San Francisco Department of Public Health lays out budget increases, warns of staffing crunch

The San Francisco Department of Public Health told the Budget and Appropriations Committee on June 16 that it is proposing a two‑year budget that sustains pandemic response services while increasing funding for behavioral health and staffing.

DPH Director Grant Colfax opened the department presentation saying, “It’s wonderful to be back in these chambers,” and framed the budget around continuing COVID‑19 response, expanding behavioral‑health services and stabilizing an overstretched workforce. The department reported 7,815 authorized FTE across clinical, behavioral health and population health functions and said its proposed two‑year budget shows a modest overall increase with concentrated investments in pandemic response, workforce and contracts management.

CFO Jenny Louie walked the committee through the mayor’s specific COVID‑response allocations for the first year: approximately $57.3 million proposed for covered response overall with line items that included roughly $12.3 million for testing, $7.5 million for vaccinations and amounts for isolation/quarantine and hotel‑based shelter supports. Louie said FEMA reimbursement declines and federal support reductions are driving some of the step‑downs in response funding.

Supervisors pressed DPH staff on whether one‑time dollars and special revenue rules limit immediate re‑appropriation. Supervisor Gordon Mar and Controller Ben Rosenfield discussed the volatility of the Proposition C special revenue stream and why DPH is proposing a 10% reserve to guard against fluctuations in collections. Rosenfield told the committee the controller’s office recommended a reserve policy because the fund is concentrated among a small group of taxpayers and is therefore volatile.

The committee focused heavily on DPH’s hiring and retention plan. Luana Kim, DPH’s human resources director, said the department has hired hundreds of staff in recent months but still faces about 350 current vacancies countywide and significant turnover — roughly 900 departures annualized — that make filling net vacancies a large undertaking. Kim said DPH and its unions are working to convert temporary registry and P103 positions into permanent hires where possible.

The board took procedural action on two DPH trailing items — an ordinance setting patient rates and a resolution accepting recurring state grants — recommending both to the full Board on July 12 with a positive recommendation.

What happens next: The Office of the Mayor and department staff will continue to refine proposed reserves and staffing plans; the full Board will take up the patient‑rates and state‑grant items at its July 12 meeting.

Sources: Presentation and Q&A at the Budget & Appropriations Committee meeting, June 16, 2022; statements by Grant Colfax (DPH director) and Jenny Louie (DPH CFO).