LA County health chiefs warn program cuts likely as state, federal funding shifts

Los Angeles — Department of Public Health Director Barbara Ferrer and Department of Mental Health Director Lisa Wong told the Los Angeles County Board of Supervisors on Feb. 13 that their departments face mounting budget and program risks as state and federal funding changes take effect.

Ferrer said the Public Health Department’s current annual budget is about $1.9 billion, with roughly 70% from state and federal grants, fees and local grants making up smaller shares and the county contributing about 13% ($255 million). She reported 5,500 positions in the department with 1,300 vacancies — about 800 of which are unfunded — and described a hiring freeze that limits filling nonessential roles.

Why it matters: Supervisors were briefed on specific program impacts and near-term requests. Ferrer said the department has already lost more than $50 million in grant funding and was told an additional $64 million would be terminated; she said the attorney general secured a temporary restraining order that pauses that termination for 14 days while the county pursues legal relief. Ferrer said the department will prioritize statutory obligations, preserve communicable disease work, and asked the board to consider county funding to sustain a small set of programs.

Key details: Ferrer identified three core budget priorities: communicable disease prevention, improving health outcomes for residents with the poorest outcomes, and public information/education. She said roughly half of the department’s budget pays staff and nearly $800 million goes to contracted community partners. The department requested under $5 million in county funding to sustain several targeted projects — examples she named were the doula hub and a worker health and safety office — and said these are critical to addressing Black infant mortality and worker health concerns.

At board prompting, Ferrer explained why seven low-volume public health clinics — including an Antelope Valley site — were selected for consolidation: low patient volume relative to staff, nearby full-service clinics that can assume services, and planned warm handoffs, transportation support and telehealth options for affected patients. She pledged to monitor outcomes and revisit decisions if consolidations negatively affect access.

Mental health outlook: Wong described the Department of Mental Health’s FY 2025–26 adopted budget at roughly $4.4 billion and outlined a FY 2026–27 request of about $206 million tied to implementation of the Behavioral Health Services Act (BHSA), effective July 1, 2026. Major DMH requests include $120 million for additional treatment beds and crisis stabilization, $35 million for housing interventions, $30 million for expanded day treatment services, and funding for positions to comply with new state monitoring and reporting.

Board concerns and federal policy risks: Supervisors repeatedly raised the effect of federal and state policy changes. On HR1 and Medicaid work requirements, Wong told the board that although a serious mental illness (SMI) exemption exists, verification processes remain unclear and could cause coverage lapses; she recommended a “claims-based” verification approach (using CMS claims) as the lowest barrier solution and asked the board for advocacy at state and federal levels.

A measles example: In response to questions, Ferrer said measles is one of the most expensive communicable disease cases to investigate and follow up, with aggregate follow-up costs the department estimated at about $200,000 for recent local cases because the virus is highly contagious, exposures multiply quickly and contact tracing and outreach are resource intensive.

What’s next: Both directors said they are working with the CEO’s office to refine mitigation strategies and will bring prioritized NCC (net county cost) requests forward as the budget process advances. The board asked department heads to return with additional details, including schedules for bed development and clinic transition plans.

Quotes: "We have already lost $50,000,000… and just yesterday we were told we were gonna lose another $64,000,000 immediately with a termination," Ferrer said, adding that a court action temporarily paused the termination. Wong said of BHSA: "We're requesting roughly $206,000,000 … which is aligned with the priorities I've just discussed."

The board did not take formal action at the Feb. 13 hearing; supervisors asked staff for follow-up reports and additional documentation to evaluate county-level mitigation and targeted investments.