County public health departments across Arizona are trying to make sense of the news that the state is losing more than $190 million in federal funding for health programs. Some layoffs are expected.

In the name of efficiency, the Trump administration said last week it planned to claw back billions of dollars in grants related to COVID-19 that had been promised to states.

“The COVID-19 pandemic is over, and HHS will no longer waste billions of taxpayer dollars responding to a non-existent pandemic that Americans moved on from years ago," the U.S. Department of Health and Human Services said in a statement.

The Arizona Department of Health Services on Friday said the cuts would impact more 269 contracts statewide with counties, tribes, universities and other organizations. The department said the funds were already committed and planned for spending in approved, multi-year projects.

Dr. Nick Staab, chief medical officer of the Maricopa County Department of Public Health, told KJZZ on Monday he did not yet know the full impact of the cuts in his department.

“At this point we’re still taking inventory of where each of those grants is affecting the department,” Staab said.

But some departments are preparing for potential layoffs.

In Pima County, a health department memo dated March 28 said at least 22 staff positions across two grant-funded projects would be impacted, in addition to some contracted positions and some staff positions that dedicate just part of their time to the programs.

The Pima County memo said a broad range of programs would be interrupted, including vaccine clinics, health insurance enrollment assistance, education programs for the overdose-reversal drug NARCAN, and extreme heat response efforts.

Will Humble, executive director of the Arizona Public Health Association, told KJZZ in February that Arizona’s public health system would be particularly vulnerable to changes in federal spending since the bulk of the budgets for almost all state and county public health programs is actually federal grant money.

“Our state has been almost entirely reliant on federal funds for their public health programming,” Humble said.