On Monday, April 20, 2026, the D.C. Council Committee on Health, chaired by Councilmember Christina Henderson, convened a budget oversight hearing regarding the proposed FY2027 budget for the Department of Behavioral Health (DBH). The hearing featured hours of testimony from clinicians, parents, and advocates who expressed deep alarm over proposed funding cuts and structural shifts that many fear will destabilize the District’s most vulnerable residents.

In the second part of the FY27 budget hearing, on Friday, April 24, 2026, the Department of Behavioral Health (DBH), led by Director Dr. Barbara Bazron, provided its testimony to the D.C. Council. Below are the main concerns highlighted during the proceedings and DBH’s response:

1. The Restructuring of School-Based Behavioral Health (SBBH)

One of the most contentious issues was the executive’s plan to restructure the SBBH program by moving services “in-house.” Historically, DBH has partnered with Community-Based Organizations (CBOs) to provide clinicians in schools. The new budget proposes a nearly $10 million cut to this program over three fiscal years and seeks to replace approximately 90 CBO clinicians with 58 in-house government employees. See DBH’s Frequently Asked Questions about this transition for more details. Here are important highlights on the potential impact of these changes. 

• • Relationship Disruptions: Parents and educators testified that therapists are “not interchangeable,” noting that it takes months or years to build the trust necessary for a child to engage in therapy.
  • Hiring Skepticism: Councilmember Henderson and several witnesses expressed “skepticism” regarding the government’s ability to hire 70+ new clinicians before the school year starts in August, especially given that the fiscal year does not begin until October.
  • Loss of Specialized Care: Witnesses noted that CBOs often provide “wraparound services,” such as dental and primary care, that DBH clinicians cannot offer.

In response, DBH shared that they will: (a) extend the rollout of these changes to 2028–2029,  (b) keep more CBO partners serving about 53 schools, and (c) aim to hire 56 clinicians by August 2026 using a rolling hiring process.

2. The Elimination of specialized Youth Crisis Response (CHAMPS)

Hours before the hearing, advocates learned that the proposed FY2027 budget effectively eliminates the contract for CHAMPS, the District’s only specialized mobile psychiatric crisis service for children and youth. DBH intends to fold the youth crisis response into the adult Community Response Team (CRT). Here are important considerations noted by some advocates who testified about this:

• • Children are “not small adults.” Experts argued that the CRT is not adequately trained or staffed to handle pediatric emergencies.
  • Increased Police Reliance: Without a dedicated youth team, schools and families warned that they would be forced to rely more heavily on the police (MPD) for mental health crises, which can lead to unnecessary trauma or hospitalization.

DBH stated that its existing Community Response Team already covers overnight youth crises, plans to add six pediatric-trained clinicians, and argues most cases don’t require in-person care, citing that 90% are resolved by phone and CHAMPS handled relatively few on-site responses each month.

3. Critical Staffing and Safety Gaps at St. Elizabeth’s Hospital

The FY2027 budget proposes a $14 million reduction and a decrease of 16.5 full-time positions at St. Elizabeth’s Hospital, the District’s inpatient psychiatric facility. Advocates highlighted the following issues:

• • Safety Concerns: Nurses and staff reported that the facility is already struggling with “security failures,” supply shortages (e.g., gloves and test strips), and “unsafe high acuity units”.
  • Forced Roles: Advocates revealed in their testimony that due to staffing gaps, nurses are being forced into defensive roles, essentially acting as security without proper training, thus undermining therapeutic care.

DBH leadership insisted that nursing and security budgets were not cut and that the hospital is a priority. DBH leadership also said that staff vacancies have dropped (82 to about 40) with more hires underway, and operational fixes, including a new system and restored food service, are in progress.

4. Substance Use Disorder (SUD) and the “Coverage Cliff.”

While the District continues to face an opioid crisis, the budget includes a $9 million reduction in substance use treatment spending, framed as a move to address “fraud, waste, and abuse”. Advocates testified to the following.

• • Unspent Funds: It was revealed that DBH has left $19 million in federal State Opioid Response (SOR) funds “on the table” due to underspending, which advocates argued could be used for critical infrastructure.
  • The Alliance Gap: Providers like La Clinica del Pueblo highlighted a “growing coverage cliff” for residents who are ineligible for Medicaid, noting that DBH policies are increasingly mirroring restrictive “Alliance” enrollment rules, leading to a decline in service access for Spanish-speaking populations.

DBH defended the budget cut as a move to curb fraud and overuse. It will cap hours, require prior authorization, and use DLA-20 assessments to limit services to those who need them. 

5. Housing Instability for the People Experiencing Mental Illness

Despite multiple closures of Community Residential Facilities (CRFs), advocates point out that the proposed FY2027 budget suggests a “flat funding” structure for DBH housing services. This demonstrates a continued lack of physically accessible housing and a shortage of vouchers, which advocates say causes consumers to “cycle in and out of institutional care”.

DBH confirmed that CPEP (Comprehensive Psychiatric Emergency Program) must move to 35K Street by June 2027 due to development projects. While community-based crisis bed contracts are being eliminated to save $1.3 million, DBH plans to build a new in-house unit at the 35K Street location, though the exact number of beds was a point of contention during the hearing.

What the Hearings Revealed

What emerged across both days of testimony is not simply disagreement over line items, but a deeper concern about process, trust, and timing. DBH is advancing a restructuring effort that includes major funding reductions across school-based care, youth crisis response, inpatient services, substance use treatment, and housing supports all at once, yet much of it is being done at speed, with limited engagement from the clinicians, community-based providers, parents, and advocates who actually operate and rely on these systems.

Perhaps the most striking example of this disconnect is the approach to budget “vacancy savings” and the so-called Medicaid “mini general fund.” DBH stated that $40 million in vacancy savings is tied to conservative Medicaid match budgeting and would only be reallocated after a first-quarter financial review if utilization remains low. That framing raises a basic but unavoidable question: why delay corrective action when the risk to services is already visible? A first-quarter review may be a standard fiscal checkpoint, but behavioral health systems do not operate on quarterly cycles—they operate on continuity, trust, and immediate access. Waiting risks reinforcing gaps that advocates, providers, and Council members are already warning will materialize.

These concerns point to a shared conclusion from community members and advocates alike: the urgency is not simply about the direction of the restructuring, but about the need to slow the pace, broaden engagement, and carefully examine the assumptions driving these decisions.

Videos to watch hearings:

Budget Oversight of Department of Behavioral Health and Department of Insurance, Security, & Banking – Public Witnesses (Part 1)

Budget Oversight of Department of Behavioral Health and Department of Insurance, Security, & Banking – Government Witnesses (Part 2)