Diversifying Doulas?! HHS Spends Hundreds of Millions Spreading DEI Through Medical Community

The private sector is learning the hard — and costly — way that much of the Diversity, Equity and Inclusion model is discriminatory and subject to expensive litigation. That has corporations “quietly altering” their approach, according to the Associated Press.

While federal agencies have also faced a mountain of legal challenges, the Biden administration has nevertheless pressed on with the President’s commitment to a “whole of government” DEI effort.

The Department of Health and Human Services — with a budget surpassed only by the Pentagon — employs 294 DEI staffers at an annual cost of $38.7 MILLION.

That’s doesn’t even include another $29.4 million in payroll for seven Offices of Minority Health embedded within various HHS agencies!

While their roles are dedicated to DEI, related efforts have permeated through virtually every area of the department.

Variations of the term “equity” appear an astonishing 829 times in the department’s 2025 budget request to Congress, impacting hundreds of millions of dollars of spending programs.

Resulting funds pour out across the country to achieve equity and “justice” in public health — to Black churches recruited to push vaccinations; to universities for hiring diverse researchers; and to special outreach for anyone from criminals, to the LGBTQ+ community, to the indigenous, and…doulas??

BACKGROUND

President Joe Biden signed Executive Order 14035 in June 2021, calling on every federal agency to make “Diversity, Equity and Inclusion” a “priority” when recruiting and promoting staff.

In response, the Department of Health and Human Services promised to dedicate 313 employees to DEI in 2023 — spread across not one, not two, but eight separate DEI offices.

For the first time OpenTheBooks has quantified the total DEI payroll at HHS, revealing the staggering $38.7 million expense. This figure captures 294 employees — very near to fulfilling the department’s promise to President Biden!

THE DEI HEIRARCHY

We identified 92 DEI employees working directly under HHS Secretary Xavier Becerra, most of them at the Office of Equal Employment Opportunity, Diversity & Inclusion.

Seven subagencies, like the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH), have separate diversity offices with their own complex infrastructure of 202 employees, for a grand total of 294.

Most of these workers — 247 of them — made over $100,000 in base salary for FY 2023. Four of them made more than $200,000. Benefits typically represent an additional 30% of base salaries.

The Food and Drug Administration alone has three separate related DEI entities: an Office of EEO and Diversity Management, a DEI Working Group and a DEI Center of Excellence.

The FDA also has the department’s highest paid DEI staffer: EEO/Diversity Director Lakeisha McClendon made $221,000 in 2023.

Over at the NIH, the Office of Equity, Diversity and Inclusion is organized like a full corporation. It has separate departments for Guidance, Education & Marketing, Data Analytics & Customer Outreach…and an inexplicably redundant “Diversity & Inclusion Division.”

NOTE: The above costs may still be undercounting: HHS lists 52 diversity employees in its staff directory whose salaries are not listed in our open records request for the agency’s 2023 payroll. The department did not answer whether they were new hires, had left the department, or were omitted from their records production.

EEO vs DEI: A MERGER OF ACRONYMS?

Normally, DEI offices are separate from Equal Employment Opportunity offices. The latter enforces a 1972 federal law designed to ensure fair and equal treatment in the workplace. DEI, on the other hand, is ostensibly designed to create inclusive environments that take various perspectives into account, but in practice promotes oppressors-versus-oppressed narratives and monomaniacally fixates on supposed “privileges” (or lack thereof) conferred by sexual, racial and gender “identities.” DEI posits that people should not be treated equally, but rather treated more favorably based on their identification with groups deemed to be “oppressed.”

HHS somehow combines these two conflicting premises into one office.

The Centers for Medicare & Medicaid Services is the only health agency whose EEO office does not also have the word “diversity” in its title, but its director Anita Pinder serves as its “chief diversity officer.”

Now, even staff with innocuous job titles like “EEO Consultant” are working under the federal government’s DEI banner.

For example, HHS’ Office of Civil Rights describes itself as a department to “enforce federal civil rights laws, conscience and religious freedom laws.” But its 2025 budget request includes $4.8 million to “assess the impact of HHS’s policies and its regulatory role in health equity barriers for underserved populations.” It’s not clear how health equity is covered under the enforcement of civil rights law.

More efforts around health equity are encompassed in a second set of staffers, within the Offices of Minority Health.

MINORITY HEALTH & ADDRESSING INJUSTICES

Yet another set of staffers populate various Offices of Minority Health. Their mission is to “improve the health of racial and ethnic minority populations through the development of health policies and programs that will help eliminate health disparities.”

OpenTheBooks identified 207 employees making $29.4 million. Again, the vast majority of them — 182 — make six-figure salaries.

These programs have existed since 1985, but the Biden administration has now encouraged them to champion health equity: “the state in which everyone has a fair and just opportunity to attain their highest level of health” by “addressing historical and contemporary injustices.”

Eliseo Pérez-Stable, director of the NIH’s Institute on Minority Health and Health Disparities, was the highest-paid by far with a $385,000 salary last year.

EXAMPLE: MINORITY HEALTH AT THE CDC

The CDC represents a textbook case of how Minority Health ethos has transformed over the last few years. The CDC’s Office of Minority Health was founded in 1988. But in 2021, the office gained a new purpose: pushing all medical researchers to incorporate “diversity, equity, inclusion, accessibility, and belonging” into their scientific work.

