Some 23% of local health departments reported that public health preparedness programs were reduced or even eliminated in 2011, while a further 15% reported similar cuts in 2012. In 2014 alone, the Hospital Preparedness Program, which links regional hospitals with local health departments to prepare for potential public health emergencies, suffered $100 million in budget cuts.
州和地方一级所面临的挑战可能更为严峻。2011年约23%的地方卫生部门反映公共卫生应急计划数量锐减甚至消失。还有15%反映2012年也有过类似的削减开支。仅2014年一年，连接地区医院与地方医疗卫生部门、为潜在公共卫生突发事件做准备的医院应急计划就蒙受了1亿美元的预算损失。