People in Hamilton County who want to support medical care for the poor and care for neglected and abused children face the ironic task of voting for levies that actually cut their funding.
That's because the two Republicans who control the Hamilton County Board of Commissioners crafted the levies not so much for the benefit of children and the poor but rather for the benefit of people who pay property taxes.
The Indigent Care Levy helps reimburse local hospitals for the care they give to people who can't pay. The levy also helps pay for the county's drug court, which provides rehabilitation services for addicts. Though legally called a "renewal," the levy includes a cut over five years. The current revenue for indigent care would drop to $45.5 million a year from the current $54 million.
The proposed property tax would cost the owner of a $100,000 house $51.78 a year.
The Children's Services Levy generates $41.8 million annually to pay for a host of programs, including foster care and adoption services, the 241-KIDS abuse-intervention hotline and services to families needing drug-abuse treatment, parenting training and help with teens in crisis. The five-year property tax would cost the owner of a $100,000 house $48.95 a year.
The levy provides no increase in funding, which, because of inflation, means an effective cut.
The ever-increasing cost of goods and services will create a funding gap that could lead to gaps in services.
But County Commissioner Pat DeWine says that, while a county task force recommended a slight increase, service providers paid by the levy proceeds had other ideas.
"The one thing I heard from children's service providers was, 'We don't want an increase, we want a renewal because that will be easier to pass,' " he says.
Todd Portune, the lone Democrat on the board of commissioners, says the slash in funding for indigent care belies claims made by the two Republican commissioners about the tax "renewal."
"The Indigent Care Levy is actually a significant decrease in funding," Portune says. "They're getting about 20 percent or more fewer dollars than they receive today. (Phil) Heimlich and DeWine put out there with all this fanfare about how they're restoring funding to Children's (Hospital) and University (Hospital) and what great friends they were of indigent care, when in reality they're cutting the funding."
But DeWine says the overall funding is sufficient.
"The reality is that there's already a federal program to compensate hospitals for providing indigent care," he says. "We will still be funding more in Hamilton County by population any where else in the state."
The Greater Cincinnati Health Council Hospital supports the levy renewal but would prefer to see an increase, according to Colleen O'Toole, president of the organization.
"There's clearly a need for support for medical care for people who can't pay for their own way," she says. "The hospitals will continue to do what they have been doing — provide this community benefit. They view it as their mission to serve the needs of the community, regardless of the ability to pay."
Local hospitals annually provide between $150 million to $170 million in uncompensated care, O'Toole says. The Indigent Care Levy covers only part of that expense. The tax proceeds go to Children's and University hospitals.
But cutting property taxes doesn't mean the public avoids paying for care for the poor, O'Toole says.
"They also recognize, as many business people do, that providing care that way means that it's likely that health care premiums will support the uninsured," O'Toole says. "One way or the other, the care has to be paid for, whether you're talking about hospital foundation money that's been donated by the community, property taxes that are funneled through a levy or increased premiums that business and private individuals pay for their own health insurance."
If the levy passes, the gap between funding and services could exceed $10 million. This reduces the likelihood of addressing other serious public health issues. Early detection of treatable diseases such as cancer and diabetes won't take place, resulting in a significant burden on the public health system because of a need for more extensive and expensive treatment that late-stage diseases require.
Portune sees this erosion of the levies as the wrong way to care for the most vulnerable individuals in our society.
"We have room and opportunity to raise money for other serious public health needs that are driven, in many respects, by lack of money or access to resources that affect health care — namely the issue of the lack of health insurance, namely the infant mortality problem we have here in Hamilton County," he says.
Portune suggests a massive Medicaid enrollment effort.
"We're losing out on accessing a lot of money that should be coming into Hamilton County because of the high percentage of people who are Medicaid-eligible but who are not enrolled, which drives up costs for everybody," he says.
Comic book approach
The Coalition Opposed to Additional Spending and Taxes hasn't yet taken a position on the two levies. But State Rep. Tom Brinkman (R-Mount Lookout), spokesman for the group, says he doesn't think it will oppose either one.
"When you look at the Indigent Care levy, which is going down substantially, that would definitely meet our criteria," Brinkman says. "It doesn't necessarily mean we'd support it, but I doubt we'd oppose it. But we wouldn't go around saying, 'Oh yeah, vote for the tax levy,' because we don't have to — we can do whatever we want.
"Obviously no levy would be good, but this one has gone down substantially and, like that comic book hero says, 'My job is done here.' "
That job is a disservice, O'Toole says.
"Hamilton County has a proud history of providing an important safety net to this community, not only through the levy, but we have one of the oldest systems of public health and federally qualified health center care in the country," O'Toole says. "Cincinnati can view itself as a compassionate, caring community, and I would hope that that kind of culture and attitude continues into the future.
"I would like people to understand that, if we as a community decide that care should not be supported through property taxes, then I'd like to see a more public debate about how we do support the care of those in need." ©