The office “declared racism a serious public health threat” and within two years had renamed itself to the Office of Health Equity.

One recent CDC program pushed for “vaccine equity” in Atlanta, Georgia by distributing 5,500 monkeypox vaccine doses to Black “LGBTQ+ men who have sex with men” to help “celebrate diversity and the impact of distinctly Black gay and queer culture on the community.”

The CDC has even deployed to Black churches in the name of “vaccine equity.” The agency “trained” 4,300 faith leaders as “vaccine advocates and influencers” who could convince their congregations to get vaccinated — and give out “incentives” for doing so. The program included 1200 church vaccination sites and distributed 650,000 doses while issuing public service announcements aimed at reducing “vaccine hesitancy” and “debunking myths.”

Records of both vaccine equity programs have been removed from the CDC’s website.

EQUITY PAYDIRT: DEI SPENDING PERMEATES THROUGHOUT HHS

When it comes to DEI and health equity spending, payroll expenses are a drop in the bucket. Promoting these topics can be lucrative for federal employees looking to expand their agency’s budget, and for private scientists hoping to win grants.

The word “equity,” or variations thereof, appears in the HHS 2025 Budget Request 829 times. Putting a dollar total on all of it is impossible; it can be difficult to find a funding initiative that doesn’t incorporate equity in some manner.

Here’s a sampling of some of the spending:

• $608 million for agency-wide General Departmental Management, which lists its top three priorities as: “racial equity, environmental justice, climate change.”
• $5 million for the agency-wide “Office of Climate Change and Health Equity” and “Office of Environmental Justice”
• $98.6 million for the Medicaid Integrity Program, which helps fund an “Equity Dashboard.”
• $5 million for the Health Resources and Services Administration (HRSA) to “diversify the doula workforce” and $24.3 million for “Nursing Workforce Diversity.”

DEI SPENDING AT THE HEALTH RESOURCES & SERVICES ADMINISTRATION

Using HRSA as an example, a closer look reveals more routine spending also incorporates equity concerns.

The agency launched its Rural Communities Opioid Response initiative in 2019 to send grants to those fighting the opioid crisis. But since 2021, grant applicants have been required to submit “Disparate Impact Statements” explaining how they will consider “systemic racism” when combating the opioid epidemic.

The next $145 million HHS is requesting for the opioid program comes with this new caveat: grant recipients are “encouraged” to prioritize “populations that have historically suffered from … other inequities,” such as LGBTQ+ individuals.

A recent press release boasts that the program will now support “key populations” like “individuals with justice involvement”; i.e. criminals.

MORE EQUITY: In the HHS budget request, every program proposal within the Indian Health Service includes an “Equity Impact Assessment.”

HRSA also received almost $102 million this year for “Training for Diversity.” It includes $28.4 million for Centers of Excellence that “goes towards recruitment, training, and retaining underrepresented minority students and faculty at health professions schools” and is used to “enhance the academic performance” of minorities.

DEI SPENDING AT THE NIH

“In medical research, lives depend on putting excellence first. The NIH distorts that value, subordinating it to political ideology and endangering those it’s supposed to serve.” – National Association of Scholars fellow John Sailer, Wall Street Journal.

The NIH Common Fund plans to spend $241 million over nine years on its Faculty Institutional Recruitment for Sustainable Transformation (FIRST). Similar to HRSA’s “Training for Diversity” program, FIRST awards grants to top universities to hire scientists from minority backgrounds.

FIRST grants are awarded to institutions considering a scientist’s “commitment to diversity” as equally important to their academic ability. Candidates are penalized for wanting to treat everyone the same regardless of their background, according to documents obtained by the Wall Street Journal.

THE PROGRAM STRATEGY is outlined in detail here.

In January 2024, NIH announced its third round of awardee institutions that have promised to “build self-reinforcing communities of scientists committed to diversity and inclusive excellence” and “aim to foster sustainable institutional culture change and positively impact faculty development, retention, progression, and eventual promotion.”

Winners included the U. of Texas at El Paso (seeking to hire a cohort focused on Hispanic health disparities) and Vanderbilt University Medical Center (seeking to diversify its research faculty in subjects like immunology, neuroscience, and “genomics and health disparity”).

The focus on commitment to diversity on par with scientific rigor has sparked controversy from critics like National Association of Scholars fellow John Sailer.

Even flagship NIH programs — “All of Us” and “Brain Research Through Advancing Innovative Neurotechnologies” — have committed to an “emphasis on diversity and inclusion in the research community” while requesting $1.2 billion from Congress for 2025.

And over at the NIH’s specialized subagency for minority health, Congress was feeling extra generous.

The National Institute on Minority Health and Health Disparities (NIMHD) was allocated $534.4 million this year, $10 million more than they actually requested.

The NIMHD funds programs like “Brother, You’re on My Mind: Changing the National Dialogue Regarding Mental Health Among African American Men,” and the “Envisioning Health Equity Art Challenge.” The third place finalist in the art challenge submitted a depiction of a “healthcare access pass” that covers the “cost” of healthcare for everyone. The runner up submitted an oil painting in which Lady Justice holds scales filled with people of various identity groups. In her other hand she’s grasping the Caduceus symbol, all against a backdrop of the Pride flag.

Reprinted with permission from Open The Books.

The opinions expressed by columnists are their own and do not necessarily represent the views of AMAC or AMAC Action.