Agencies like Montgomery County Children’s Services, Montgomery County Developmental Disabilities Services (MCBDDS), Montgomery County Alcohol Drug Addiction Mental Health Services (ADAMHS), Older Adult Services and Public Health - Dayton and Montgomery County have pointed to financial obstacles ahead related to an uptick in demand for services and an increase in costs for delivering those services, among other challenges.
Some of these agencies see more than half of their total budgets come from the Human Services Levy, according to 2024 levy allocation records, and many have asked for a larger slice of the $137.9 million funding pool for 2025.
A combined levy
The Human Services Levy was proposed to the public decades ago as a method to support multiple agencies that provide social services to residents under one funding umbrella. Both levies — Levy A and Levy B — span eight years.
Levy A was on the ballot in 2021, passing with nearly 75% of the vote. It won’t see the ballot until 2029.
Levy B was up for renewal in 2017. It will return to the ballot in November 2025, and Human Services Levy Council officials are evaluating what changes, if any, will be made to the levy.
The levy council consists of more than a dozen members selected from candidates offered by the Mayors and Managers Association and Township Trustees Association, the United Way Board, the City of Dayton, Human Services agencies, the county commission and more.
The 18-member council recommends allocations of funding to local agencies; those allocations are then rubber-stamped by the Montgomery County commission.
The bulk of the major agencies funded through the human services levies made their pitch for allocation adjustments during the November meeting of the Human Services Levy Council, and dozens of programs benefit from the social services funding.
Board of Developmental Disabilities Services
For the MCBDDS, which serves people with disabilities and their families, a financial crisis has been brewing for several years due to an increase in costs for services, an increase to state and federal mandates and an increase in clients — all of whom are served for a lifetime, said Pamela Combs, who will serve as the MCBDDS’ superintendent and CEO through next week.
The MCBDDS receives $28.9 million in Human Services Levy funding, and the county commission approved a $58 million budget for the agency for 2024.
The Montgomery County commission awarded $17 million in American Rescue Plan Act (ARPA) funds to the MCBDDS when the board declared a fiscal emergency in 2023.
This fall, the MCBDDS announced $8.9 million in proposed cuts to present a balanced budget this year. This announcement followed a rate increase for Medicaid waivers.
The MCBDDS’ obligation to match waivers for the end of 2024 will be more than $25 million. Combs said Medicaid waivers are the largest budget item for the Montgomery County Board of Developmental Disabilities Services and are a mandated service.
Once a person receives a waiver, they are guaranteed this funding for their lifetime as long as they live in Ohio. The county that granted the initial waiver funding is responsible for continuing to grant the level of waiver funding they authorized.
After it announced proposed cuts, the MCBDDS was given an emergency, one-time award of $5 million in Human Services levy funding, which will come to the agency in 2025. The MCBDDS will still need to make $3.9 million in cuts to balance its budget.
This will result in reduced funding to Early Intervention, Family Support Services, Recreation Services and other programming. Other programs will be discontinued altogether, including a special needs preschool contract with United Rehabilitation Services and the School to Adult Life Transition Series.
What Montgomery County citizens contribute to MCBDDS fund ranks 85 of 88 counties. Other metro areas’ citizens contribute significantly more funding to their county boards: Cuyahoga ranks as 48th; Franklin, 47th; and Hamilton, 53rd, according to the Ohio Department of Developmental Disabilities
In terms of revenue provided, the MCBDDS ranks 78 out of 88 county boards in the State of Ohio, according to the Ohio Department of Developmental Disabilities.
The MCBDDS has been contemplating its own levy to make up for budget shortfalls, although DD officials are still determining its feasibility and how it would fit with the Human Services Levy.
“We need help in figuring out a sustained plan, whether it’s to work at a DD-only levy — we’ve been wanting to do that for a while — or whether it’s to seek additional funding through the shared levy, we just need to sit down at a table and say, hey, let’s figure out what this is,” Combs said.
