County Millage for Human Services?
Five of Washtenaw County’s top elected officials – the sheriff, prosecuting attorney, clerk, treasurer and water resources commissioner – sent a letter to the Board of Commissioners Thursday morning asking the board to consider putting a countywide millage on the ballot in 2010. The millage is aimed at raising money to fund human services programs.
But their main message was this: The county’s basic mandated services – those that are required by law – can’t endure additional funding cuts.
The letter comes at a crucial moment in the county’s budget process, as officials battle a projected $30 million general fund deficit over the next two years. At their Sept. 16 board meeting, county administrator Bob Guenzel will be presenting budget recommendations, which will likely include job cuts. Commissioners – who are also elected – will spend the next two months deliberating, with the goal of adopting a 2010/2011 budget at their Nov. 18 meeting. County administration has tentatively set a public hearing devoted to the budget on Oct. 22.
Over the past few months, supporters of many human services programs funded by the county – from 4-H to Food Gatherers to vocational training for the developmentally disabled – have lobbied commissioners during their public meetings, making often-emotional pleas that programs not be cut.
Larry Kestenbaum, the county clerk/register of deeds, told The Chronicle on Thursday that he and other officials who sent the letter were concerned because there had been no voice of support for mandated services. Each of the five officials who signed the letter have responsibility for supervising mandated programs, ranging from staffing the county jail to prosecuting felonies and misdemeanors to recording documents like birth certificates and deeds.
Kestenbaum, who’s been designated as a spokesman for the group, said they aren’t attacking the value of the human services programs that the county funds. That’s why they’re proposing a millage specifically for that purpose, he said. But at the same time, they believe that mandated programs have already been cut to the bone and can’t sustain additional budget reductions.
This summer, commissioners passed the first phase of cuts to address the projected deficit. The $6.7 million in cuts included eliminating at least 26 jobs – many of them in departments responsible for mandated services – and reductions in compensation for non-union workers. The county administration has also been negotiating with union leaders over the past few months, hoping to gain wage and benefit concessions. About 1,000 of the county’s 1,350 employees are represented by 17 different bargaining units. If the unions don’t agree to concessions – at one point the county needed to gain as much as $12 million – then the next phase of budget cuts could be draconian, Kestenbaum said.
Though Thursday’s letter doesn’t propose a specific amount for the human services millage (see below for full text), Kestenbaum said that 1.5 mill would likely be adequate, raising about $22.5 million annually. Providing this funding mechanism for human services would help alleviate the budget pressure on mandated services, Kestenbaum said.
Currently, the county levies 4.5493 mills, and has a roughly $102 million general fund budget. [Previous Chronicle coverage of the county budget situation includes: "County Board: Plan for the Worst, Hope for the Best"; "Opening Up the County Budget"; "Pizza, Payroll and Budget Pain"; "County Considers $12 Million More in Cuts"; and "County's Budget Crisis Gets Emotional."]
The Letter
The group of five elected officials have been meeting regularly since early 2009 and have a good working relationship, Kestenbaum said. Much of their discussion has focused on the budget crisis. Knowing that commissioners would be presented with budget recommendations later this month, a week ago the group met for lunch at Quarter Bistro and decided to move ahead with a letter proposing the human services millage. Brian Mackie, the county’s prosecuting attorney, drafted the letter, with input from Kestenbaum, sheriff Jerry Clayton, treasurer Catherine McClary and water resources commissioner Janis Bobrin:
Commissioners:
As office holders elected to provide essential services to all the people of this county, we have watched the budget process with great interest and growing concern. Having attended your committee and Board meetings, as well as the retreat held on April 11, we are concerned that competing demands for a vast array of programs and services have led to the lack of a clear Board consensus to adequately fund the basic mandated services that our citizens demand, pay for, and are entitled to as a matter of law and responsible government.
We have spent much time this year answering questions designed to inform the budget process. We have documented those services that are mandated by the Michigan Constitution and by statutes. We have worked through worst-case scenarios illustrating what would happen if the services we must provide were cut even further. These exercises further illustrated that across-the-board cuts, by whatever name, are not responsible. The essential services of county government – the reason that county government exists – cannot be cut further.
