CHICAGO — The Chicago Department of Public Health’s budget could shrink by more than $100 million next year due to a loss in COVID-related grants.
Mayor Brandon Johnson’s recommended budget allocates $76.8 million from the city’s general operating fund to the public health department for 2024. That’s about $6.5 million more than this year. Money for the operating fund comes primarily from local and state taxes and fees.
But even with that increased funding, the health department’s overall budget will drop nearly 10 percent. About 87 percent of the department’s $888 million budget for 2024 comes from grants.
The City Council’s budget committee will hold a hearing on the health department’s budget Thursday.
Andrew Buchanan, spokesperson for the Department of Public Health, said in a statement the decline in grant funding comes from temporary COVID-19 funding. Spending on many of these grants will continue through 2026, he said.
To address this decline in grant funding, the Office of Budget Management will assess existing health department programs through early 2024 to create service efficiencies and prioritize programs that have a demonstrated impact, Buchanan said.
“Certain losses in temporary COVID funding have already been mitigated by increased investment in [the public health department’s] corporate budget, and it is important to note that the [department’s] budget does not include staff cuts and no programs have been halted,” Buchanan said.
Former health Commissioner Allison Arwady warned at last year’s hearing a big chunk of federal pandemic emergency dollars would expire over 2023-2024, creating a long-term funding dilemma.
The hearing was covered by Crain’s Chicago Business, which also interviewed Arwady earlier that year about the impending loss in funding.
The flow of hundreds of millions of dollars in federal grants allowed the public health department to grow its staff by about 50 percent and develop infrastructure to support public health initiatives, Arwady told Crain’s. Without funding, those resources could be at risk.
Arwady declined an interview with Block Club. Acting Health Commissioner Fikirte Wagaw did not respond to Block Club’s requests for comment.
Some public health policy advocates and organizers have said the city needs to invest more of its tax revenues into the health department so it’s less reliant on grants. Advocates say Chicago’s public health department is still underfunded compared to those in other large cities.
In Johnson’s proposed budget, 8.6 percent of the department’s funding comes from the city’s operating fund, also known as the corporate fund. That’s up from 7.1 percent last year.
“Overall, the local dollars are rather meager compared to the grant funding and also compared to similar health departments around the country,” said Wesley Epplin, policy director at the Health & Medicine Policy Research Group. “It’s great that we have state and federal grant dollars to go into public health, but it’s not enough.”
Even before the pandemic, the public health department’s budget was mostly made up of grants. Just 20 percent of the department’s budget came from city spending in 2019.
“The challenge with that is that grant funding from the state and [feds] tend to be categorical, meaning they must be spent on certain activities associated with those grants,” Epplin said. “That’s great for those particular health issues, but it leaves out the idea of flexible funding so the department can be nimble and responsive to things happening right now on the ground.”
Funding for public health has dwindled over the past few decades, which also greatly affects staffing. Former assistant health Commissioner Howard Ehrman has said the department had 2,000 employees in 1989; that has dropped to about 600.
What results is a system where money is only pumped into public health departments after a health emergency arises, Epplin said.
“So you end up with emergency funding to support them, but that’s temporary, in that moment and it fades over a time,” Epplin said. “The key lesson from COVID is we need staffing to be there all the time so we can respond in the moment to a public health crisis, while at the same time having the capacity to address the long-standing emergency of public health inequities.”
Support Local News!
Subscribe to Block Club Chicago, an independent, 501(c)(3), journalist-run newsroom. Every dime we make funds reporting from Chicago’s neighborhoods. Already subscribe? Click here to gift a subscription, or you can support Block Club with a tax-deductible donation.
Listen to the Block Club Chicago podcast:
