Behavioral Health
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Cuyahoga County Finalizes 2022-2023 Biennial Budget

Will Tarter
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January 18, 2022
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The 2022-2023 Cuyahoga County budget, totaling $1.5 billion, represents the last proposed budget for the Armond Budish administration. Budish recently announced that he will not be running for re-election in 2022. In this county budget review, we will examine the 2022-2023 Cuyahoga County budget, as well as some of the amendments performed by Cuyahoga County Council, and offer a glimpse into what issues lie before the county moving forward.

 The 2022-2023 Cuyahoga County budget, totaling $1.5 billion, represents the last proposed budget for the Armond Budish administration.

Anxiety, inequity, and economic strain have defined recent budget needs

The COVID-19 pandemic introduced an amount of economic and community development uncertainty, as well as federal, state, and local public policy change, that is unparalleled in recent memory. Not only were there policy changes that had to be made in real-time, it also created an enormous health issue resulting in thousands of lives lost. It also created an economic anxiety that reverberated throughout the young Cuyahoga County government, causing the county executive to issue furloughs for executive departments. While those furloughs were ultimately repealed, the economic dominos are still being felt today as the county must continue to monitor the current economic impact of the pandemic, with the uncertainty of new variants and not knowing how long the public health effects of the pandemic will continue to be felt.  

The pandemic also elevated the visibility of many of the gaps that exist in the health and human services fabric of the county, state, and nation. Rules were relaxed and waivers applied that streamlined access for county residents to HHS resources including food and shelter. Recognizing that the pandemic disproportionally fell harder on communities of color and older residents, federal legislation such as the American Rescue Plan Act (ARPA) has created a clarion call for state and local governments to pursue strategies that would ensure a more equitable economic recovery.

Mental health, workforce shortages, and economic development demand priority

In terms of the actual county budget, the county received $217 million in Coronavirus, Aid, Relief, and Economic Security (CARES) Act money from the federal government. As of November 2021, the county has allocated approximately $213 million of those dollars, with the remaining dollars being earmarked. The Center for Community Solutions has offered analysis previously on how the county used those dollars for public safety, which freed up general fund dollars and created a more stable foundation for the fund in cash reserves than compared to previous budgets. For the latest on the county expenditures using CARES Act funding, click here. Nevertheless, the county still finds itself wrestling with how best to move forward in supporting programs and organizations that have continued to serve on the front lines of the community, including supporting a population that faces mounting mental health strain associated with the impact of the pandemic. The county is also dealing with a workforce shortage, which means that economic development and workforce issues will become an even higher priority in the coming months.

 As of November 2021, the county has allocated approximately $213 million of Coronavirus, Aid, Relief, and Economic Security (CARES) Act dollars, with the remaining dollars being earmarked.

Finally, as was stated earlier, the county has received dollars from the American Rescue Plan Act to the tune of approximately $240 million. The county will begin deliberating in the coming weeks on how those dollars should be spent, now that the 2022-2023 county budget has passed. The county is also evaluating the future of the diversion center, both in the effectiveness of the current setup at Oriana House, as well as its potential permanent location.

Issue 33 and the 2022-2023 County Budget process

This county budget was also unusual because, due to the support of the county residents for issue 33 in the spring of 2020, the county underwent a mini-budget process last fall where the county had earmarked additional dollars for a number of agencies beginning in 2021. The county budget for 2022 and 2023 remains largely unchanged from the 2021 amounts. It was said during one of the testimonial hearings, that every funding increase request that was made by division heads to the budget planners, was denied by leadership in the county administration. This will be an important issue to keep an eye on in the next year as the county makes decisions on what positions will be filled and which will remain vacant, especially now that county revenues are higher than expected.

 The county budget for 2022 and 2023 remains largely unchanged from the 2021 amounts.

Mental health was identified in the presentation process, but funding increases were not approved

Over the last quarter of 2021, administrators presented their case on what their current allocation is for the 2022-2023 county budget. Very few agencies asked for additional dollars directly from County Council. MetroHealth, as has been widely reported, requested a line item of $10 million to be set aside for an effort which would streamline service delivery and improve outcomes from individuals who are in need of behavioral health and drug addiction services. The public critique of the current delivery of behavioral health services was unusual enough, made more unusual to have such a funding request take place during the budget hearings. Ultimately, County Council did not approve the funding increase request.  

Additionally, the ADAMHS Board requested an additional $1 million on top of the $43 million that was suggested in the executive budget. However, County Council did not approve that funding increase request.  

The county has not yet spent its allocation of funding from the opioid settlement, so it will be interesting to see what the county decides to do with this source of funding.

 The county has not yet spent its allocation of funding from the opioid settlement.

Other agencies such as the Department of Senior and Adult Services, saw their budgets maintained from the previous budget at approximately $24 million and staffing level maintained at 165.  

Cuyahoga County Department of Children and Family Services gains increase to add social workers

As far as Health and Human Services, Cuyahoga County Council did not make many major amendments to the executive budget. The biggest HHS amendment was an increase in the budget of the Cuyahoga County Department of Children and Family Services by $4.4 million over the biennium, in an effort to increase the number of social workers from 453 to 490.

Looking Forward: Justice Center and sales tax increase

The county has a series of major capital decisions related to the Cuyahoga County Justice Center, the future location of the county courthouse, as well as several other major capital projects. The county currently has $1.2 billion in outstanding debt, with a debt service of approximately $97 million for 2022 (as of October 2021). The county is about to issue approximately $200 million in bonds to finance the renovation of Progressive Field. The county is also looking at the potential costs of $450 million+ new Justice Center. The county executive has proposed extending a .25 percent sales tax that was passed for the convention center to be extended indefinitely, after it expires in 2027, as a means to buttress the general fund and to provide a major portion of funding for some of these major capital expenses including the Justice Center.

 The county is about to issue approximately $200 million in bonds to finance the renovation of Progressive Field.

Sales tax revenueThe good news is that the sales tax revenue in 2021 is expected to eclipse the sales tax revenue from the pre-pandemic levels of 2019. This means that the General Fund, while already with a healthy reserve due to outside support from the CARES Act, will have an even more stable financial situation over the coming biennium.  

American Rescue Plan ActThe county is also about the undergo public discussions on how to spend the $240 million that the county received from the American Rescue Plan Act. The Budish Administration will have the opportunity to work with a new Cleveland mayor for the first time since the new county governments inception. It will be interesting to see how the city of Cleveland executes its vision for the American rescue Plan act dollars and how it proposes to allocate the $511 million it received from ARPA.

 There can be no doubt that the decisions that will be made in the coming 12 to 18 months will have long lasting health, humanitarian and economic consequences.

There can be no doubt that the decisions that will be made in the coming 12 to 18 months will have long lasting health, humanitarian and economic consequences. Therefore, it will remain imperative that advocates stay engaged and informed on the county budgeting process forward.

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