The budget cuts proposed by County Mayor Jim Coppinger for the range of county-subsidized civic agencies and the county’s Health Department are terribly short-sighted and needlessly counter-productive and self-destructive.
The value of the work performed by the public service agencies and organizations is crucial to the health and welfare of citizens across the county. Agencies that provide cultural and educational programming are no less important. They provide many of the amenities that are essential to attracting economic growth — just ask Volkswagen officials — and much of their programming is specifically targeted to serve the county’s most under-served and vulnerable youth.
For the public-service agencies, the ultimate social cost of failing to help support these agencies will be higher in terms of both the human toll and the actual dollar costs of defunding the agencies’ work. The higher social costs will simply outweigh the perceived savings to countywide taxpayers.
When the county cuts mental health services, for example, more of the mentally ill haphazardly end up in jail, where their public costs soon exceed the costs of treatment. That has been the documented trend since the state began cutting back both in-patient and out-patient care.
Coppinger’s hit on the county health department is especially brutal and tragically short-sighted. The county provides a little less than half of the health department’s $21 million budget; the larger share comes from state and federal matching grants allotted on the basis of specific health focus areas.
Of the 37 employees to be cut under Coppinger’s proposal, 14 will come from the sparsely staffed health department. Of the 17 job vacancies also to be left unfilled, four are in the health department.
Coppinger’s budget reduction of $617,000 — roughly 6 percent of the health department’s local funding — is almost certain to mean the loss of a greater amount in state and federal matching grants for the department’s programs.
The health department’s chief administrator, Becky Barnes, declined to discuss the impact of the job losses with this page, but other people in the medical community here are deeply concerned about the impact and associated long-term costs of the cuts with regard to the overall health and well-being of the community.
Cuts in health department spending and staff may require closing down health care centers and clinics; reducing the number of vaccinations; reductions in abstinence and family planning education, in smoking cessation resources, and in pre-natal care and education.
Hamilton County is already next-to-last in the state in the incidence of low-birthrate infants, a harbinger of higher medical and social costs. The new cuts and corresponding loss of services are likely to leave the county last in this vital area of public health.
Coppinger also proposes to halve the $3 million in annual funding to Erlanger hospital to help offset the cost of indigent care. The $3 million figure comes nowhere close to the actual costs of uncompensated care provided by Erlanger, a figure now around $82 million annually.
Yet the $1.5 million reduction to Erlanger may be the only Coppinger cut that makes some sense. Erlanger’s bureaucracy has become conspicuously bloated since Jim Brexler became CEO. He has nearly doubled the number of Erlanger vice presidents and top executive staff, from the nine at the hospital when he took over. That has enabled him to more than double his own compensation, to more than $700,000 in salary, bonuses and other perks.
Bonuses handed out to the hospital’s top executives and managers totaled more than $1.7 million in 2009, and $1.9 million in 2010. If cuts are necessary at the hospital to offset the Coppinger cut, bonuses should be the first item on the table.
But Erlanger is an anomaly in the category of county-subsidized public service agencies. The others are all small and work on shoestring budgets to improve the lives of orphaned or abused children, broken families, the medically needy and to serve other legitimate public health care and social needs. The County Commission should dismantle Coppinger’s cuts and, if need be, dig into the county’s excessive large $85 million contingency fund until it finds the will to fix a modest property tax increase.