News: Clinical Decision

Heath department at center of city's budget clash

Joe Lamb

Budgetary hearings are usually pretty mundane affairs, but controversial proposed funding cuts prompted a large turnout for the Dec. 12 hearing at the Duke Energy Convention Center.

Cincinnati officials are scheduled to decide this week on what services to cut in the 2007-08 municipal budget to avert a projected $28 million deficit. The cuts could reduce funding to arts programs and close some inner-city health clinics and recreation centers.

City council members spent the weekend of Dec. 16-17 making a series of telephone calls to each other trying to hammer out a budget deal in anticipation of a vote Wednesday on the two-year spending plan.

As of CityBeat's publication deadline, two council factions had competing proposals, and they were doubtful that a compromise could be reached. As a result, several council members say a 5-4 vote or 6-3 vote is the most likely outcome this week.

A council majority comprised of Democrats Jeff Berding and Laketa Cole, Republicans Chris Monzel and Leslie Ghiz and Charterite Chris Bortz was pushing a proposal that kept some of the funding reductions proposed by City Manager Milton Dohoney Jr. and made even steeper cuts to the Health Department. The faction wants to refocus city spending on what they describe as basic services and reduce or eliminate services they say are also provided by county, state or federal governments.

Close the clinics
Although Dohoney had proposed closing one of the city's nine health clinics, saving about $1.4 million annually, the faction wants to cut the Health Department's budget further — by up to $4 million. If they are successful, that could entail closing up to three clinics.

The steeper cut would allow the majority to reduce Dohoney's proposed cuts to human services programs and recreation centers, although the amounts still would be less than in the current budget.

Typically, the city sets aside 1.5 percent of its general fund for such programs as shelters for battered women and the homeless and programs for youth and senior citizens. Dohoney proposed reducing the amount from $2.5 million to $1 million, but the council majority wants to lessen the cut, making the total allocation between $1.5 million and $2 million.

Also, while Dohoney proposed cutting subsidies for arts groups by more than two-thirds, from $633,000 to $200,000, the majority wants to restore part of the amount.

"We're all well aware those (proposed) cuts were too much," Ghiz says.

The majority believes the Health Department can handle steeper cuts because many of the same services are provided to low-income residents by Hamilton County through its indigent care levy.

Cincinnati is one of fewer than 10 cities nationwide that operate municipal health clinics. The city's Health Department receives the third-highest allocation in Cincinnati's budget, behind the police and fire departments, receiving about $32 million annually. Of that amount, about $10 million is earmarked for specific purposes such as lead paint abatement.

"After looking at everything in the budget, we decided they waste a lot of money. They're not as efficient as they could be," Ghiz says. "Health clinics are nice, but we don't need them on every corner. It's not fiscally responsible. We're not a wealthy city."

Under the proposal being drafted by the council majority, the Health Department would get a set amount and decide for itself which clinics to close. One possibility would be keeping all clinics open but with a reduced schedule of three or four days a week.

Similarly, the city's Recreation Department also could decide which centers to close to meet its budget goals. Dohoney proposed that the Mount Auburn center be closed, but that's unlikely because it offers a heated, indoor pool that serves many elderly residents, Ghiz says.

"They know best where they can make the cuts," she says.

Another proposed change involves how much the city pays into the pension fund for retired workers. Dohoney wanted the city to pay 21.77 percent of its total payroll into the Cincinnati Retirement System to help cover shortfalls in its liability, but the council majority instead wants some retirees to begin picking up part of the cost for their medical insurance coverage. The coverage now is entirely paid by the pension fund, even though skyrocketing health care costs have forced current workers to pay 20 percent of the coverage, with the city paying the remainder.

"An 80/20 split is what most city employees are paying, and that is fair," says Ghiz, who was an attorney who handled labor union issues for the city before being elected to council.

Under the plan being mulled, older retirees still would have the entire insurance amount paid by the city, but younger retirees would have to cover some of their own costs. City government has about 4,500 workers drawing a pension.

By reducing the city's pension contribution, about $3 million to $4 million could be saved annually that would be used to pay for other services, Ghiz says.

Save the clinics
The other council faction is determined to keep all city health clinics open and also doesn't want to raise the amount paid into the pension fund. The faction includes John Cranley, who heads council's Finance Committee, and fellow Democrats David Crowley and Cecil Thomas.

Noting the city's earnings tax revenues for the year are up by 3.4 percent over 2005, some of the budget pressure is lessened, according to Cranley says.

"The economy is recovering and revenues are up," he says.

But that will change, Ghiz says.

"We need to make permanent changes so we don't find ourselves in this same exact position again later," she says.

Cranley supports a plan to hire 65 police officers over a two-year period, costing about $4.4 million, but says many of the human services programs help crime victims and are equally important. He cites the Rape Crisis Center and a battered women's shelter as examples.

"That is directly related to crime," Cranley says. "I am not going to let those be cut."

Health clinics also are too vital to close, he says.

"They provide basic preventative care for children in our community," he says. "The bottom line is I'm going to push for a budget that's about creating a safe and healthy city."

Dohoney's proposal calls for laying off 61 City Hall workers, but Cranley believes there are more jobs that could be eliminated.

"We still have a long way to go toward cutting the City Hall bureaucracy," he says. "We need to be tightening our belts internally before we cut services to residents."

Most of Cranley's proposed personnel cuts would come from middle- and upper-level management.

"There are a disproportionate number of management workers at City Hall compared to the number of line workers," he says.

Cranley, who in years past prided himself on forging coalitions that unanimously passed the overall budget, realizes that might not be possible this time.

Privately, some members of the council majority partially blame Cranley for the current budget impasse. They say the city's Retirement Board almost approved a policy change a few years ago that would have required retirees to pick up more of their health care costs. Cranley, who sits on the Retirement Board, initially supported the change until he was pressured by retirees to change his stance.

Dohoney's proposed budget totals $2.4 billion over the two-year period, although the amount might be reduced after council's tinkering. ©

Scroll to read more News Feature articles

Join CityBeat Newsletters

Subscribe now to get the latest news delivered right to your inbox.