A mid-point review of several Hamilton County levies shows multiple worries related to federal and state funding cuts.
The Tax Levy Review Committee (TLRC) says the Indigent Care, Mental Health, and Senior Services levies are all in stable financial positions and being well managed. However, committee members like Gwen McFarlin are worried that will change.
"The financial circumstances of the agencies could change dramatically, which we're all concerned about, if federal funding and/or Medicaid expansion is altered or eliminated in any way," she told Hamilton County commissioners Tuesday. "We know that we're very concerned about what the future looks like."
McFarlin was speaking specifically about the Indigent Care levy, but fellow committee members echoed her sentiments when presenting on the Mental Health and Senior Services levies.
"When we talk about the fiscal outlook of the levy, sustainability depends on ongoing Medicaid expansion. That's a key concern and watch-out for this levy and the services being provided," added member Christie Kuhns, speaking about the Mental Health levy. "A rollback could force major service cuts if that were to happen."
President Trump's tax and spending bill signed into law earlier this month includes more than a trillion dollars in federal health spending cuts over the next decade, mostly through Medicaid cuts. It's unclear what the federal cuts could mean for Ohio's Medicaid expansion program.
Big worries ahead for Developmental Disabilities Services
The outlook is much more dire for the Developmental Disabilities Services levy, according to the TLRC report.
The DDS levy provides mandated services to an increasing number of people. The latest figure is nearly 10,500, topping into the five-digit range.
The key word, according to Eric Landen, TLRC committee member, is "mandated."
"They provide excellent services, and do it well, and they are cost-conscious," he said. "But there are these significant headwinds that DDS is facing. And I'll also note that these are mandated services. So if they're not covered by the levy funds, then they would need to be covered by general funds."
Not only are the services federally and state mandated, the number of people receiving Medicaid waivers or certificates for services is increasing and expected to continue rising. On top of that, provider costs — the costs for care — also are increasing.
"DDS presented us with some plans in terms of their next steps to look at bending that cost curve, which is what they absolutely have to do here," Landen concluded. "The low hanging fruit is looking at how they can reduce their costs without impacting the services they provide. And we need them to do that, and we also need to have them look at reducing their costs while mitigating the service cuts that are unfortunate but are going to be necessary in order to bring the levy funds in line with the costs."
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