Cuyahoga County Asks Voters to Raise Taxes for Behavioral Health

Cuyahoga County voters will decide on Nov. 3 whether to renew and enlarge the property tax levy that funds the county's health and human services safety net, a measure that would raise $261.5 million a year for a decade, up from the $144.1 million the levy generates now.

Issue 11 combines a 4.7-mill renewal with a 2.5-mill increase, for a total of 7.2 mills over 10 years. For a home valued at $100,000, the county says the levy would cost $196 a year, an $87.50 increase over the current bill. Early voting in Ohio began Oct. 6.

What the levy actually pays for

The county collects two health and human services levies that together raise roughly $279 million a year. The money covers children in county custody, senior services, universal pre-K, the MetroHealth System and the Alcohol, Drug Addiction and Mental Health Services Board.

That last item is the part of the budget most directly tied to addiction care. The ADAMHS Board contracts with providers across Cleveland and its suburbs for detoxification, outpatient counseling, crisis response and medication-assisted treatment, and the county levy is one of the few local funding streams the board can count on as state and federal dollars shift.

A safety net fund close to empty

County projections put the fund that pays for safety-net services at just $3.1 million by the end of the year, according to a county fact sheet. The county expects a widening deficit in the years after that, requiring either cuts or a subsidy from the general fund.

Health and Human Services Director Dave Merriman told County Council that expenses keep climbing as the county takes on work that federal money used to cover. "A levy — plus fiscal discipline — would bring 10 years of HHS stability," he said, according to Signal Cleveland.

The second levy on the same ballot

Cuyahoga voters are deciding a second countywide tax question. Issue 10 would increase the property tax that supports the Cuyahoga County Board of Developmental Disabilities, which serves about 15,000 residents from birth through adulthood.

The board's tax has not been raised since 2005, and its leadership says the revenue no longer keeps pace with costs and caseloads. "Everything costs more than it did in 2005, services cost more and more people need us," CEO Amber Gibbs told Signal Cleveland. The 2.25-mill levy would raise $99.7 million for a board whose current budget is about $177 million.

The developmental disabilities board spends about 81 percent of its levy dollars on the local share of a Medicaid-backed caregiving program, covering transportation, wheelchairs and other equipment and helping pay certified caregivers. A state-mandated raise for those caregivers in 2024 added to the board's costs.

Sixty-two levies across Ohio

Cuyahoga is one of 62 Ohio counties with a health and human services levy on the Nov. 3 ballot, according to a tally by the Center for Community Solutions, a Cleveland research and advocacy group. Renewals make up the largest share at 41, followed by 15 new levies, five renewals with an increase and one renewal with a decrease.

Thirty-two of those counties have more than one levy in play. The research group has endorsed both Cuyahoga measures.

What the vote does not settle

A levy renewal does not by itself add treatment capacity, and the county's own projections assume it will keep absorbing responsibilities that were formerly federal. The county opened its first 24/7 walk-in crisis center in September, a $36 million recovery campus on Cleveland's near west side that operators expect to serve about 12,000 people a year.

If the levy fails, the county would have to cut programs or pull money from its general fund, and the services most likely to be protected are those with federal matching dollars attached. The levies that fund addiction treatment, recovery housing referrals and crisis lines are typically the ones with the least federal leverage behind them.