Unlawful Health and Human Services grant conditions threaten millions in critical funding used to support early childhood development, disease prevention, and mental health services
SAN FRANCISCO (July 11, 2025) — San Francisco City Attorney David Chiu announced today that his office filed an amended complaint that challenges illegal conditions on grants administered by the U.S. Department of Health and Human Services (HHS), in addition to the U.S. Departments of Housing and Urban Development (HUD) and Transportation (DOT). The lawsuit challenges the Trump Administration’s attempt to impose extreme political conditions on federal grants to force local governments to adopt its political agenda or risk losing critical funding.
On June 3, 2025, U.S. District Court Judge Barbara J. Rothstein granted a Preliminary Injunction Order preventing the Trump Administration from imposing illegal conditions on federal grants from HUD and DOT. The Plaintiffs are now seeking a preliminary injunction for the newly added HHS conditions. The amended complaint, filed on July 10, 2025, also includes 52 additional plaintiffs, bringing the total number to 60 local governments and agencies.
“These grants provide billions in funding that help our city support early childhood development, health services, safe and effective transportation, and housing to our most vulnerable,” said City Attorney David Chiu. “These new grant conditions not only violate the Constitution, but they also have nothing to do with the purpose or performance of these grants. This is part of Trump’s strategy to push his extreme political agenda by threatening local programs and budgets.”
“As states and counties grapple with significant cuts to Medicaid and food assistance for vulnerable residents, the federal administration’s efforts to condition Health and Human Services grant funding add insult to injury,” said Kavita Narayan, Chief Assistant County Counsel for the County of Santa Clara. “These grants support critical County programs that prevent infectious disease, support maternal and child health, provide social services to children and families, and deliver life-saving care at our safety-net hospitals and clinics. With at least $275 million at stake for these programs, we will continue to stand up for our community in court and challenge the administration’s unlawful actions to withhold critical funding at a time when public health and safety is already under threat.”
Background
HHS, HUD, and DOT issued grant agreements this year that included new conditions that are not authorized by Congress, but instead unlawfully impose President Trump’s anti-immigrant, anti-LGBTQ+, anti-choice, and anti-equity policy preferences.
San Francisco relies on approximately $325 million in active non-Medicaid and Medicare HHS grant funding, including approximately $148 million from the Administration for Children and Families, $90 million from Centers for Disease Control and Prevention, $48 million from Health Resources and Services Administration, and $19 million from Substance Abuse and Mental Health Services Administration. This funding provides financial assistance and supportive services for low-income families, foster families, and other vulnerable residents, such as refugees and asylees, those experiencing homelessness, and those suffering from mental illness or substance abuse disorders. In addition, HHS funding supports vital work to monitor, intervene, and respond to public health concerns, such as the transmission of HIV, other sexually transmitted infections, and tuberculosis.
HUD provides San Francisco approximately $240 million in HUD grant funds to expand affordable housing opportunities, provide services to maintain housing stability and reduce displacement for low- and moderate-income residents, and provide housing and emergency shelter services to homeless residents. This funding includes approximately $50 million in Continuum of Care funds to address homelessness.
The conditions have also appeared in general terms and conditions and grant agreements from departments overseen by the DOT, including the Federal Transit Administration (FTA), Federal Highway Administration (FHWA), and Federal Aviation Administration (FAA). A significant portion of federal funds committed to San Francisco come from the DOT.
The lawsuit alleges these grant conditions violate the Spending Clause, Separation of Powers, and Fifth Amendment of the Constitution as well as the Administrative Procedure Act.
The original plaintiffs are:
- King County, WA
- Pierce County, WA
- Snohomish County, WA
- San Francisco County, CA
- Santa Clara County, CA
- Boston, MA
- Columbus, OH
- New York City, NY
An additional 52 local governments and agencies have joined through amended complaints. These plaintiffs include:
- Denver, CO
- Nashville-Davidson County, TN
- Pima County, AZ
- Sonoma County, CA
- Bend, OR
- Cambridge, MA
- Chicago, IL
- Culver City, CA
- Minneapolis, MN
- Pasadena, CA
- Pittsburgh, PA
- Portland, OR
- San Jose, CA
- Santa Monica, CA
- Tucson, AZ
- Wilsonville, OR
- Central Puget Sound Regional Transit Authority, WA
- Intercity Transit, WA
- San Francisco County Transportation Authority, CA
- Treasure Island Mobility Management Agency, CA
- Port of Seattle, WA
- King County Regional Homelessness Authority, WA
- Santa Monica Housing Authority, CA
- Alameda County, CA
- Albuquerque, NM
- Baltimore, MD
- Bellevue, WA
- Bellingham, WA
- Bremerton, WA
- Dane County, WI
- Eugene, OR
- Healdsburg, CA
- Hennepin County, MN
- Kitsap County, WA
- Los Angeles, CA
- Milwaukee, WI
- Milwaukee County, WI
- Multnomah County, OR
- Oakland, CA
- Pacifica, CA
- Petaluma, CA
- Ramsey County, MN
- Rochester, NY
- Rohnert Park, CA
- San Diego, CA
- San Mateo County, CA
- Santa Rosa, CA
- Watsonville, CA
- Culver City Housing Authority, CA
- Puget Sound Regional Council, WA
- Sonoma County Transportation Authority, CA
The coalition is represented by Public Rights Project (PRP), and Pacifica Law Group, who are serving as co-counsel in the case. Together, they’re supporting local governments across the country as they push back against federal abuse of power and defend their right to make decisions in the best interest of their communities.
The case is Martin Luther King, Jr. County, et al., v. Scott Turner, et al., U.S. District Court for the Western District of Washington, Case No. 2:25-cv-00814-BJR. The amended complaint can be found here.
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