Committee of the Whole Meeting/Budget Hearing

Call to order

Meeting started at 1:07 p.m.

The meeting was packed, with MetroHealth and the Department of Public Safety & Justice Services presenting about major financial challenges and initiatives, including the opioid fund. Council members focused on reviewing these plans while expressing some uncertainty about their implementation and long-term sustainability.

Roll call

All council members were present.

• Patrick Kelly (District 1)
• Dale Miller (District 2), council president
• Martin Sweeney (District 3)
• Mark Casselberry (District 4)
• Michael Gallagher (District 5)
• Robert Schleper (District 6)
• Yvonne Conwell (District 7), vice president
• Pernel Jones Jr. (District 8)
• Meredith Turner (District 9)
• Michael Houser (District 10)
• Sunny Simon (District 11)

Public comment

Public comments came from several constituents, including board members, staff and patients of MetroHealth, all advocating for maintaining funding for the county’s hospital. Below are a few comments:

Loh – community member

Loh emphasized the critical role of MetroHealth in supporting all residents, especially those experiencing homelessness or extreme poverty, stating, “The funding for MetroHealth is the most important thing today.” Loh highlighted that “having those locations are extremely important, because these people are the ones having very little access … once they go into homelessness due to poverty” and stressed that providing primary care in these settings preserves health and supports the workforce. Loh warned that without adequate healthcare, the county’s future will be “dark” and “scary,” emphasizing the need for local support to help all residents thrive. 

John Moss – Metro Health board member, 15+ years

Moss, MetroHealth Board member for 15-and-a-half years,  addressed the committee, stressing the importance of continued support for MetroHealth. He acknowledged the county’s challenges, saying,“We know that you care about MetroHealth.” He emphasized the impact of federal cuts, explaining that “$400 billion is going to be cut from primarily Medicaid…. Medicaid is our bread and butter.”

Jae Williams, joined by Pastor Jimmy Gates – community members

Williams emphasized MetroHealth’s role as a lifeline for trauma and burn patients, noting that people often go “past Cleveland Clinic, go past University and end up at Metro.” Williams urged the committee to consider the impact of funding cuts, saying, “If any money is taken away … we’re hurting.”

John Corlett –  Metro Health board trustee

Corlett said MetroHealth is the “only remaining urban county-chartered public hospital in the state of Ohio,” serving more than 300,000 patients annually, two-thirds of whom are uninsured or on Medicare/Medicaid. He warned that federal and state cuts could leave thousands without coverage and asked the county to maintain funding levels to support care for all residents, saying the hospital cannot do it alone.

Jodie Mitchell – Well Link / Northeast Ohio Opioid Consortium

Mitchell emphasized the consortium’s collaborative work to address substance use disorder and reduce stigma. She noted that while overdose deaths have decreased, “We have seen an increase in emergency room visits with suspected drug overdoses,” underscoring the need for continued support.

Gail Wong – Metro Health patient

Wong called MetroHealth “one of Cuyahoga County’s finest and most valuable assets” and urged the committee not to cut the $35 million subsidy.

Matter referred to committee/discussion

Council Member Meredith Turner opened the session noting that departments presenting the 2026-2027 biennial budget provide services that impact residents daily. She asked each department to focus on key operational priorities, staffing needs, service outcomes, and major changes from prior years, beginning with MetroHealth and its CEO, Dr. Christine Alexander-Rager:

The MetroHealth System – President and Chief Executive Officer Dr. Christine Alexander-Rager

Alexander-Rager highlighted MetroHealth’s life-saving services, including Level 1 trauma and burn centers and a top-ranked rehab research program. Alexander-Rager noted, “We are the only hospital in Northeast Ohio to achieve level 10 informatics status, and only one of two in Ohio.” [Editor’s note: Informatics uses “computer and information science to manage data, improving patient care and outcomes,” according to the American Nurses Association.] The system reported rising demand of 14% more prescriptions, higher ER and outpatient visits, and expanded evening hours, alongside a projected $31 million operating loss and $90 million increase in charity care. Cost-saving measures include hiring freezes and program reviews. The 2026 budget is more than $2.3 billion due to staffing and facility expansions like the 300,000 square foot outpatient health center with a 24/7 drive-through pharmacy, which Alexander-Rager called, “a game changer for our community.” Alexander-Rager also stressed maintaining the $35 million Health and Human Services levy subsidy, warning that “a cut to $32 million means roughly 1,000 community members lose access to care and prescriptions.”

Dialogue/Questions

Council Member Simon raised concerns about transparency surrounding MetroHealth’s psychiatric emergency department closure, suggesting that “someone hasn’t been fully honest about where the funding went.” She questioned whether the state truly withdrew support or if “there’s more to the story.” Alexander-Rager responded that the “loss of $4 million in state funding directly impacted our ability to sustain the unit,” but she assured council that MetroHealth “remains committed to behavioral health through multiple points of care.”

Council Member Gallagher began by outlining his plan to introduce an amendment restoring MetroHealth’s subsidy to roughly $36 million, stressing the hospital’s vital role and remembered a colleague telling him once, “You can cut, you can trim, but you don’t touch Metro.” Gallagher went on to say: “And you got touched. That’s unacceptable…even though these are difficult times. I’ve never seen anything like this in my days.” He asked about MetroHealth’s plans and information provided at a previous meeting. Alexander-Rager clarified the difference between the Behavioral Health Hospital in Cleveland Heights and the psychiatric emergency room there, which is what is closing. The Behavioral Health Hospital will remain open. Gallagher criticized MetroHealth board members for their absence during a prior meeting. Gallagher strongly defended Alexander-Rager. 

Council Member Sweeney Thanked Alexander-Rager, the board and staff for their leadership and partnership, praising the clear explanation about the Behavioral Health Hospital in Cleveland Heights and the closure of the psychiatric emergency room there. Alexander-Rager highlighted the new Outpatient Health Center, which will be at the main MetroHealth campus. It will expand access to care, provide innovative treatments such as integrated cancer care, and repurpose space to meet community needs, including the 24/7 drive-through pharmacy. Sweeney noted that collaboration with neighborhood leaders helps ensure the community feels welcomed and supported.

Department of Public Safety & Justice Services (including opioid fund) – Director Brandy Carney

Carney provided an overview of the Department of Public Safety & Justice Services, including the opioid fund. She highlighted key investments, including $12 million and $23.8 million allocated to local addiction service providers such as Stella Maris, which expanded residential beds, community space and programming. MetroHealth’s dedicated jail pod and patient navigators have supported 3,700 individuals in medication-assisted treatment, with more than 4,500 patients linked to ongoing recovery services. The diversion center has served more than 5,100 individuals in crisis, 70-75% with co-occurring mental illness and addiction. Carney also noted initiatives such as community outreach, crisis intervention training for law enforcement, and a countywide public awareness campaign. Additional highlights included workforce development, emergency management accreditation, AMBER Alert leadership, and efficient grant utilization, with the 2026 budget supporting continued operations and strategic projects.

Questions/Dialogue

Council Member Conway asked if the vendor would coordinate with 211 and existing systems. Carney confirmed that the communications vendor, hired for a multi-year campaign, will work with agencies like 211 to avoid service duplication and stay aligned with community resources.

Council Member Gallagher pressed on the effectiveness and accountability of the diversion center, emphasizing that its primary purpose was to keep people out of jail. He expressed concern that the program hadn’t fully met its intended goal and that data on individuals diverted from incarceration should be more visible, stating, “That should be a blaze in the sky. Look at what we’ve done.” Gallagher also raised long-term financial concerns about funding for the new crisis center in Central, questioning why the $12 million commitment only covers three years and urging a binding agreement with the ADAMHSs board for the remaining seven years to avoid the county being “on the hook” for $70 million.

Carney explained that while the diversion center receives individuals from law enforcement, most admissions come from elsewhere and adjustments were made due to changing community needs, COVID-related jail reductions, and service gaps. She clarified that the new crisis center will provide expanded services beyond diversion and that the majority of its funding will come from Medicaid, Medicare or insurance, not the opioid fund. Carney acknowledged Gallagher’s concerns but emphasized the one-time nature of opioid funds and the need to structure reimbursement through standard healthcare channels rather than relying on county funds.

Council Member Houser asked about challenges from the hiring freeze, and Carney explained several staff losses due to grants and other financial issues, but said support from HR and the chief of staff has helped stabilize operations. On funding the Office of Violence Prevention, Houser questioned the contingency if the $2 million federal grant doesn’t come through. Carney responded that while the grant was previously rescinded and rewritten, they’ve applied again and are coordinating with law enforcement partners while also exploring additional funding opportunities to ensure sustainability.

Council Member Simon raised concerns about the sustainability and funding of the new crisis center. She asked, “How are you projecting that money to keep coming in to support the behavioral center without the county having to get more money?” She added, “I hope you’re not going to come back to us asking for money for this. I hope not, and that someone’s going to pay for transport, there’s going to be fundraising, and no one’s going to come back to us to pay this grant back.” She also questioned triage procedures: “Somehow, somewhere prior to getting there, somebody’s going to make a decision about whether they need a medical ED versus a behavioral health center?”

