Baltimore City Health Department warns federal funding cuts could force program prioritization in FY26 budget

Interim Commissioner Marybeth Haller of the Baltimore City Health Department told the Budget Appropriations Committee that the department’s FY26 budget is heavily dependent on external grants and that anticipated federal changes could force program reductions.

"BCHD is about 72% reliant on grants and 49% of our funding comes from the federal government," Commissioner Haller said, adding that grant requirements restrict the agency’s ability to shift funds between programs.

The department outlined agency goals including improving equitable access to care, strengthening grant management and compliance, improving recruitment and retention, expanding equity work, and implementing a language‑access plan. Haller emphasized the limits of flexibility when grant funding is lost: "Loss of funding in 1 area does not mean that we can use another grant to fill that gap." She warned the council that budgets "may need to be revisited as events unfold."

Deputy Commissioner Jennifer Martin told the committee that the department and the mayor’s office developed a five‑year infrastructure plan tied to newly allocated restitution funding; some positions funded through that plan will be placed on the general fund where possible to preserve capacity. Kelly Eastman, BCHD chief of staff, said several ARPA‑funded staff were being transitioned where feasible: three employees are moving to the general fund in FY26 and four to five remain on ARPA through FY26, with the department seeking other vacancies or funding to retain staff.

Haller described administrative improvements — for example, contracting processing time decreased by 32 days — and highlighted program results such as declines in infant mortality in several neighborhoods and reduced tobacco use during pregnancy. She also noted recent operational steps including an electronic medical record rollout and efforts to expand billing capacity in clinical services, while acknowledging implementation challenges.

The department asked the council to consider the distinction between activities that are statutory or core public health functions and those that are discretionary, noting staff and service retention should prioritize work that directly improves equity and health outcomes.

Committee members requested follow‑up detail on positions moved from grants to the general fund, and on contingency plans and specific program impacts if federal funding is reduced. Haller and senior staff said they would return the requested breakdowns and noted that contingency planning will include exploring philanthropy, other grants, and partnerships but that every option will be constrained by grant rules.

The committee did not take formal votes during the presentation; members requested supplemental budget details and a list of grant‑to‑general fund moves to inform later deliberations.