Mayor Eric Adams lowered funding levels on several public health initiatives in his preliminary budget, leaving major holes to be filled over the next year.
When Adams unveiled his $114.5 billion preliminary budget on Thursday, it included $646 million less for the Department of Health and Mental Hygiene compared to the agency’s current spending plan, budget documents show. Officials say some of that funding will be added-in over the year as federal grants and City Council discretionary dollars are issued. But the practice of “underbudgeting” distorts the city’s financial position ahead of negotiations with the City Council that will take place over the next several months, according to fiscal watchdog group Citizens Budget Commission.
The health spending difference stems from approximately $258 million in current city funds, $363 million from the feds and $16 million from the state that were not included in the preliminary budget proposal. The administration attributes the apparent drop in federal funds to the city’s practice of rolling federal grants into budget modifications at the end of the fiscal year, said Amaris Cockfield, a spokeswoman for Adams. The same is true of City Council discretionary funds, which are included in the budget at the time of adoption, she said.
Much of the apparent federal funding decrease comes out of the city’s disease prevention and treatment work. In the preliminary budget, funding for communicable disease prevention dropped $138.8 million compared to current levels, the documents show. Spending on HIV, immunization, sexually transmitted diseases and the city’s public health laboratories also saw significantly lower levels in the mayor’s initial proposal.
Meanwhile, most recorded drops in city funding for the Health Department – which is controlled directly by the mayor and City Council – come from just three spending categories: early intervention, school health and mental health services. The largest shrinkage – $115 million – is for mental health services, which include many of the outreach programs Adams has touted to address the unmet mental health needs of homeless New Yorkers, according to budget documents. At the same time, the mayor has placed an additional $137 million in the preliminary budget for temporary shelter beds and housing services for homeless New Yorkers as part of a new mental health push.
Some of the gaps may be the result of a tendency by the Adams administration to underbudget for existing services – a practice that does not represent the city’s true fiscal outlook, according to Chris Hendrickson, director of city studies at Citizens Budget Commission. The group found the city budgeted close to $4 billion less than is needed to continue funding current programs. In the case of school health and early intervention, which includes services for children with developmental disabilities, the city added funds midway through the year to correct for a fiscal cliff in earlier budgeting. Last week, the city added $55.1 million for early intervention and $96.2 million for school nurses to the current budget to make up for holes in the budget adopted last July. While spending on those programs has increased year-over-year, they saw proposed funding for the next fiscal year drop back down by $57 million and $95 million, respectively, in the preliminary budget proposal.
“The question it begs is: are they actually going to downsize these programs next year or do they plan to continue business as usual and add funding midway through the year as they did this year?” Hendrickson said. “You need to make choices about what you’re going to do and what you are not going to do and be plain about that in the budget,” he added.
