billion shortfall in Oklahoma’s funding for services like Medicaid and SNAP, the Supplemental Nutrition Assistance Program. 

Federal grants make up most of the State Department of Health’s budget, with state funds providing a baseline that “in no way covers the total cost” of services, said Sen. Julia Kirt, D-Oklahoma City.

Abegail Cave, spokesperson for the governor’s office, said Stitt has maintained DOGE-OK’s purpose as focusing on state-level efficiencies to manage national debt concerns and federal funding changes without impacting services.