We are aware that the Board has a tradition of generous funding to non-governmental organizations that provide important human services. We also support these services. Clearly, however, county government can no longer provide tax money to generously support non-governmental agencies, and even certain important but non-mandated services within County government.
The commitment of members of this Board and the people who tirelessly lobby commissioners illustrates the strong support for human services in this community. To harness this support and provide adequate funding for these non-mandated services, we propose that a human services referendum be placed on the November 2010 ballot to fund those services that county government can no longer afford to support with current tax dollars.
We believe that the taxpayers should have a direct voice in determining if we should support good, though non-mandated services, and that service providers should become our partners in securing a sustainable source of funding by working for passage of such a millage. The likelihood of success is great when the cause is the right one. Recall, for example, that a millage to support Safe House passed in 1992 with over 60 percent of the vote. A human services millage would have an even wider potential base of support.
As county-wide elected officials, we commit to supporting and campaigning for a human services millage. We urge the Board to take the necessary action that will allow us to do so. We also urge the Board to adopt a budget that ranks those services mandated by the Constitution and state law as its highest priorities.
What’s Next?
Kestenbaum said that the five elected officials had discussed a possible human services millage with commissioners earlier this year. “They were in a general way receptive,” he said, “but they didn’t pursue it.” Though the five department leaders are elected, just as county commissioners are, it’s the commissioners who hold the pursestrings, Kestenbaum noted. “This is a policy matter – this is for the Board of Commissioners to decide.”
Ultimately, if commissioners do put a human services millage on the November 2010 ballot, Washtenaw County voters would make the final decision.
I think a human services millage is well worth considering. Are other such millages possible? Is there any legal restriction governing their purposes or amounts?
I believe we owe thanks to these five for their bold statement.
They have issued a timely and important call for the Board of Commissioners to place a millage on the ballot to fund human services. Several of us have discussed this course over the last six months as we navigated the budget challenge, and I for one believe it is the right one. The people of Washtenaw deserve the opportunity to more actively fund the county’s programs rather than being subjected to the cuts forced on us by a declining economy.
As the chair of the Ways & Means Committee of the Board, I am confident that the budget advanced by the commissioners will give sufficient support to the services mandated by the Constitution and state law to allow their smooth functioning. At issue always is the question of “serviceability” (to what level to we fund our mandates?) and more importantly how we make strategic and systemic investments that reduce the costs of those mandates. Our mandates are, by their very nature, a service of last resort. They are put upon us to ensure that when all other courses fail, the people may have confidence that their health and safety are protected. Frequently, the mandate that is “the cure” is more costly and more disruptive than the “preventative medicine” that it is our option to provide.
Such is often the case with our support of outside agencies. An investment in a nonprofit that provides housing or food may very well keep individuals out of the shelter or our jail. While we can easily articulate the cost differential (almost always to the public’s benefit), the social “return on investment” here is simply immeasurable. The people of Washtenaw recognize this principle — certainly their willingness to invest in SafeHouse as our countywide officials note in the letter is evidence of their interest in more comprehensive solutions to our challenges than simply funding our mandated services allows.
The right answer, in my mind, is to ensure that each aspect of the programming that allows us to fulfill our mission and our purpose as county government is sufficiently funded to adequately, if not optimally, perform.
There very well may not be enough money in the system to do that. Some argue that there is waste or extravagance at the county, but I do not share that perspective. We have a high-performing organization that delivers world-class results. Our current funding (due to Headlee reductions, cuts from the state and a declining economy) is insufficient to continue providing services at that level.
As a resident and taxpayer, I am dismayed by this, as it comes at at time when the provision of excellent public services is so much more meaningful for people’s immediate needs (e.g. community health, housing and hunger) as well as our long-term prosperity (e.g. intelligent and strategic investments in economic development).
As a voter and an elected official, I am happy to put my name and energy alongside our five bold countywide officials in support of the effort to secure the revenue needed to maintain our county services.
Sounds serious and difficult. The elected officials are to be commended for taking an explicit stand.
Personally, I am overall indifferent to the issue. I certainly can support community health. I wonder about the value of 4-H funding with 10% of American’s out of work.
Having a vote on the issue seems reasonable. The individual beneficiaries can be identified and the people who are going to pay for it can make their choice.
