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DPH outlines mayor's budget instructions, warns of $936M two-year city deficit and $17M CBO cuts

San Francisco Health Commission · January 5, 2026
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Summary

Deputy finance staff and DPH budget leads told the commission the city's five-year outlook shows a roughly $936 million two-year deficit and instructed departments to identify ongoing general-fund reductions; DPH plans $50 million in division-level savings and a $17 million CBO reduction to phase in for FY 26-27.

Deputy Finance Officer Emily Gibbs and DPH budget staff on Jan. 5 presented the mayor's budget instructions and the department's planning approach as the city faces a multi-year fiscal challenge.

Gibbs summarized the mayor's guidance and the five-year financial projection, saying the city's fiscal outlook is "challenging." Slides from the mayor's office show a projected $936,000,000 two‑year deficit, with roughly $262,700,000 in the first year of the projection (FY 26‑27). The chief remedy called for by the mayor's office is $400,000,000 in ongoing general‑fund savings across the city through service restructures and targeted program eliminations.

DPH-level targets and process

Drew (DPH budget…

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