Every Monday, retired teacher Maurine Gentis waits for delivery from the meals of Wheels On Wheels in southern Texas.
“Foods help me grow my budget,” said Gentis, 77. Living alone and in a wheelchair, she is grateful that someone will have her look on a regular basis. The nonprofit organization, which is the same group, delivers books from the library and provides dry food for cats.
But Gentis is worried about what will come first. The small agency responsible for overseeing programs such as dietary wheels has been demolished as part of an overhaul of the US Department of Health and Human Services' Trump administration. According to several employees who lost their jobs, the staff were let go of a recent layoff, and all 10 regional offices have been closed.
“I'm a bit worried that everything might go down the drain,” Gentis said.
In his quest to end what President Trump called an “illegal and immoral discrimination program,” one of his executive orders encouraged cracking down on federal efforts to improve accessibility and representation for people with disabilities. Specific research studies are no longer funded, and many government health workers specializing in disability issues have been fired.
The agency's reduction, the Community Living Bureau is part of the widespread cuts planned by the HHS under the Trump administration's proposed budget.
Federal funding could continue until September, the end of the government's fiscal year, with some workers temporarily recalled, but there is great uncertainty about the future. Additionally, some groups have reported delays in receiving expected federal funds.
“There's a lot of confusion,” said Becky Yanni, executive director of the Aging Council in St. John's County, Florida. She said she was told that the latest funding for the Meal On Wheel program and other services could be delayed.
If the funds don't arrive, “many communities will consider reducing services,” says Sandy Markwood, CEO of the use, representing a network of local agencies of aging.
The Community Living Department coordinates services and funds seniors and Americans with disabilities so that they can stay home rather than live in nursing homes. With a budget of $2.6 billion, the unit represents a small percentage of the total number of HHS spending.
Under the reorganization introduced by Health Secretary Robert F. Kennedy Jr., community unit responsibilities will be divided into other institutions, including the Centers for Medicare and Medicaid Services and the management of children and families.
“This integration will allow the sector to better meet the current health needs of vulnerable populations across the country,” a HHS spokesperson said in a statement. “This will continue elsewhere within the HHS and will not affect the critical work of these critical programs.”
So far, several programs under the unit have been eliminated under budgets, including budgets to provide ombudsman in nursing homes, ensuring residents' safety and welfare, as well as respite care programs, and providing breaks for those looking after the elderly or disabled. The nation also has more latitudes in deciding where to allocate funds.
In addition to meal delivery, Community Living Agency supports a number of programs, including non-profit centers in which people with disabilities are located.
Theo W. Brady, executive director of the National Council on Independence and Living, representing the Center and people with disabilities, said uncertainty has improved the plan.
“Everyone has the advantage. I can't say anything because I don't know anything yet,” he said.
Advocates say the recent cuts have further alienated older Americans and disabled Americans. “We've seen a lot of different things,” said Dr. Joan Lynn, clinical professor of geriatric medicine and palliative care at George Washington University.
“We have lived a very uncomfortable life in our disability and old age,” she said. “Of course, we can make it practically endure.”
Community groups like the dietary wheel have been significantly reduced. Republican lawmakers are proposing to cut grants to states that use alternative federal funds in addition to the potential loss of funds from the administration for community life. The Trump administration and Republicans are also calling for significant cuts to the Medicaid program.
“We are concerned about many potential threats happening at once,” said Josh Protas, the leading advocacy and policy director for dieting at Wheels America, an association of local nonprofits. He said about a third of the association's local units already have a waiting list, and he said that fewer meals will be obtained for fewer people.
Those over the age of 60 and have difficulty preparing food for themselves are usually eligible for wheel diets. As food prices rise and more people need help, demand for services is increasing. Over two million older Americans get food delivery every year, and many say it's difficult to pay for food without a program.
“Food is a godsend for me,” said Richard Beatty, 70, who lives in Baltimore, who has poor eyesight and limited mobility. He gets delivery four times a week and doesn't know how to manage it without the program.
If funding is cut, the program must make strict choices as to who is eligible for delivery. “We have to make dramatic changes to who we serve,” said Dan Capone, CEO of Meals On South South Texas. His group has also received private donations, and the federal fund accounts for about 40% of the budget, he said.
The federal community unit under AX plays a key role in supporting Americans with disabilities, including seniors.
“A lot of the work we do is to give people dignity in their lives,” said Karen Tamley, chief executive of the Chicago-based Center, one of 400 people across the United States.
The center connects people with a variety of services and provides job and skill training to young adults with disabilities. They may teach someone to drive or help them find affordable housing.
The Community Living Department helped organizations navigate state and local bureaucrats responsible for ejecting federal funds. When Capone made it clearer about how Texas is sharing money, he contacted the Dallas unit's regional office. “We were just beginning to build relationships with field offices and that field office is gone,” he said.
“It's frustrating on a practical level,” said Fay Gordon, one of the community managers who were let go earlier this month. “These programs are live and require direction.”
Some groups do not wait before taking steps to reduce costs. Brittany Boyd Chisholm, chief executive of the Center for Independent Living in Central Pennsylvania, said more than half of her funds will come through federal agencies. She asks all managers, including all managers, to cut their salary by 5-10%, to weigh other behaviors. She said her centre is already underfunded.
No one has provided her with information about future grants and her emails have been returned. “It makes you feel completely for yourself,” Boyd Chisholm said.
The institution, established under the Obama administration, was intended to unite the work of the other three institutions. The government on aging, the office on disability, and the government on developmental disorders.
“These programs were about efficiency and coordination to be around them,” said Alison Bakoff, former acting administrator under President Biden, who resigned last fall.
During the first Trump administration, during the pandemic, agencies worked with the Civil Rights Office to ensure hospitals and doctors have secured clear guidelines and not deny care for people with disabilities if they are understaffed.
“We discovered a common foundation and problem,” said Daniel Davis, who worked at the government's policy and assessment centre.
