Hawaii health officials are bracing for at least $6.2 million in federal cuts to state programs that cover everything from emergency preparedness and immunizations to water-quality testing, air-pollution control, children’s health and hazardous waste.

The state Department of Health has identified millions of federal dollars that President Donald Trump has proposed cutting in his budget that’s being considered by Congress.

“We know there will be cuts but we don’t know what they will be,” Health Director Virginia Pressler told state senators last week.

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The Health Department is hardly alone. Other department heads have expressed similar concerns over the past week as they face uncertainty over looming federal funding reductions.

The Legislature, which convenes Jan. 17, must either find the funding elsewhere or force departments to reprioritize.

Pressler provided a laundry list of services that could be reduced or eliminated if federal money dries up.

The entire federal subsidy for the polluted runoff control program in the department’s Clean Water Branch would be eliminated, for instance. That’s five positions and $1.2 million from the Environmental Protection Agency that goes toward protecting Hawaii’s drinking water sources, recreational waters and marine life from runoff polluted with sediment, bacteria or toxic chemicals.

“As resources diminish, we’re just going to have to be smarter about how we work together collaboratively in the community.” — Virginia Pressler, Department of Health director

A related monitoring initiative that relies on EPA money faces a similar fate. Pressler, in her testimony to lawmakers, said the potential for a 29 percent reduction in federal funding — almost $600,000 — could mean “no oversight of construction, industrial and wastewater treatment facilities.”

She said it could also mean “no enforcement response to sewer spills and no investigations into water pollution violations, no groundwater monitoring projects and no assistance to other groundwater related agencies.”

Officials are trying to find alternative sources of money, such as revolving fund loan fees, for some of the programs, but have given no guarantees.

Money for some services would be completely eliminated if the federal budget is approved as Trump has proposed.

The universal newborn hearing screening program, which helps determine intervention services for young children with hearing loss, would be eliminated with the loss of the nearly $700,000 grant from the Health Resources and Services Administration.

The loss of a $1.9 million immunization grant from the Centers for Disease Control would translate to dramatically reduced immunization services. School assessments, public education campaigns, data quality checks and other services would be cut. The department has no places to find another source of funding for those services, Pressler said.

“As resources diminish, we’re just going to have to be smarter about how we work together collaboratively in the community,” Pressler said.

The department’s proposed operating budget for fiscal 2019, which starts July 1, is $1.06 billion. State tax collections provide the bulk of the budget, but federal funds are expected to make up $154.7 million of the total. In fiscal 2018, which ends June 30, the budget called for $202.4 million in federal funding.

Here’s a breakdown of $6.2 million in programs that the Health Department has identified: