As the Chicago Department of Public Health prepares to trim its budget next year, some of Mayor Brandon Johnson's promises to help people become healthier are being scaled back.
There are currently no plans in 2025 to reopen more mental health clinics that have been closed for years. Instead, the city plans to continue providing services to where people are located or rely on connections with other organizations. For example, nurses visiting families with newborns may also screen for everything from depression and trauma exposure to domestic violence and access to weapons in the home.
“The necessary capital investment for more sites, we don't have it in 2025,” Chicago Public Health Commissioner Dr. Simbo Ige said in an interview with WBEZ. “But we want to deliver on our promise to expand mental health services by leveraging other assets to bring services closer to people.”
The city also plans to retool what was an aggressive plan to have so-called CARE teams of behavioral health professionals and EMTs respond to 911 mental health calls without police. The Department of Public Health has hired 17 EMTs instead of up to 55 EMTs — a reduction resulting from staffing challenges and the reality of grant dollars that will soon expire. Instead of teams being assigned to a region, they will work in multiple locations, and Ige expects teams to be working across the city by January.
Moving forward, Ige said she hopes the city can keep part of the program, but that will depend on how much help the county and state can provide. The program also faced opposition; The firefighters union argued that removing the paramedics was a violation of their contract.
There is some additional help on the way. Johnson is proposing $1.5 million to establish a 14-person dispatch unit to take mental health-related 911 calls within the Office of Emergency Management and Communications.
Ige has been on a difficult mission for about a year. Johnson fired her predecessor, Dr. Allison Arwady, who led the city through the COVID-19 pandemic for then-Mayor Lori Lightfoot. In 2019, researchers found that Chicago had the largest gap in life expectancy among neighborhoods in America — about 30 years. But the city's Department of Public Health, the main city agency charged with reducing health equity to help Chicagoans live longer, healthier lives, is largely funded by grants. This makes programs vulnerable to cuts when money runs out.
Another financial threat looms: the potential loss of more money under a Donald Trump administration. Vaccine skeptic Robert Kennedy Jr. is one of Trump's senior advisers. The federal Centers for Disease Control and Prevention, which provides much of CDPH's funding, is under threat of budget cuts, Ige said.
“If the CDC doesn't get the funding, we won't get the funding,” Ige said.
In 2025, Johnson's proposed budget for CDPH is about $700 million. The bulk of the money is $608 million in grants that include pandemic relief dollars. Governments across the country are bracing for the money to disappear, as their Covid-19 funds must be spent by the end of 2026.
During a budget hearing Thursday, Ige revealed a giant financial cliff looming for CDPH: More than $500 million in one-time grants are set to expire in 2026.
Overall, CDPH's total estimated budget will be 22% lower in 2025 than this year. But it would still be much more than in 2019, the year before COVID-19 struck, when CDPH's total budget was about $177 million, according to that year's appropriations act.
During the hearing, aldermen peppered Ige with concerns about HIV funding, how to protect Chicagoans from extreme heat, air quality monitoring, and persistent vacancies, particularly in mental health roles, among other issues.
I give birth. Daniel La Spata, of Ward 1, noted that about 40 of CDPH's 280 vacancies appear to be the same as they were last year.
Ige detailed a common struggle in public health systems: not paying enough. She told the Alders newspaper that about 100 people had turned down job offers this year in favor of better offers. A psychiatrist working in the city will make about $90,000, but can earn four times that in private practice, Ige said. The city is now hiring psychiatric nurses instead of doctors, for example, to run mental health clinics.
“If the solution really is that we need to offer more competitive salaries, then I think the board needs to hear that, because there's no point in listing a position if it's just for show, as if there's not a world in which we would be able to.” “To fill it with the salary we offer,” La Spata said.
Meanwhile, CDPH proposes eliminating 124 vacancies next year.
Before the hearing, more than 80 organizations sent a letter requesting that $25 million be added to CDPH's budget so that the department would not rely so heavily on grants.
“Chicago suffers from staggering health disparities, with an 11-year gap in life expectancy between black and white Chicagoans,” the organizations wrote in a letter to Johnson and City Council members, among others. “Along with racial and class health disparities in almost every disease, the reality of massive health disparities means untold suffering and thousands of premature deaths annually. This is unacceptable and requires a stronger response.”
The organizations, including the AIDS Foundation of Chicago and the Health and Medicine Policy Research Group, argue that the California Department of Public Health had long been underfunded and did not have the capacity to “fully respond” when the pandemic hit in 2020. The organizations wrote that this would be Latest public health emergency.
They called for faster hiring as well. “The city needs to cut the red tape and fix this. Lives depend on it,” the groups wrote.
Creola Hampton, board chair of the Black Leadership Advocacy Coalition for Health Care Equity, also urged the department to allocate $3 million annually to Black-led organizations, noting that the Black population makes up the majority of people living with HIV.
“Racism is a public health issue,” Hampton said Thursday. “Equality in funding is the mandate.”
Ige said she understands the call for more money. She told WBEZ that people don't always value prevention until something bad happens. She said she's concerned about politics becoming more intertwined with public health and science with Trump in office. These sentiments gained momentum during his first term, when the pandemic struck and Trump downplayed the severity of the virus.
Right now, Eiji is planning how to take care of the city as its chief doctor.
CDPH's goals for next year include addressing the main reasons behind the racial life expectancy gap in Englewood, Garfield Park and North Lawndale, rather than addressing the issue across the entire city. Public health data shows that people living in these three neighborhoods have the shortest life expectancy in Chicago.
These premature deaths are largely due to heart disease, homicides and opioid overdoses, Ige said. The city plans to help residents by using programs they already have in place, such as the Newborn Home Visiting Program, to screen people and connect them with community organizations.
Aldermen hold budget hearings over a period of weeks and must approve a final budget by Dec. 31.
Kristin Schorsch covers public health and Cook County for WBEZ. Tessa Weinberg and Maria Wilfel cover city government for WBEZ.
