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DPH Budget Hearing Highlights COVID Costs, Behavioral-Health Bed Gaps and Staffing Constraints
Summary
The BLA report and DPH briefing showed a decade of growth in DPH spending, roughly $96.5 million in COVID-related DPH costs to date, and recommended reallocation of one-time funds plus $10.65 million annually to add 117 behavioral-health beds; DPH said some beds were delayed or repurposed and COVID response and hiring freeze complicate rapid implementation.
The committee—s July 15 hearing on the Department of Public Health budget focused on long-term spending growth, COVID-19 expenses and behavioral-health capacity.
Dan Goncher of the Budget Analyst—s Office summarized the pre-budget report, noting DPH—s total budget rose roughly 66% over the past decade and that approximately $752 million (31% of the department—s $2.47 billion budget) comes from General Fund support. The BLA reported DPH had spent about $96.5 million on COVID-related activities and had encumbered another $76.7 million as of early July; FEMA is expected to reimburse 75% of eligible direct-response costs, and Cal OES has historically matched some FEMA funds but has not yet activated a match program.
The BLA presented a Mental Health San Francisco patient-flow analysis recommending an increase of 117 beds (emphasizing locked subacute and residential placements) at an estimated ongoing cost of $10,649,788 annually. The BLA also noted earlier-funded bed projects totaling 212 beds: 47% opened, 37% not yet opened (delays related to site selection and COVID), and 16% eliminated or repurposed.
DPH Director Grant Colfax said the department is operating under intense COVID response demands that have redirected staff and funding and that the city—s revenue mix (roughly two-thirds of DPH costs are supported by revenue, with Medi-Cal/Medicare accounting for roughly $1 billion) constrains flexibility. On staffing, DPH reported progress in reducing psychiatrist vacancies (citywide vacancies improved from about 23% to 5% after a new classification/pay scale) but acknowledged hiring freeze directives and redeployment to COVID response that complicate rapid expansion.
Supervisors pressed DPH on the status of beds intended for transitional-age youth, delays due to site selection and financing issues, and whether one-time funds could be reallocated to pursue the BLA—s recommendations. DPH said some allocated funds were repurposed for the COVID response but that it remains a priority to find funding and sites where feasible.
After an extended public comment period, with many callers urging the committee to cancel the MOU with the Sheriff—s Department and remove armed deputies from DPH facilities, the committee voted to file the hearing.
