The City Council is seeking hundreds of millions of dollars more for health services in the next city budget under the shadow of sweeping federal cuts to the Department of Health and Mental Hygiene.
The Council released its response to Mayor Eric Adams’ $114.5 billion preliminary budget proposal on Wednesday, calling for $378.9 million in additional health and public safety spending plus $1.1 billion in capital funding for related initiatives. Speaker Adrienne Adams, who is running for mayor in the Democratic primary this year, says the city can afford the increase and still have money – close to $2 billion – leftover as a buffer against looming federal cuts due to additional revenues not accounted for in the mayor’s proposal.
The additional funding focuses on a myriad of services impacting mental health, public hospital funding, gender affirming care, maternal health, EMS pay, justice-involved supportive housing and other programs, some of which has been reduced under the mayor’s plan and other parts the Council is hoping to expand for the first time.
The Council’s $116.9 billion response will serve as the basis for negotiations ahead of the July 1 start of the city fiscal year. It comes as the city grapples with the loss of $100 million in federal funding for infectious disease control as part of the Trump administration’s $12 billion cut to pandemic-era funding nationwide. Those reductions, which were handed down last week, include another $360 million to state health agencies, the damage of which is still being assessed, officials say.
The additional spending the Council is pushing for is backed by $6.3 billion in found revenue, mostly from the city’s tax base, that the body says was left out of the mayor’s proposal. In total, the Council’s plan adds $2.2 billion to account for what it calls under-budgeting for existing services and another $2.2 billion in new spending. That leaves an unearmarked $1.9 billion surplus, which the Council says should be used to backfill future federal cuts and policy changes.
Here are some of the biggest items:
Mental Health
A large portion of the increased funding would go to a slate of mental health programs for individuals with varying needs and levels of acuity. That includes $6 million for crisis respite centers, $6.3 million for residential treatment beds and $37 million for so-called step-down programs, which are used to transition homeless people with the most severe cases of untreated mental illness from intensive mobile services to more stable housing-based care.
The Council also proposed $4.5 million to hire 60 peer specialists, trained service providers who have experienced homelessness and mental health crises. Another $3 million would support smaller clubhouses – programs that offer services in a social club environment – that were initially cut out of city contracts when the administration changed procurement criteria to favor fewer larger nonprofits.
The Council also urged the administration to hire more police officers to cut down on the NYPD’s ballooning overtime spending. Some of the $1.2 billion in overtime the city is on track to spend this fiscal year pays for the surge of police in the transit system, which the mayor has deployed to address public safety and untreated mental illness among homeless New Yorkers.
The city’s 988 mental health and substance use hotline is set to see a $12.1 million reduction in fiscal year 2026. The Council wants to see that partially restored with a $10 million allocation for staffing to reduce wait times.
Public hospital funding
The plan includes tens of millions for improvements at public hospitals throughout the city. The largest sum in that category is a $65 million push for a new emergency department at Metropolitan Hospital in East Harlem, which currently has the capacity for 25 emergency patients despite regularly seeing double the number of cases, according to the plan. Another $5.3 million would cover new CT scanners at Bellevue Hospital in Kips Bay, which is expected to absorb the bulk of traffic from the shuttering Beth Israel Medical Center when Mount Sinai closes its doors. The Council is also seeking more capital funding for a new outpatient building at Lincoln Hospital in the South Bronx.
Gender-affirming care
The Council is urging the city to allocate an additional $15 million to nonprofits providing gender-affirming care after the Trump administration has set its sights squarely on services for transgender individuals. The funding would help fill a gap in care after several private hospitals scaled back those services following Trump’s executive order that would pull federal funding from institutions providing them.
Maternal health
The plan includes a baseline for maternal health programs that is $15.7 million above what the mayor included in the preliminary budget. The increase would restore $13.3 million that was removed under previous cuts from the Adams administration and add $2.4 million for outreach and education. The Council also wants another $5 million to add psychologists in each of the public hospital system’s maternity wards.
