Health levies are rare in Ohio. There are currently six medically related levies in the state, of those, two are in the Mahoning Valley.

For 48 years, Mahoning County voters have approved a levy for tuberculosis and for 44 years, Columbiana County voters have approved a levy for a cancer clinic.

The Columbiana cancer clinic levy is the only one of it's kind in the state. Mahoning County's TB levy is one of five.

Why are our local levies such outliers and are they even needed? Here's part one of our Watchdog report that looks closer at Mahoning's TB levy.

 

History of the Mahoning County tuberculosis levy

At the beginning of the 20th century, tuberculosis was the leading cause of death in the U.S., with no treatment or cure. Valley newspapers told stories of hundreds of deaths, that's why Ohio law requires that every county have a TB plan.

While TB still exists, it's much less of an issue. Mahoning County provides treatment through a TB levy, last renewed in 2022, bringing in more than 1.2 million dollars every five years.

Most of Ohio's 88 counties have come up with other ways to fund treatment. Mahoning is one of five counties still using a levy.

"We're a completely different society where maybe it flourished 150 years ago, where you had 200 per 100,000 people dying of TB, you don't have that in this country anymore," Lorain County Health Commissioner Mark Adams said. "We wash our hands differently, the way we do personal care is very different than the way it was when we were discovering the west," he said.

 

Is the levy needed?

Mahoning Health Commissioner Ryan Tekac tells 21 News Reporter Sydney Canty, the most important part is prevention. It's geared towards people with latent TB, who have no symptoms and are not contagious.

"Our program's designed to actually identify those that are latent and then for those individuals to start undergoing treatment of latent TB," Tekac said. "If you're not treating these latent TB cases, 10 to 15 percent have the potential to be active TB," he said.

"That treatment is providing the medications, the chest x rays, the the case management, the blood work and then seeing our TB medical officer," Mahoning County Public Health Director Erica Horner said.

Between 2019 and 2023, Mahoning County had 138 latent cases, with some still being treated today. Tekac said without the levy, they wouldn't be able to provide that level of care.

"The prevention piece of it would be very difficult," Tekac said. "It's not just a one time treatment, it's a couple months of treatment that that individual has to go through which is all covered under our Mahoning County TB program," he said.

Other counties 21 News spoke with do not treat latent, saying it's not an active concern. For example, Stark County does not have a TB levy and their program costs $16,000 per year.

Unlike Mahoning, Stark will bill your insurance.

It's a formula that's been working for decades and they haven't had an outbreak.

So when we asked Tekac why the levy is still needed, he reiterated that he felt preventative care was important.

 

Where does the money go?

In 2019, one quarter was spent on testing and supplies and three quarters went to salaries.

Tekac says the cost to taxpayers is extremely low for the services.

Lorain is another county with a TB levy although their health commissioner is not convinced they even need it.

"For us, there would be no reason to actually keep it going," Adams said. "We have that funding mechanism to be able to support doing the tuberculosis program which would end up saving the citizens in the county, at least in Lorain County, it would end up saving them money," he said.

Lorain does this by using general fund dollars and billing insurance. So are these levies still needed?

"When it comes to, you're looking at 3 or 4 cases per year, really those individuals that you have on staff are already doing other work that's public health related with so many other infections or communicable diseases," Adams said. "So, you just wrap tuberculosis into it it and that's the benfit that we had the ability to do here. The thing is though, not every health department is built the same. it really just depends on what that financial picture looks like for that public health department," he said.

The Mahoning county tuberculosis levy will be back on the ballot in 2027. In part two of our Watchdog report, we'll take a closer look at Columbiana County's cancer clinic levy.