I think that this is a good idea worthy of further discussion. I’d like to think that the citizens of Washtenaw County would react well to a targeted millage that leveraged taxpayer resources with the existing non-profit infrastructure. However, since money is fungible, I’d want to make sure that a substantial percentage of the funds raised via this millage was dedicated to be redistributed to the non-profits who are working to provide some of these mandated services. Otherwise, this millage could just become a back door way to fund deficiencies in other County departments.
I share the concern of the five elected officials about mandated services. They are the bone and nerve of our governmental infrastructure, essential to maintaining a civil society. (I’m puzzled by what Cmr. Smith says about them, “Frequently, the mandate that is “the cure” is more costly and more disruptive than the “preventative medicine” that it is our option to provide.”)
If I understand the logic, it is to have a millage for human services so that mandated services will not be cut. Do these veterans of countywide elections believe that this is more likely to be supported by county voters than a simple Headlee override? My experience with countywide millage issues indicates a strong skepticism from many township voters about being charged for services they do not believe that they benefit from. I’m wondering how well a human services millage will fare, considering that most recipients of those services are thought (rightly or wrongly) to be from the urban area. Or is the subtext that the human services will be cut out if the millage fails?
@ Vivienne, I do think that this would be an easier sell than a Headlee override since it is easier to explain and more targeted. Especially if a substantial proportion of the funds raised were dedicated to the non-profit sector which I sense still enjoys the respect of most citizens (perhaps unlike some government departments.) Most people have no clue how the Headlee Amendment works. You do make a good point about the potential selfishness of the voters with respect to “what’s in it for them.” But then, childless couples (such as myself) do vote for school millages!
Bob, hope you are right.
I should have been a little less terse: I hope that you are right. (I’m childless and vote for school millages too.)
If the comments on the annarbor.com site on this same topic are any indication, then my optimism may have just flown out the window.
Here is the link to annarbor.com in case anyone wants to get to their story and “discussion” quickly:
AnnArbor.com specializes in anonymous trolls who post negative comments on everything.
If AnnArbor.com runs a poll on the issue, that will be more significant. Typically over 700 people cast votes on these polls.
I’m don’t have a position either way on the millage until the details become available, but I suspect that passage will be a difficult hill to climb.
As I see it, there are a handful of County insiders that support a millage, but they have little connection to the general population who will be voting on the initiative. Its my experience that they do a very poor job of selling the need for this type of tax. As ballot initiatives go, the no position is always an easier sell, just look at the whole jail expansion vote.
If were setting odds, I’d say its about 12 to 1 that this passes. II’d even bet about 5 to 1 that it even gets on the ballot at all…
Good luck Larry, you have your work cut out for you.
Yeah, I know Chronicle readers are a bunch of high-monded insider/elitists compared to the annarbor.com readers! ;)
Still anarbor.com’s posters are not as bad as those on the Free Press or Detroit News sites. Have you ever bothered to look at that drivel! I don’t know why they bother to keep the posting active. I’d have killed it a long time ago.
Bob…
I read your comment at Annarbor.com and offering a reasoned response, I would never support a millage used to support area non-profits. I agree there are a few that are well run and deserving of support (Food Gatherers and Delonis Center), but there are massive inefficiencies, with no discernable outcomes and oversight.
Most of the non-profits are funded based more on politics and personal affiliations, with little regard to the quality and need for the services provided. I could support a millage if it was meant to enhance mental health services through CSTS or an expansion of the Washtenaw Health Plan, but they are going to suggest distributing the funds among non-profits, it’s a non-starter.
Richard, This format does have some limitations with respect to promoting thorough discussion, but I thank you for your comments as they provide me with the opportunity to further clarify my thoughts.
I was indicating that I would support a millage that dedicated a meaningful portion of the money raised to be used to fund non-profits that are currently providing County mandated services (such as your example re: The Shelter Association @ Delonis) or otherwise contribute directly to the support of County mandated services such as Food Gatherers and various mental health programs (and there are many other examples that I shall not mention.)
I see certain non-profit organizations as being quite capable of providing services less expensively than can the County, also they can leverage donated dollars and the “dedication to mission” that is so often a part of the employees and volunteers or those organizations.
I did not mean to suggest that any funds would go to support non-mandated services (I will refrain from giving any examples so as not to offend) and I would also expect that there would be some active oversight by the County for quality control and cost effectiveness.
I am always amazed at how cost effectively a well run non-profit can deliver direct services and, in this age of shortages, we need to stretch our dollars as far as they will go. I simply believe that partnerships between the County and certain non-profits needs to be explored and where sensible, expanded. Such partnerships need a steady and dependable funding source, hence the need for the contemplated millage.
I have to disclose that I have not read the letter prepared by the five elected officials that is the subject of the above article, so I do not know if the concept that I am embracing fits with the vision of those individuals. I’m sure that at some point, we will learn more about their intentions.
Since I do not know your last name I do not know if we know each other, but, if we do (or did) know each other, you’d realize that I am far from a proponent of non-profit proliferation. And, while they are certainly by and large well meaning, I see many non-profits in our community that are simply not cost effective or viable and I would not want any millage dollars going to shore up such organizations.
Please be advised – the services referred to in the discussion of a human services millage are all NON-mandated services.
The county is NOT mandated to support grants to non-profits, nor is is mandated to fund such county departments as Head Start or MSU Extension. You need to understand that in no way is Washtenaw County MANDATED to provide money to either Food Gatherers or to the Delonis Center.
If you look at the budget documents on our web site, you will see what is “mandatory” and what is “discretionary”.
I am a strong supporter of putting a human services millage on the ballot because county revenues in the near future will not be able to support even mandated services at the level that we need. The County has no ability to raise taxes, and revenues from property taxes (upon which the General Fund is based) have fallen.
And the State of Michigan is in such disarray that we can expect no help from them.
The local non-profits that the County funds do a better job and in a more cost efficient manner than government can. And, they are held accountable for carrying out the grants they receive – they are in the form of contracts with measurable results. Washtenaw County does not waste the taxpayers’ money on non-performing non-profits.
As to whether or not there are too many non-profits, that is a discussion definitely worth having.
Leah and Bob,
I appreciate your responses. I would only make one suggestion, which I hope you will consider.
The County should clearly define the priority outcomes it seeks achieve and fund to those needs. If you could articulate the specific needs to the County taxpayers, the millage would be more likely to succeed. The problem with the County, as I see it, is far too often (and with 11 separate commissioner agendas) it tries to be all things to everyone. Instead, it needs to focus its resources where it can have the biggest impact.
Leah…while I agree the County does a decent job of funding non-profits in an efficient manner and seeks measurable results. The measurable results are not verified, nor are the benefits to the community articulated in any meaningful way. As an example, many of the non-profits serve the same people and families, which results in a lot of double counting. These individuals are also served by ETCS, CSTS, and Public Health and are likely on Medicaid.
I’m not saying that the services aren’t important and the families shouldn’t be served, it just distorts the impact.
I also, from experience, think the County funds a lot of needless programs based on the potential availability of state and federal funding.
Regardless…it’s just my opinion.
The Chronicle provided a document that listed mandated services some time ago. My indexing system is not up to finding it. Is it possible to post it again here to aid this discussion?
Here are a few links from board meeting materials in March 2009:
County Mandated/Discretionary Department Analysis
County Services with Funding
The County has many complicated criteria and a complex scoring system for deciding who, among private non-profits, gets funded, and they are required to report back to us their results. If the results are not satisfactory, the funding is not renewed.
And, there are times when many agencies must serve the same client because the person is in need of many different services – some through government (federal, state and county) and some through services from non-profits. For example, a mother may be receiving substance abuse treatment through CSTS, while her children may need Medicaid. Her baby may be in need of WIC services, and one of the children may need special educational services from the public schools, while another attends Head Start. She is also in need of affordable housing or homeless sheltering. And, at the same time, the father may be in prison. Did you know that there are about 20 agencies that provide services in the Delonis Center? These so-called “overlapping” services are not duplicative – they are simply fulfilling the multiple needs of a family in distress. And, to be even more complex about the whole thing, agencies can be funded through governments as well as private funds. For example, if you read the annual reports of many of the non-profits, they leverage private giving to receive government grants, and also the opposite.
The pressure on local non-profits, and the inability of local governments (the only other local government that funds human services is the City of Ann Arbor, I am proud to say) to fund them, is at a crisis point, and that is why this whole idea has been put forth.
Hi Leah,
Thanks for that clarification. Am I correct in assuming that the types of services that would be supported by such a millage are related to the County’s basic social welfare functions? By social welfare I mean homelessness, hunger, mental health, medical care, and the like? If so, that would fit within my thinking of “mandated services.” Perhaps my use of that terminology in the earlier post was not as precise as it should have been.
I do agree with Richard that there seem to be a lot of government and non-profit “departments and agencies” (with the associated plethora of initials) that overlap and in many cases appear to offer duplicative, redundant and often complementary services. And of course, each of these organizations brings it’s own overhead to the party (anyone who follows my posts certainly knows my position on overhead!) and some are undoubtedly more efficient and effective than others.
I’m sure that when a lot of these organizations were created it was in response to some need or funding opportunity at the time. Is there any consideration to giving all of these organizations a top down review to see what opportunities exist for efficiencies by combining some of them? I suspect that if the voters were shown a well thought-out and comprehensive restructuring plan which showed some cost savings, that they would be more likely to support the millage we’ve been discussing.
Andy, Thanks for your post with the mandated/discretionary breakdown of County services. I did not notice it before I replied to Leah. I’ll look at it now.
Bob, “mandated services” are those required by state or federal law that counties have been given responsibility for. What may be confusing you is that Washtenaw County has provided some services for so long that it has been taken for granted that they are required and expected, whereas it has actually been through the actions of the BOC (for decades) in spending discretionary funds. Also, the State of Michigan supplemented many federally-mandated services (delivered by counties) for decades and that funding has disappeared. Another source of confusion is that the county has amplified and supplemented mandated services by putting in general funds to pay for services beyond the mandate. So some people are mandated to receive mental health services who are Medicaid-qualified, but the county expanded the scope of those given service through supplements to CSTS, for example.
The example of a collection of services needed by one individual family that Leah provided also points to the need for case workers to help coordinate services. Funds for that case work may not be part of the funds allocated for mandated services.
What we are seeing is a breakdown of our entire social safety net that we have enjoyed for many decades, because of the economic crisis and also because of the tax resistance movement, that has tied the hands of local government (e.g., Headlee). It is hard for us all to comprehend that this safety net will go away because it has “always” been there.
I just wish we hadn’t built all those buildings.
Leah,
I understand your point, and I am very familiar with the scoring system used by the County. I believe you greatly exaggerate the impact and the level of information received from those agencies through the application and reporting process. Those numbers are easily massaged to show greater impact for budgetary purposes, I know, I’ve been witness to it firsthand.
As I’ve said before, I’m not part of the knee jerk anti-tax crowd and I want to see the County provide a high level of service. However, I would argue that the County Board and bureaucracy have very little interest in taking the difficult steps to actually understand the impact of services and clearly define any real outcomes.
The non-profit world in Ann Arbor and Washtenaw County is highly politicized and while I believe you are sincere in your desire to provide high quality service and maintain an adequate social safety net, I question the ability of the Board of Commissioners to make the tough choices demanded by the current economic situation.
I offer my comments respectfully and I wish you would make an effort to understand my point and not be so defensive in your response.
We don’t need a millage to vote whether we should collect additional taxes to fund human services through charitable agencies. Individuals are free to fund those services. That local governments mandate charitable giving to a few selected charities is an encroachment of our freedom. For years the county has reached into taxpayers pockets to fund a “Healthy Babies Initiative”. The result has been a 75% abortion rate among pregnant low income minority women enrolled in this program administered by Planned Parenthood. If funding for this slaughter had not been coerced, I doubt they could have successfully raised the millions we have contributed to fund this atrocity. I strongly suggest that the county concentrate on providing mandatory, necessary services and let us determine how best to direct our charitable giving.
Eos, from where exactly do you get these statistics?
I blog under my own name, Richard.
I find that “EOS” comments reflect a harsh ideological rather than a well-reasoned position. He/she/it obviously has limited experience with trying to make judgments on which charitable organizations to donate.
