TLRC: mental-health levy expanded services and stabilized providers but remains vulnerable to Medicaid changes

TLRC finds mental-health levy investments have expanded crisis response and stabilized community providers. The Tax Levy Review Committee’s midpoint review presented to the Hamilton County Board of County Commissioners on July 29 said the 2022 mental-health levy increase has supported higher provider rates, expanded crisis services and housing support, and investments in workforce development — while recommending ongoing monitoring for workforce stability and Medicaid-related financial risks. Chrissy, identified by TLRC staff as the mental-health levy review chair, told commissioners the levy supports services serving more than 30,000 residents annually, with about 86% low-income and 54% people of color, and that new leadership at the Mental Health and Recovery Services Board (CEO Leonora Godfrey) has prioritized provider stability. The committee cited faster payment schedules, contract-rate increases, expansion of 24/7 mobile response and school-based suicide-prevention, growth in supportive housing and wraparound services such as HomeLink, and workforce investments including recruitment and retention efforts. Assistant city administrator Lisa Webb told commissioners the mental-health levy has been utilizing fund balance since its last increase. The committee’s budget figures show a projected 2025 carryover balance of roughly $29 million and a projected balance of about $12.5 million at the time the levy would come up for renewal in 2027 (projections based on 2025 budget, not actuals). Committee members stressed that sustainability hinges in part on Medicaid expansion and warned that a rollback or reduction in federal funding could force major service cuts. The TLRC recommended continued monitoring of workforce stability, crisis-response funding and potential Medicaid changes. The committee listed the 2025 midpoint review as a status check midway through the five-year levy cycle; the next comprehensive review ahead of a 2027 ballot decision would begin in January 2027. The report did not propose immediate policy changes; commissioners asked TLRC to include reserve numbers and to continue tracking financial risks.