Combs announced her resignation last week. Her deputy CEO, Kamarr Gage, will become the new CEO of MCBDDS.
Public Health
In 2024, Public Health - Dayton & Montgomery County received approximately $18 million in Human Services Levy dollars, which is about 39% of its total $47.3 million budget, according to Public Health records. The agency reported expenses exceeding its operational budget for a deficit of $1.4 million.
The health department last year projected a “severe” deficit that would result in layoffs and salary freezes, but health commissioner Jennifer Wentzel said Public Health was able to balance its budget for 2024.
But through 2028, the agency is looking to eliminate nearly $8.8 million in costs in order to present a balanced budget, according to Wentzel.
The combined health district has a few additional financial needs, said Wentzel. The health department hopes to transition to a new, more efficient medical records system, and the department is also looking at ways to reduce costs related to interpreter services — a service it has needed more in recent years.
“We’re always going to need to be on our toes,” Wentzel said. “But we’ll continue to push forward.”
ADAMHS
Montgomery County ADAMHS has taken $16.5 million in voluntary cuts to its Human Services Levy base award over the past several years, but the agency is asking for a $4.1 million increase. Roughly $3.2 million of this increase would go toward treatment.
After ADAMHS spent down its reserve funds and grant dollars while taking lower allocations from the county’s human services levy, some of the agencies to which it provides grant dollars saw deep reductions in funding.
“Unfortunately, the need exceeded our expectation, just like it did with the other agencies, so we had no way really projecting where we were going to end up with a two-year budget allocation,” said Helen Jones-Kelley, executive director of Montgomery County ADAMHS.
ADAMHS received $19.7 million in Human Services Levy dollars in 2024, with its total 2024 budget being $40.7 million.
Taking less from the Human Services Levy has been a theme for ADAMHS since the pandemic. Meeting minutes from the Human Services Levy Council since 2021 show that decreases in funding for ADAMHS were discussed multiple times while other county agencies discussed their financial challenges.
ADAMHS faces multiple challenges looking ahead to 2025. The agency said state allocations have remained stagnant while the need for mental health and addiction services continues to rise, according to Jones-Kelley.
Human Service Levy dollars represent 60% of the agency’s total revenue budget. Efforts to stabilize the budget include reducing treatment contracts to remove Medicaid-eligible services, and ADAMHS is seeking state and federal grants that do not require significant cash matches.
Next year, providers will also be required to have a 25% match for contracts funded by levy dollars.
“The whole process is complex. It was probably simpler when everybody was doing their own single-purpose levy, but then that forced all of the agencies into a position of always being in campaign mode, and campaigns can run a lot of dollars. This is efficient for the use of taxpayer dollars,” Jones-Kelley said.
“But it is complex because we are looking at a system of care rather than one singular agency.”
ADAMHS is also making adjustments to funding schedules. The shortened funding cycle for prevention services this year came about by ADAMHS moving those grant allocations to a fiscal year cycle (January through December) instead of the state fiscal cycle, which is from July 1 of one year through June 30 of the following year.
That has led to changes in funding for organizations like Samaritan Behavioral Health Inc. (SBHI).
For SBHI, it was necessary to adjust the scope of certain programs focused on suicide prevention, mental health screening in school-age students and services for adults with severe mental illness, the agency told the Dayton Daily News.
- Suicide prevention services for students were discontinued.
- SBHI’s Screening, Brief Intervention, and Referral to Treatment program for local school students was also impacted. This program is currently operating at reduced capacity and will close by June 2025.
- SBHI’s Consumer Advocacy Model serves people with severe mental illness, and the scope of the program was reduced by one position.
The difference in funding schedules from the state and the county levy caused ADAMHS to, at times, use levy funds to pay organizations that weren’t receiving state funds on the same schedule. They organizations would then reimburse the levy funds with the state funds when they arrived.
This is helping them avoid a future fiscal emergency, Jones-Kelley said.