I own a small business and for 17 years we get phone calls from various charitable organizations asking for donations. Some are meritorious, others are scams. It is sometimes not easy to figure out which are which.
I welcome my elected representatives trying to sort out which is which. I do not agree with all of their choices but on-the-whole they probably do a better job than I would on my own.
The statistics came from the 2007 Children’s Well Being Progress report submitted by Planned Parenthood Mid-Michigan to the County that is required as a condition of having received funding. In addition, I used the Community Grants Outcome Funding Application submitted by Mid-Michigan Planned Parenthood to the county in 2007 requesting a $100,000 grant for 2008. In 2006-07 the Mid-Michigan Planned Parenthood grant title was changed from prenatal care to comprehensive prenatal care. Because of an ACLU lawsuit, “comprehensive prenatal care” must include access to abortion services for any woman who “chooses”. Under the guise of funding “Children’s Well-Being” we are using county tax dollars to encourage and pay for low income women to abort their babies. Planned Parenthood’s stated target objective in 2006 was to provide 315 patients with prenatal care and to deliver 125 healthy babies. This is shocking! They clearly state that their goal is to have only 27% of the pregnant women referred to them actually give birth. The actual numbers show that they provided care for 510 women and only delivered 126 babies (24.7%). One baby was of low birth weight and so they reported a greater than 99% success rate. The incidence of low birth weights is being reduced by reducing the number of babies being born to already pregnant women.
County-wide statistics show low birth weights occur in 8.4% of all births, and 14.8% of African American births. Nationally, 30% of pregnancies result in abortion. Our taxpayer dollars in Washtenaw County are being used to target low-income African American women and perhaps lead as many as 75% of them to abort their babies. This taxpayer funded eugenics program has continued and expanded over the past 12 years.
Mandated taxpayer funding of Planned Parenthood of Mid-Michigan results in more than doubling the number of abortions that would
occur in this target group without this subsidy from the county. It certainly doesn’t contribute to the “Children’s Well-Being” in our county. And this grant does nothing to help the women with the grief and depression that usually results from an abortion. It further endangers the health of subsequent babies born to these woman because, as recent studies have shown, babies born to women who have previously had an abortion are much more likely to be of low birth weight and suffer from cerebral palsy and other disorders. Studies have also shown
that the women themselves are more likely to get breast cancer as a result of having had an abortion.
The County can not afford to continue to take money from citizens to be used for the slaughter of our children. Apathetic residents who don’t pay attention to how the County Commissioners have spent our money are to blame. Because of the current fiscal crisis, we need now, more than ever, to reign in the spending of the county and donate as individuals to the charities of our choosing.
Once again we see the “Tax and Spend” approach to resolving problems. Guenzels cronies are leading the charge to raise taxes. I guess we should be used to this by now.
Leah,
You state, “The County has many complicated criteria and a complex scoring system for deciding who, among private non-profits, gets funded, and they are required to report back to us their results. If the results are not satisfactory, the funding is not renewed.”
I have studied the 2009-11 Human Services Ranking Criteria as posted on the County Web Page. The paradigm for evaluating the comparative value of requests for funding awards a total of 70 points.
10 pts Clearly stated outcome
10 pts Targets economically vulnerable
7.5 pts Identify how target population is reached
7.5 pts Quantifiable performance targets
5 pts Key people are listed on application
5 pts Requester collaborates with other agencies
5 pts Requester already has some funding
5 pts Requester has had county funding in past
5 pts Bonus if request provides shelter or food
10 pts Provides for a community need
Don’t you see any flaws in this evaluation grid? Shouldn’t the main priority be that the program provides for a real community need and that it does so in fiscally responsible manner? Why doesn’t the evaluation include whether funds awarded would address the problems in a judicious and cost effective manner? Shouldn’t priority be given to problems that are not currently being satisfactorily addressed by other programs, rather than awarding points for duplication of services/collaboration?
30 of the possible 70 points are awarded for merely providing clerical information. 15 of the 70 points are awarded if they can identify another agency already currently working on the problem, that they can show that they already have funds to accomplish their stated goals, and that they have been lucky enough to have gotten funding from the county in the past. Only 25 of the possible 70 points even attempt to address whether the program is worthy of funding – that it targets the poor, focuses on food or shelter, and/or provides for a community need.
