FOCUS 2020: Boston Public Health Commission

In the forefront of COVID-19 & systemic racism solutions

The Boston Public Health Commission (BPHC) is one of the most important departments in managing two priority policy areas for Boston: leading Boston’s public health response to the COVID-19 pandemic and carrying out programs to address racism as a public health crisis. These two priorities for FY21 are in addition to the BPHC’s ongoing work addressing substance abuse, homelessness and other community issues driving additional resources toward public health over the last five years.

FY21 Key Programs and Policy Initiatives

In FY21, the BPHC received $4M in City funds from the reallocation of the Police overtime account to address systemic racism by improving access to health services, working with other City departments on policy changes to improve the health and well-being of Boston residents of color, and ensuring that health inequalities by race and ethnicities are documented.  The Child, Adolescent, and Family Health Bureau will receive $1M of these funds for counseling services for victims of community violence.

The BPHC will also focus on managing the City’s public health response to the COVID-19 pandemic. BPHC has been on the frontlines of battling the virus since the beginning of 2020, leading the City’s testing and disease control efforts.

Under the CARES Act, Boston received $121M in aid, of which BPHC received $10.4M, or 8.6%, for unrestricted COVID-19 spending.  As of August 2020, BPHC spent a total of $7M:  $2.8M on personal protective equipment (PPE), $1.6M on overtime costs and $2.6M on COVID testing equipment, supplies, and other necessary items.

Trends in Budget and Personnel

The BPHC is the fifth largest city department, accounting for 2.9% of Boston’s General Fund budget.   The BPHC FY21 budget totals $106.5M, a 14% or $13.1M increase over FY20—the largest of the decade. From FY17 through FY21, BPHC spending rose 37.8% or $29.3M. Unlike other departments, BPHC’s appropriations include health insurance costs, pensions and other post-employment benefits.

BPHC’s budget for personnel in FY21 is $112M, a 7% increase of $7.5M from $105M in FY20. This significant increase was due to the settlement of BPHC’s collective bargaining agreements, which resulted in increased salaries accounted for in this fiscal year budget. From FY17-FY21, the department’s personnel spending has increased by $22.3M or 24.8%. Over the last five years, over half (62%) of BPHC’s growth in appropriations have gone towards EMS to accommodate the increasing amount of 911 calls and opioid-related emergencies.

City-funded BPHC employees total 941.8 full-time equivalencies (FTE).  This is an increase of 71.1 FTE’s or 8.4% from FY17.  This includes an additional 29 FTE’s for a new EMT class and 80 FTE’s for the Community Assistance Team (CAT)/Squad.  Recovery Services and EMS account for 60.8% of personnel increase over the last five years (43.22 FTEs in total), which further reflects a more aggressive focus on substance abuse and EMS.

BPHC’s FY21 external budget is the third largest of all departments and 12.3% of the City’s total external funds ($374.1M). External funds come via federal, state, and private grants. Support for Homelessness Services make up 22.3% ($10.2M) of BPHC’s external funds and the Ryan White HIV/AIDS program and other grants in the Infectious Diseases Bureau makes up 37.2% ($17.1M). These two bureaus make up the greatest share of the Commission’s $45.9M external funds budget.  Click here for the PDF

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