Should Congress fail to pass legislation to continue funding the federal government, as it appears likely, the Department of Health and Human Services will be forced to furlough more than half of its employees. And the Office of the National Coordinator for Health IT would be hit particularly hard.

Of the total 184 on-board staffers at ONC, only four would be retained and charged with handling “orderly phase-down and suspension of operations.”

[See also: ONC makes big changes at the top.]

Indeed, a government shutdown would mean ONC will put on hold its standards and interoperability work, privacy and security policy activities, clinical quality measure development, as well as maintaining the Certified Health IT Product List.

Across the whole of HHS, 48 percent of employees would be retained, 52 percent furloughed. The percentages will vary across agencies and offices, HHS explained in a document stating contingency plans, such that units with “a substantial direct service component” like Indian Health Service  maintain most of their staff while employee-intensive and grant-making agencies, like AHRQ and SAMSHA, will be operating sans the majority of employees.

[See also: Ready or not: HIPAA gets tougher today.]

CMS, for its part, would keep driving “large portions of ACA activities, including coordination between Medicaid and the Marketplace,” as in the health insurance exchanges that open on Tuesday. Medicare will not be disrupted in the short-term and states will still receive Medicaid funding but “CMS would be unable to continue discretionary funding for healthcare fraud and abuse strike force teams, resulting in the cessation of their operations.” 

Also functioning at reduced capacities, the National Institutes for Health will continue caring for current patients but not admit new patients or initiate new protocols and it will reduce some veterinary services, while the Centers for Disease Control and Prevention will function at a minimal capacity to respond to outbreak investigations and operate its emergency centers, but it will be unable to run its annual influenza program, or support state and local health departments for biosurveillance.

“This plan reflects the anticipated number of staff who would be on-board the second business day of a near-term funding hiatus, after initial shutdown activities would have been completed,” HHS explained. “HHS expects to complete initial shutdown activities within the first day after OMB notification to implement the contingency plans.”