Carney explained that anyone, police, EMS, families, or individuals can bring people to the center. Most crisis centers nationally have low rates of hospital transfers, and sustainable funding models are being explored with the ADAMHS board. Simon emphasized caution, clarity and ensuring the county does not bear ongoing costs.

Office of Violence Prevention – Administrator Myesha Watkins

Myesha Watkins, administrator of the Office of Violence Prevention, has been in this role for 84 days. She presented on the office’s efforts to address the root causes of gun violence through community-based solutions. Initiatives include gun safety programs, countywide prevention tours, and partnerships with local organizations. Funding focuses on grants and community investment, with 70% of dollars going directly to programs. Council Member Patrick Kelly, a former police officer, highlighted firearm safety education, including the Eddie Eagle program he implemented and home gun safety classes, which Watkins called valuable resources.

Cuyahoga County Clerk of Courts – Clerk of Courts Nailah Byrd 

Byrd presented the office’s 2026-2027 budget and operations. She outlined the office’s role in managing court documents, fees and records for multiple courts, emphasizing transparency, accuracy and collaboration with judges and court stakeholders. The proposed budget is approximately $10 million annually, with 78% allocated to personnel and the remainder covering operating costs and chargebacks. Byrd noted there are no new initiatives, budget cuts or additional funding requests. 

Cuyahoga County Office of the Medical Examiner – Dr. Thomas Gilson

Gilson provided an overview of the office, noting autopsy numbers are expected to rise and the 2026 budget is $20.3 million, primarily for salaries and lab upgrades, including a CT scanner and improved data systems. He highlighted the office’s national leadership: “We are the most accredited public sector agency that I know of in the United States. We’re able to offer not only quality information, but quality solutions,” and he emphasized tracking violent deaths, transgender homicides, and suicide data.

On drug trends, Gilson noted a shift from opioids to stimulants like cocaine: “Unlike opioids, we don’t have a Naloxone antidote. This is going to be much more intensively behavioral-directed.” He flagged rising firearm suicides among people of color and the need for targeted interventions. Council Member Simon asked how to prevent stimulant overdoses from escalating, and Gilson said the focus must be on behavioral interventions, public education, and recognizing overdose signs such as heart complications, seizures or acute unresponsiveness and calling 911 immediately.

Department of Development – Economic Development Director Paul Herdeg

Herdeg highlighted the department’s small but impactful team supporting municipalities and businesses, with a $1.6 million staffing budget, $1.3 million operating budget, and an additional $2.5 million per year from casino tax revenue for loans and occasional grants. He detailed two major programs: the Economic Development lending program, which has approved 28 loans totaling nearly $39 million and created almost 2,000 jobs, and the Office of Small Business, which provides technical assistance, guidance, and funding to more than 3,000 small businesses, delivering more than 3,500 hours of support and $13 million in loans.

In response to Council Member Conway’s question about oversight of the lending program, Herdeg explained that two full-time staff manage loan compliance, monitor payments and reports, and follow formal policies for late or noncompliant loans. Any loans that exceed their legislative sunset period are reported to the clerk of council, with rare requests for extensions handled formally. He concluded that the department’s budget and programs are sufficient to continue connecting businesses to resources and fostering economic growth.

Department of Housing & Community Development – Director Anthony Scott

Scott, newly appointed Director of Housing and Community Development, provided a brief overview of his department. He emphasized its small but effective team and recent accomplishments and led a round of applause to his staff. He highlighted the department’s mission to ensure safe, affordable housing and vibrant, resilient communities, and he introduced key staff, acknowledging their critical behind-the-scenes work. Despite limited funding, the department has been highly productive, he said, administering more than $48 million in grants and loans since January 2024 for new development, home repair, lead abatement, and professional services. Scott noted HUD entitlements, CDBG, HOME, and ESG allocations as the primary funding sources supporting this work.

Scott also mentioned ongoing planning and collaboration with the administration, including a 90-day assessment to guide future initiatives. He stressed the department’s commitment to proactive strategies, responsible fiscal management, and maintaining high-quality service despite budget constraints. Council members commended the department’s accomplishments and expressed appreciation for the staff’s dedication.

Cuyahoga County Planning Commission – Executive Director Mary Cierebiej

Cierebiej gave a concise overview of her department, highlighting its small but skilled team of 20 full-time employees, one intern, and one unfunded vacancy. She emphasized their work in community planning, GIS mapping, economic development lending, and support for municipalities, all delivered cost-effectively compared to private consultants. She outlined the department’s careful budget management, noting that past shortfalls were addressed early, personnel is the top priority, and creative cost-saving measures are continuously implemented. She highlighted that 76% of the budget goes to personnel, and revenues generated, including grant funds, are returned to the general fund to benefit the broader community.