“I know it doesn’t feel like it or sound like it, but it is real good fiscal management, which prevents a fiscal emergency and right sizing our funding cycles,” she said.
Children Services
The allocation to the county Jobs & Family Services Children Serviceswent from $27.5 million in 2022 up to $30.5 million in 2023 and 2024, according to county records.
“The increase in the JFS allocation is based on the needs and costs for children that are placed in the custody of Children Services,” said assistant county administrator Geraldine Pegues.
The county approved a $155.1 million budget for the department, with $66.7 million of that funding approved for Children Services.
Within the first 10 months of 2024, Montgomery County Children Services had already outpaced the number of families served last year. The cost of placing children into other homes, too, has jumped 38% since 2021, it said.
The agency reported that 669 children were in substitute care as of last week. More than 120 children were placed with kinship providers — relatives that have a role in the child’s life. Another 16 children were placed out of state, and all 16 of these placements were covered by Medicaid.
Specialized services for children with developmental disabilities, mental health concerns and involvement in the juvenile justice system all contribute to increased placement costs, Pegues said.
“This issue affects not only Montgomery County Children Services, but child welfare agencies across the state,” Pegues said.
Additionally, the county needs more kinship caregivers and traditional foster families, she said. Those types of placements tend to be less expensive when the settings are appropriate to meet children’s needs.
“Montgomery County remains focused on reducing placement costs, whenever possible,” Pegues said.
Older Adults Services
For Older Adults Services, formerly known as Frail Elderly Services, the demand for services is expected to spike given the population of Baby Boomers entering into their 60s and 70s. It’s estimated that 24.5% of Montgomery County residents are above the age of 60.
The number of people aged 65 and older is expected to increase by 20-25% by 2028, according to officials.
Doug McGarry, the executive director of the Dayton Area Agency on Aging, called this a “silver tsunami.”
“The reason for that is the Baby Boomers have now reached that gray-haired status and are quickly growing the ranks,” he said.
Roughly $9.9 million in human services dollars were allocated to Older Adult Services in 2024. Older Adult Services funding goes toward multiple organizations that provide transportation, housing, food, health, recreation and legal services for seniors. This includes organizations like Goodwill Easterseals - Miami Valley and Catholic Social Services, among others.
The Area Agency on Aging for the Dayton area receives more than $8.7 million from the county’s human services levies, which help fund its ComCare program.
ComCare provides older adults who are not eligible for the Ohio Medicaid Program and their caregivers a package of in-home services and assistance that help residents remain in their own homes. The services, which are based on a sliding fee scale, include personal care, home-delivered meals, emergency response systems, transportation, medical equipment and other assistance.
McGarry said the Older Adults Services budget is projected to have a deficit of more than $280,000 due to provider rate increases.
No new clients have been accepted into the ComCare program to help stabilize the budget going into 2025.
Other agencies
Other nonprofits and government agencies are funded through more than $130 million in levies dollars.
Stillwater Center, an intermediate care facility located in the Clayton area, is home to 100 Montgomery County residents with severe to profound developmental disabilities and/or significant medical needs. The Montgomery County commission approved a 2024 budget of $28.5 million for Stillwater, and Stillwater received $3.2 million in human services levy dollars for 2024.
Oakwood is the only city listed as a Human Services Levy recipient. Its $116,289 allocation goes toward operating its health district, which addresses issues related to public health including inspections of food service operations, retail food establishments, public swimming pools, schools and the municipal jail.
Miami Valley Housing Opportunities, a nonprofit focused on permanent supportive housing solutions for homeless persons with mental illness, chemical dependency, and other disabilities throughout Montgomery County, also sees support from the Human Services Levy through a $525,000 allocation for New Hope Villa.
In 2024, another $5.3 million went toward Indigent Ill programs. These programs focus on financial assistance that can help eligible people afford their hospital bills. These mandated programs that discount the cost of care are required under the Affordable Care Act and IRS rules.
