Explaining Cuyahoga County's Health And Human Services Levy Deficit

Cuyahoga County’s two health and human services levies raise around $240 million each year. The money goes to MetroHealth Medical Center, children and family services, drug and alcohol recovery and many other programs.

But the revenue isn’t keeping up with costs. The county expects its health and human services levy fund to go into the red this year — and that deficit will keep getting bigger.

The fund is projected to end the year with a $7 million deficit, according to the county’s first quarter financial update. That will grow to a $33.5 million hole next year.

What’s Driving The Cost Increase?

More and more kids have been entering the custody of the county Department of Children and Family Services—a statewide trend driven by the opioid crisis. Around this time in 2015, there were 1,800 children in out-of-home placements in Cuyahoga County. That number has grown to around 2,700.

“The numbers just keep going up every week,” county budget director Maggie Keenan told county council in May. “I track these every Monday, and they’re just going up, up, up. I can give you the data on 2015, ’16, but those numbers would not even be on the charts, they were so much lower.”

DCFS has hired 20 more social workers, following the recommendations of an expert panel convened after the deaths of children who had open cases with the county.

Keenan said the department is hiring another 20 social workers on top of that to address rising case loads, bringing the total to 40.

The county also increased spending this year on the First Year Cleveland infant mortality program, Job and Family Services call center workers and a program for seniors, according to Keenan.

What Else Does The HHS Fund Pay For?

The fund pays for a wide range of services for kids, seniors, addiction recovery and healthcare.

Nearly $40 million in levy funds go to the county Alcohol Drug Addiction and Mental Health Board. The levy also generates around $32 million for MetroHealth Medical Center. The Juvenile Court also receives funding from the taxes.

Will Tarter, a policy associate with the Center for Community Solutions, produced an analysis of the county’s HHS budget in 2017. You can read that here. In an interview, Tarter pointed out that the levy also funds job training programs.

“It’s more than just older adults, mental health, children,” he said. “There’s tangible economic development implications here as well.”

Have Rising Home Values Brought The County More HHS Money?

There are two HHS property tax levies in Cuyahoga County. But the most recent round of reappraisals won’t bring in more revenue.

That’s because a 1976 state law known as House Bill 920 effectively prevents inflation from increasing the burden of voted levies. If the county did want to capture that new value, council could vote to put a replacement levy on the ballot.

Will The County Ask For A Tax Increase?

Keenan told council in May that the administration has discussed asking for a levy increase, but said no decision had been made.

The next HHS levy will be up for renewal in the March primary next year, meaning council has until December to decide what to put on the ballot.

But Councilman Dale Miller pointed out that council will have to make a decision before then. He said council should tell the Greater Cleveland Partnership its intentions sooner, in order to get businesses on board with a levy campaign.

Even if voters were to pass a levy increase next year, the county still faces a problem in the near term, Tarter said. In the meantime, the county would need to subsidize the levy fund from its general fund, according to the quarterly budget update.

“The soonest that the money could come in is 2021,” he said. “And the deficits begin this year and build next year. So there’s a short-term question that needs to be asked.”