As our elected representatives, shouldn’t the commissioners do a better job at ensuring our hard earned dollars are better spent?
EOS’ passion is obvious and his use of statistics is questionable. I am researching his comments regarding the prenatal program funded by the County and hope to have some substantive facts to post.
Bob,
Let me help. Ask for a copy of Grant Application #1949 from Aug 2007.
As an employee of Planned Parenthood and someone very familiar with the grant and our prenatal program I have to set the record straight. Planned Parenthood started providing prenatal care over 10 years ago because low income women had few options for care in Washtenaw County. Today, our Ann Arbor and Ypsilanti health centers are the only choices for women on Medicaid to received prenatal care in a community setting in the county. Their only other option is University of Michigan Medical Center.
The program is “comprehensive” meaning that women not only receive prenatal medical care from Nurse Midwives, they are helped with Medicaid enrollment (eligibility is expanded for pregnant women) and they can also consult with a nutritionist, and social worker. Our patients are encouraged and supported to breast feed and once she delivers her baby each patient is provided birth control to help her prevent an unintended pregnancy. Most of the women in our program are very low income, with multiple life issues which put them at risk for delivering a low birth weight baby. Our patients thrive under the comprehensive care they receive in our program and as a result, our low birth weight rate is a fraction of the County average.
Now to the statistics that EOS quotes. Yes, last year we did provide prenatal care to 350 women (25 more than we committed to seeing under our grant through the County Children’s Well Being Program) and delivered 125 health babies.
Some women must transfer out of our program because their pregnancy is high risk and must be seen by the physicians at University of Michigan. In addition, low income families are very transient. Some leave our prenatal program because they move out of the area to live with a family member or take a job. As a result these women don’t deliver their babies in our program.
But, the biggest differential is because those statistics represent a 12 month “snapshot” of time. If the program numbers are counted from January through December those women who join the program in say June and November are counted in those who we provide care to, but since a pregnancy is 9 months long, their delivery will not be counted until the following year.
Unfortunately, the cost of this program far exceeds the reimbursement from Medicaid. The grant from the Children’s Well Being program and private contributions are the only way we can afford to continue this valuable program.
Women who join our prenatal program have already made the decision to continue their pregnancy and Planned Parenthood is proud to be the organization in our community that is helping them deliver healthy babies.
“The grant from the Children’s Well Being program and private contributions are the only way we can afford to continue this valuable program.”
- Because the Hyde Amendment prohibits Federal funds from being used to pay for abortions. Medicaid is already paying for their prenatal care.
Leah,
I would blog under my own name, but having worked for and with County…I don’t wish to subject myself to anymore petty retribution from people like you.
As I said, I offered my comments respectfully and I made no personal attacks. If you can’t stand the criticism, perhaps you should find another vocation.
Richard, I supposed I can understand your concern about blogging anonymously to avoid petty retributions, but honestly, I see no such incident from Leah in this thread. Were you perhaps referring to some other individual? Or some other thread?
Bob…
Its frustrating because I don’t have any axe to grind with Commissioner Gunn, and in fact, I have always felt that she was one of the better and smarter local representatives.
I choose to post anonymously because I don’t wish to subject myself to anymore retribution from County folks. It has nothing to do with posting on AA Chronicle, and everything to do with my experience in County government.
I also would say…in my defense, I have posted respectful comments based on my experience and I haven’t attacked anyone. It is why I’m disappointed with her comments directed at me.
Richard, I would agree that your comments (that I have read) have been most respectful and on point. I’d suggest that you and Leah get together for a cup of coffee sometime.
Leah and Conan,
You have both voted multiple times to support giving taxpayer dollars to Planned Parenthood for a Children’s Well Being Program. In Margy Long’s post, the spokeswoman from Planned Parenthood, she stated that of the 350 pregnant women enrolled in their program last year, only 125 healthy babies were delivered. Yet they claim, year after year, that they meet their goals more than 99% of the time and the board has consistently increased the amount of tax dollars given to them. Margy stated that without the county funded program, these women would have to receive their prenatal care at the University of Michigan Medical Center. Isn’t that Medical Center one of the best in the state? Is there any evidence that Medicaid patients are receiving less than optimal care at U of M? Do either of you think that if the mother delivers her baby at the University of Michigan, or elsewhere in the state, that these births can’t be documented and included in their progress report? Do either of you think that it is possible that in 12 years of funding this program, that 75% of the mothers do not give birth during the calendar year, each and every year? Did either of you, in your role as Commissioner, ever think to ask Planned Parenthood, the nation’s leading provider of abortions, to document the number of pregnant women referred to their program whose pregnancy was “voluntarily” terminated?
