San Francisco Department of Public Health outlines $3.2 billion budget and a two‑year shortfall, seeks 15% reductions

The San Francisco Department of Public Health presented its first hearing on the fiscal year 2025‑26 and 2026‑27 budget at a San Francisco Health Commission meeting, outlining a $3.2 billion departmental spending plan and warning that expenditure growth will outpace revenue and create an $876 million shortfall over the first two years of the plan.

The presentation, led by Drew Morell, DPH chief financial officer, and Jenny Louie, DPH chief operating officer, described the size and composition of the department's budget and the mayor's budget instructions. "It's that shape of the curve and actually the distance in between those two that are more significant," Louie said, describing how expenditures are growing faster than revenues. Morell said DPH's annual operating budget is about $3.2 billion and that personnel costs — salaries and fringe — are a major driver of rising expenditures.

Why it matters: DPH provides core public health and hospital services across San Francisco. Department leaders said revenues remain available in some program areas but are insufficient to cover rising personnel and baseline costs, and the mayor's instructions ask departments to identify ongoing, permanent reductions equal to 15 percent of general fund support beginning in FY25‑26.

Key numbers and…