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Proposed Tax Levy (Renewal)
Majority Approval Required
Pass: 103,689 / 69.96% Yes votes ...... 44,516 / 30.04% No votes
Index of all Issues
|Information shown below: Summary | Fiscal Impact | Impartial Analysis ||
A majority affirmative vote is necessary for passage.
A renewal of a tax for the benefit of Hamilton County, Ohio, for the purpose of SUPPLEMENTING THE GENERAL FUND OF THE COUNTY TO PROVIDE FUNDS FOR THE ALCOHOL, DRUG ADDICTION AND MENTAL HEALTH SERVICES DISTRICT FOR THE OPERATION OF MENTAL HEALTH PROGRAMS AND THE ACQUISITION, CONSTRUCTION, RENOVATION, FINANCING, MAINTENANCE AND OPERATION OF MENTAL HEALTH FACILITIES at a rate not exceeding two and ninety-nine hundredths (2.99) mills for each one dollar of valuation, which amounts to twenty-nine and nine-tenths cents ($0.299) for each one hundred dollars of valuation, for five (5) years, commencing in 2012, first due in calendar year 2013.
FOR THE TAX LEVY
AGAINST THE TAX LEVY
The levy was placed on the ballot by the Hamilton County Commissioners. This levy is for mental health purposes. Under Ohio law, the Mental Health and Recovery Services Board (MHRSB) is responsible for planning the County's mental health service strategies and then using available funding to contract with private providers to work with enrolled clients.
MHRSB requested an increase in millage to maintain a "fixed yield" basis for the next five years. The Tax Levy Review Committee (TLRC) recommended the Commissioners place the Mental Health Levy on the November ballot on a "fixed rate" basis as a renewal levy at 2.99 mills. Local, state and federal events create uncertainties regarding funding and providing health care. While details need to be work out, the Patient Protection and Affordable Care Act (PPACA) requires all Americans to be covered by some type of health insurance and mental health and substance abuse services must be provided in those plans. A millage increase now would seem unwise since some services must be funded by Medicaid and private insurance beginning in 2014.
The State elevation of Medicaid will allow MHRSB to reduce the number of service providers and modify eligibility criteria to better control costs and help those most in need of service. TLRC is hopeful a more modern Information Technology infrastructure will allow for increased efficiency at the service provider level. TLRC assumed the County is reviewing the significance of continued flat revenue from property taxes and the Duke Energy appeal decision.
TLRC reports are available at: http://www.hamiltoncountyohio.gov/hc/bocc_tlrc.asp
Because State law prohibits MHRSB from direct service delivery, MHRSB contracts with 51 service providers: 25 exclusively mental health providers, 15 related to alcohol and other drugs and 11 agencies that provide services to both. Programs and services funded by MHRSB were provided to 14,684 adults and 7,619 children in 2011, a 25% increase in adult clients and 17.2% increase in children clients since 2007.
The services most in demand included: counseling, case management, diagnostic assessment and pharmacological management.
The MHRSB is the product of the merger of separate boards in 2006: the Mental Health Board and the Board of Alcohol and Drug Addiction Services (ADAS). A consultant was hired by the County to review the MHRSB's operation and use of Mental Health Levy funds. The Consultant review found MHRSB to be a well-organized and effective public organization managing a growing service demand with limited resources and anticipated revenue shortfall. The current Mental Health Levy Funds accounted for $187,075,754 or 41% of the MHRSB revenues during the levy period 2008-2012.
Local and state issues have affected Mental Health levy funds and will continue to do so in the coming years. From 2008 - 2012, levy yield to MHRSB dropped 10.4% due to declining property values which raised fewer dollars. Continued flat property values will result in reduced tax yield. In the past year, six positions were eliminated to control expenses in light of falling revenues. If levy responsibility of the Probate Court's Civil Commitment Program is transferred from the Indigent Care Levy to the Mental Health levy, a projected additional annual cost of $641,764 annually will be added to this levy. The long-term impact of the Duke Energy appeal of its real property values could add to revenue shortfall. The current levy request estimates a negative fund balance.
As of July 2012 the Ohio Department of Jobs & Family Services has assumed responsibility for management of Medicaid-funded programs for mental health services, impacting revenue structure, staffing and service delivery planning of MHRSB. This so called "Medicaid elevation", under which the Ohio Department of Mental Health would administer all Medicaid services and providers, results in the elimination of about 48% of MHRSB annual revenue and 50% of its billing activity and the expected elimination of six to ten staff positions. The role of the MHRSB is being redefined. State and local allocation of responsibilities need to be resolved.
If ODJFS does not share certain information with local boards, MHRSB could lose information related to publicly supported mental health services and result in overlapping and cost duplicative services. However, loss of Medicaid restrictions provide opportunities in instituting best practices in mental health care, selecting providers, negotiating cost effective rates and developing a more effective information technology system.
League of Women Voters
Issues Forum by the League of Women Voters