Thursday, October 21, 1999
Council affirms clinics are a priority
Rising costs may put city in red
BY PHILLIP PINA
The Cincinnati Enquirer
A day after learning that cost increases at Cincinnati's health clinics are a major contributor to a budget shortfall expected by 2003, city leaders said funding the centers is a priority.
At their Wednesday meeting, several Cincinnati City Council members railed at City Manager John Shirey for not warning them sooner on the city's financial outlook.
The day before, Mr. Shirey updated his six-year general fund forecast, which shows an $18.8 million shortfall by 2004. Rising costs at the clinics will account for nearly $16 million of that deficit, noted Councilman Charlie Winburn.
Yet, while bemoaning the budget outlook, council members unanimously directed Mr. Shirey to find alternative ways to fully fund the health centers.
“Citizens should not be forced to go without health care,” said Councilman Paul Booth.
City leaders are blaming an increase in the number of uninsured patients at the health clinics for a potential $2.7 million health department budget shortfall in 2000. Welfare reform programs mean thousands of residents have lost their Medicaid coverage, a city report said.
Unless the city makes up the shortfall, the clinics may have to cut two doctor positions, two dentists, eight nurses and some pharmacists. Projections show as many as 7,000 people may not get medical services anymore because less staff would mean fewer clinic hours, longer waits, and restrictions on new patients.
Finding the money, while dealing with a bleak financial outlook, will be a task. But the health of city residents is too important an issue to ignore, Mr. Winburn said.
Council members said the job would be a lot easier had they known the potential for a budget shortfall. As recently as last month, Mr. Shirey's six-year forecast showed a $7 million carry-over from the 2004 budget.
“I don't know how we go so far on the one hand, to so far on the other,” said Councilman Todd Portune. He said council members were being asked to make decisions without all the facts.
Several of those decisions were highlighted by Mr. Shirey's report on the six-year forecast. Along with rising costs at the health clinics, other reasons for the shortfall include a property tax rollback approved this month, a $3 million cost overrun in the fire division and an increase in debt service for the Albert B. Sabin Convention Center expansion, approved on Sept. 29.
But Councilman Tyrone Yates said there were warning signs. The city administration had warned about the possibility of the health clinic increases, he said. And large projects are dependent on city money, such as Fort Washington Way and riverfront improvements, he said.
“I knew there would be a day of reckoning,” Mr. Yates said.
At Wednesday's meeting, Mr. Winburn suggested the city let voters decide whether to create a citizens spending and waste-reduction panel. The panel would review city services and look for ways to cut costs. Council sent the idea to a committee for review.
There have been panels with similar goals in the past, noted Councilman Phil Heimlich. He supports the idea if it includes business leaders and others who can get it done. But he added that the city already has a citizen group charged with cutting taxes and waste: City Council.
“We shouldn't blame Mr. Shirey” for the forecast, Mr. Heimlich said. “He gave us a budget. The discipline has to be on us.”
Also Wednesday, council voted to keep a series of steps linking neighborhoods closed for at least another five years. Calling the steps a conduit for criminals, residents along Klotter Street in Fairview got the city to close them about a year ago. A review has found that crime has fallen about 50 percent in that neighborhood since.
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