Since neither of you have given sufficient oversight to how our tax dollars have been spent on charity in the past, would you please consider letting county residents donate to the non-profits of their own choosing? Isn’t the job of handling all the county mandated services in this time of reduced revenue sufficiently difficult? Please reconsider your advocacy of an additional millage to mandate that all county residents donate to the charities of your choosing and let us donate our hard earned dollars where we believe they can best benefit our community.
I second the commenter who said that the county should clearly articulate the necessity for the specific human services needs that it wants funded. I read through the linked mandatory/discretionary document, but it doesn’t have the impact of “There are X county residents who can’t heat their homes in the winter. There are Y county teenagers who would go to adult jails if not for the juvenile programs.” etc.
It might also be interesting to see the breakdown of “donor communities” vs. “recipient communities” for such a millage. The general perception is that many of these are urban problems, but (as it is with the US in general), it may be that the urban centers are bigger donors than they are users of services. Does anyone know?
As I have stated time and time again, the objective of children and family services is to turn our young citizens into citizen taxpayers. We cannot realize this objective unless assist our families in their efforts to raise their children.
Understand, we all receive public assistance. My kids attended tax supported schools, played in tax supported parks and were protected by tax supported law enforcement. Public health activities protected them as well.
Some of our citizens need more support that my husband and I did in order to raise productive citizens. This is why I intend to work to place a HUMAN SERVICES millage on our ballot. Current county tax revenues do not support current human needs of our fellow citizens.
The service needs are seen in our urban and rural communities. Substance use is endemic across Washtenaw County. Poverty is seen everywhere.
Budget technicalities have been explained above. I will go into them again.
Please support placing this HUMAN SERVICES MILLAGE on the ballot and urge your commissioner to acknowledge this need in this way. Then when we are successful in placing it on the ballot, work with all of us to see that it passes
I’m totally sympathetic. Rather than generalities, however, I’m suggesting giving the voters specifics that might motivate them to think about the issues in concrete terms rather than activating a knee-jerk “vote down the tax and spend”.
Bridget,
How about last year there were 225 pregnant women who would have had healthy babies had we not steered them to Planned Parenthood for prenatal care and used funds confiscated from county taxpayers to pay for their abortions. Barbara, these children will not grow up to be tax paying citizens. We shouldn’t be forced to pay for Planned Parenthood no matter how much you and your fellow commissioners believe it to be a worthy charity. There will be many like me to work against such a millage, especially when we are already voting on millage increases for education and police and God only knows how much the health bill will end up costing or the next stimulus package. Aren’t there already enough foreclosures in the county?
Bridget,
I think you are absolutely correct, but I’m not optimistic that the Board is capable of developing clear outcomes and articulating the community need in any meaningful way.
I’m not part of the knee jerk anti-tax crowd, but this is a tough sell in this economic climate and I suspect that most of the Commissioners are more interested in supporting their pet projects as Commissioner Bergman has demonstrated in her comment above.
I agree. The crux of the matter seems to be that we have (as Gary Salton says)to trust our elected officials to fund the services they think are needed. No voter has time (nor could we reach a consensus) to do a line-item veto on services the county should fund.
At the same time, there doesn’t seem to be a lot of trust of the county commissioners to do that. Maybe the whiff of “pet projects” is a part of that? There is a big difference between additional millage for mental health services that would otherwise be cut, for instance, and the 4-H. I fear that unless the programs that would get the millage money were clearly identified, non-controversial, and demonstrably essential, the knee-jerk “no new taxes” will win.
Bob,
How’s the research coming along? I would hope that you could confirm by now that what you called “questionable” is actually substantive fact. Have you been able to obtain the documents yet?