The city’s public health department provides a wide range of services across the city, including infectious disease prevention, mental health services, and food sanitation and nutrition programs. As a heavily grant-funded department and the main response organization for disease outbreaks, CDPH’s budget has been heavily influenced by the COVID-19 pandemic and federal response funding.
Chicago Department of Public Health Snapshot: Appropriation & Staffing Changes from 2026 Budget
This year’s slight decline in CDPH’s total appropriations comes after several years of dramatic reductions, primarily driven by expiring and/or expended COVID-19 relief funds.
CDPH’s net increase of 26 positions and FTEs is primarily driven by increases in emergency and crisis staffing, with 15 additional EMT positions and 18 positions across various crisis clinical roles, along with eight additional Community Intervention Specialist positions. At the divisional level, the Behavioral Health division saw the largest increase in budgeted headcount, with a net additional 62 positions and FTEs from the year prior, while the Health Protection division saw the largest decrease, with a net reduction of -29 positions and FTEs.
CDPH’s budget has one of the lowest rates of fringe costs for nongrant employee pension and benefit costs, due to the department’s large number of grant-funded employees and substantial non-personnel expenses.
The department’s largest single-category appropriation increase in the 2027 proposal is for violence reduction programs, up $6.6 million (20.6%) from the previous year.
Historical Context
As the city’s point department for infectious disease response, the Chicago Department of Public Health’s responsibilities and budget increased dramatically during the COVID-19 pandemic. CDPH allocations more than quadrupled from 2020-2022, driven primarily by federal grants, before beginning to decline in 2023 and 2024 and dropping more precipitously in 2025.
Prior to the pandemic, from budget years 2011-2020, CDPH appropriations grew at an average rate of 2.3%, or 1.1% when adjusted for inflation through 2025. CDPH budgets have declined since its pandemic high point in 2022. The current proposal would decrease the department’s appropriations by 0.5% from the previous year.
Chicago Department of Public Health Appropriations and Inflation-adjusted Appropriations (2025 dollars)
Values in nominal dollars.
Values in 2025 dollars. No supplied inflation factors for 2026, 2027; those years remain gaps.
City budgets do not break out “fringe” pension and benefit costs for non-grant positions by department, instead grouping them together as citywide expenses under the Finance General section of the budget. To better reflect the real cost of service for departmental operations, BGA Policy has included an estimate of pension and benefit costs for the years 2018-2026, using Department of Finance fringe memos from each relevant year. An estimated fringe cost for the 2027 proposal uses the average annual rate of increase for each of the inputs into the fringe formulae.
Based on the city’s fringe formulae, the CDPH fringe cost for nongrant employees averaged 3.2% from 2018-2026, compared to a citywide average of 26.8%. (Departments with a larger proportion of their budget dedicated to non-employee costs or with a larger proportion of grant-funded employees tend to have lower fringe costs, as their pension/benefit costs are either already factored into grant funds or are a smaller percentage of the overall departmental budget.)
Chicago Department of Public Health Appropriations with Estimated Fringe Cost of Pensions and Benefits for Budgeted Non-grant Positions, 2018–2027 (proposed)
Local fund actuals are only a limited snapshot of CPDH’s overall expenditures, as in recent years the department has been heavily grant-funded. With that caveat, CDPH spent on average 79.6% of its locally funded budget from 2022-2025, compared to the citywide average 86.6% local fund spend.
Chicago Department of Public Health Local Fund Actuals, 2022–2025
As with appropriations, budgeted headcount at CDPH went under a pandemic-era surge and has been declining since peaking at 2024. The proposed 2027 budget would increase budgeted headcount by 3.4% from the previous year, the first increase since 2024.
Chicago Department of Public Health Budgeted Workforce, 2011–2027 (proposed)
From January through September of 2026, the months for which full-time position vacancy data is currently available, CDPH averaged a 23.0% vacancy rate, compared to the citywide average of 11.2%.
Chicago Department of Public Health Full-time Vacancies, Jan-Sept 2026
89 of the department’s budgeted full-time positions were persistent vacancies (defined as the number of positions within the same combination of title, subsection, section, division, department, and fund codes that remained vacant in all nine months of available data):
Chicago Department of Public Health Persistent Full-time Vacancies, Jan-Sept 2026
CDPH’s net increase of 26 positions and FTEs is primarily driven by increases in emergency and crisis staffing, with 15 additional EMT positions and 18 positions across various crisis clinical roles, along with eight additional Community Intervention Specialist positions.
21 positions were eliminated across various environmental health and inspections titles as those functions are transferred to the Department of Environment.
Chicago Department of Public Health Net and Percent Position/FTE Changes, 2026 to 2027 (Proposed) Budgets
At the divisional level, the Behavioral Health division saw the largest increase in budgeted headcount, with a net additional 62 positions and FTEs from the year prior, while the Health Protection division saw the largest decrease, with a net reduction of -29 positions and FTEs.
Appropriations
CDPH is 36.5% locally-funded in this year’s budget proposal, up from the previous year’s 31.3%
Federal grants make up nearly half of CDPH’s appropriations, up about $10.7 million from the previous year, and the department appropriates $41 million from the new Protecting CARE Fund, which draws on the new social media entertainment tax revenue.
Corporate fund appropriations for CDPH are down -$24.1 million (-26.6%) from the previous year. Appropriations from the COVID-19 Grant Fund are down -12.7 million (-28.3%), and the Coronavirus Local Fiscal Recovery Fund, from which CDPH drew $16.3 million in 2026 appropriations, has been eliminated entirely.
Chicago Department of Public Health Fund Comparison, 2026–2027
Grant funding overall declined by -$36.1 million from the previous year’s budget, with 20 grant-funded positions or FTEs eliminated. Much of that reduction came from expiring or expended COVID-19 grants, which have been largely eliminated or greatly reduced in the 2027 CDPH budget.
As with most departments, salaries and wages on payroll make up CDPH’s largest appropriation. The 2027 budget also has the department holding a substantial amount of grant funding in reserve balance, with large appropriations in pass-through spending for delegate agencies, violence reduction programs, and outside contracting as well.
Chicago Department of Public Health Top 10 Largest Appropriations, 2027 proposed
In 2025, the most recent complete budget year for which local fund actuals and encumbrances data is available, CDPH spent 83.3% of its locally-funded budget.
Chicago Department of Public Health 2025 Actual Spend (Local Funds)
CDPH’s largest single-category appropriation increase in the 2027 proposal is for violence reduction programs, up $6.6 million (20.6%) from the previous year.
Outside contracting through the professional and technical services appropriation is down a comparable -$6.9 million (18%) from the previous year. Pass-through spending to delegate agencies is also down -$1.6 million (-2.3%).
Chicago Department of Public Health Net and Percent Appropriation Changes, 2026 to 2027 (proposed) Budgets
Geoffrey Cubbage analyzes policy and budgets at the Better Government Association, covering state lawmakers and Chicago City Council. He joined BGA in 2022 after directing policy and economic development for Chicago’s 40th Ward.
