The White House Office of Management and Budget (OMB) proposes to cut the U.S. Public Health Service (USPHS) Commissioned Corps from 6,500 to 4,000 officers. The goal is a "leaner and more efficient organization that is better prepared to respond to public health emergencies and provide vital health services," according to the proposal, Delivering Government Solutions in the 21st Century: Reform Plan and Re-organization Recommendations.

The U.S. Public Health Service (USPHS) medical staff assist each other in donning personal protective equipment during the 2014 Ebola outbreak in Monrovia, Liberia, one of the many public health emergencies around the globe to which the USPHS and its Commissioned Corps has responded. Photo by Michel du Cille / The Washington Post via Getty Images.

The proposal, part of the Trump administration's fiscal year 2019 budget, questions the need to pay Corps officers more for jobs civilians can fill at lower salaries. Under the plan, officers who do not provide critical public health services would become civilians. Remaining Corps officers would be initially required to work in hard-to-fill areas and travel as needed during public health emergencies. A Reserve Corps, similar to military reserve units, would also be created, made up of government employees and civilians who agree to serve in times of national need. The administration believes these changes will lead to more effective use of taxpayer dollars.

Created more than 200 years ago, the Corps has fought yellow fever, cholera, and plague, screened immigrants at Ellis Island, and, more recently, helped victims of hurricanes in Florida, Puerto Rico, and Texas and tended to the mental health needs of school shooting survivors. Health professionals in the Corps typically work alongside civilian counterparts but are often paid more and also receive military-type benefits.

Members of the Corps include physicians, nurses, public health professionals, dentists, and engineers. Corps nurses serve in positions at more than 20 government agencies, such as the Centers for Disease Control and Prevention, National Institutes of Health, Indian Health Service, and the Federal Bureau of Prisons.

"If the nearly 38% proposed reduction goes through, nurses most certainly will be cut. You can't cut 2,500 positions overall and not affect nurses," John McElligott, deputy executive director of the Commissioned Officers Association of the USPHS, told AJN. He noted that Congressional approval is not required to make the proposed cuts a reality. "That's scary," McElligott said, calling the proposal "misguided and premature."-Carol Potera