DPH outlines $2.8 billion two-year budget, priorities include behavioral health and CalAIM

Jenny Louie, DPH chief financial officer, presented the department's proposed two-year budget for FY22–23 and FY23–24 and said DPH's total budget is about $2.8 billion. Louie said roughly one-third of DPH funding is general fund support and that the 22–23 base includes nearly $1 billion in general-fund subsidy.

Louie summarized the department's expenditure mix—personnel as the largest share, followed by non-personnel contracted services including community-based organizations—and noted the citywide five-year projection prepared by the mayor and controller showed a near-term surplus but longer-term risks. Departments were instructed to avoid new general-fund requests, reprioritize resources and focus on recovery priorities such as vibrancy, accountability and equity.

Louie described four departmental focus areas for the budget: bringing COVID task-force functions into regular operations, expanding behavioral-health services and supports for people experiencing homelessness (including continued implementation of Mental Health SF), strengthening core operating functions (human resources, contracts, data and facilities) to reduce administrative bottlenecks, and preparing for implementation of CalAIM (Enhanced Care Management, Community Supports, PATH incentive funding and behavioral-health quality improvement). She noted that CalAIM details—rates, eligibility and allocations—remain incomplete and that DPH will monitor state guidance and available funding closely.

Greg Wagner, DPH chief operating officer, told commissioners that human resources and contracting have become implementation bottlenecks after years of program expansion and COVID response; he said DPH is proposing to "right size" administrative capacity to speed hiring and contract execution and cited pending projects including a behavioral-health EHR replacement and IT investments to support service rollout.

Commissioners asked for implementation timelines, clearer use cases and assumptions about CalAIM funding and enrollment. Louie said FEMA reimbursements for COVID response were set to expire in April and that long-term funding remained uncertain; she committed to return with more detailed balancing items and projections at the next commission meeting.

No formal vote on the budget took place at this meeting; DPH said it will present a balancing plan and proposed submission for Health Commission approval at a future meeting.