Council Member Jones asked about potential federal changes on the department’s operations. Cierebiej noted the department does not rely on federal funds, though some grants, like the Safe Streets and Roads for All grant, were deferred due to contract delays. On budget projections for 2026 and 2027, she estimated a possible $180,000 shortfall per year in personnel services but stressed no reduction in staff or services is planned. The department continues proactive work with municipalities on zoning, transit-oriented development, and small business support to ensure communities are ready for investment and growth.

Cuyahoga Soil & Water Conservation District – Executive Director Kristen Hall

Hall highlighted the work fostering a healthy, resilient urban environment through Soil & Water Conservation, community engagement, and environmental stewardship.  Hall emphasized outreach and education programs, watershed and stormwater management, stream restoration projects totaling more than $1 million, and leadership in the Cuyahoga River Area of Concern. She also noted the Healthy Urban Tree Canopy program, conservation action grants, and plans to expand soil health programs in 2026 and 2027. The organization recently celebrated 75 years of being an organization. Hall recognized her dedicated staff and partnerships, including the National Wildlife Federation for the Sacred Grounds program, and she explained that the department operates efficiently on $150,000 in county funds while leveraging state matches and municipal service agreements, with over 80% of funds supporting staff salaries. She concluded by stressing ongoing goals to improve efficiency, enhance service delivery, and expand soil and forestry initiatives while inviting residents and council members to stay engaged with the district’s programs.

Department of Sustainability – Director Melanie Kinter Knowles

Knowles presented the 2026-27 budget and highlighted recent departmental changes, including the transition of programs like Cuyahoga Green Energy, BYO Bags, and Healthy Urban Tree Canopy to other departments. She outlined new initiatives, including the Freshwater Institute, which runs youth education, workforce programs, and regional freshwater collaboration, as well as the municipal climate action pilot and toolkit for municipalities. Council members asked clarifying questions about funding for the Freshwater Institute director position in 2027, and Deputy Chief Jenita McGowan confirmed it is currently in the general fund but they are seeking additional grant funding. Council also discussed ongoing sustainability collaboration, loan programs, and the need for labeled recycling stations to reduce contamination in offices. Overall, the discussion focused on funding, program transitions and continued engagement with county communities.

Department of Public Works – Director Michael Dever

During the Cuyahoga County Public Works budget presentation, Dever provided an overview of ongoing and upcoming projects, including road and bridge maintenance, facility upgrades, lakefront improvements, and the Hilliard Road Bridge. Dever highlighted the community corrections facility, noting a $30 million state grant from the Ohio Department of Youth Services, a design-build contract in progress, and plans for HHS consolidation and sewer projects in Olmstead Township. Council dialogue focused on decision-making timelines for the Justice Center, with council members pressing for clarity on funding and investments.

Council Member Simon raised concerns about the women’s bathroom in the old courthouse, emphasizing the need for renovation and updated furniture to support domestic relations operations. Matt Reimer, facilities administrator, confirmed the design is complete but full renovation awaits funding approval and court acceptance, while Simon pressed for a concrete plan and timeline.

Council Member Gallagher expressed frustration over the Justice Center’s redevelopment, referencing prior ADA compliance cost estimates and emphasizing that the county lacks sufficient funds to renovate the existing facility. He criticized delays, stating, “Why are we playing games with this? Let’s make a decision and get moving.” He highlighted tension over escalating costs, prior assessments, and uncertainty on whether the county should stay in the current building or pursue a new facility.

Department of Public Works – Cuyahoga Green Energy Public Utility – Administrator Mike Foley

Foley outlined the division’s accomplishments and upcoming projects, including a $129 million U.S. EPA climate grant, development of solar projects at MetroHealth, Euclid, Brooklyn, school rooftops, and the new county jail, as well as public EV charging stations at Huntington Park, Harvard Road, and the jail site. Foley noted that much of the next few years will focus on implementing these projects, navigating federal tax credit rules, and completing the Euclid microgrid and residential solar co-op programs, though the latter is temporarily on hold due to changes in tax incentives.

Council members asked clarifying questions about EV charging station counts, school agreements, and the jail solar site, with Foley providing details on project timelines, school participation, and funding. The presentation concluded with Council President Miller confirming no further questions and reminding members of the upcoming Committee of the Whole session for additional budget discussions.

Miscellaneous business

• None

Adjournment

Meeting adjourned at 5:15 p.m. 

These notes are by Documenter Mikayla Coleman.

If you believe anything in these notes is inaccurate, please email us at documenters@signalcleveland.org  with “Correction Request” in the subject line.