In 2005, Kansas City, Missouri, voters passed a 22-cent increase to the City's health levy. The health levy, which consists of approximately $50 million from property taxes and service charges, supports Truman Medical Centers, five safety net clinics, and ambulance services. With much collective advocacy supported by local foundations and safety net providers, the health levy was again approved in 2013, extending important funding for the local safety net system for an additional nine years.