From the May 3, 2006 edition of Cool Cleveland:

Why don't our huge non-profits pay taxes? It's a fair question, and one that Cuyahoga County Treasurer James Rokakis isn't getting any answers to.

He's proposed a program called PILOT, for Payment in Lieu of Taxes, since 2004, asking [tax-exempt non-profit] groups like Case, University Hospitals, and Cleveland Clinic (which alone earned $3.9 billion in 2004) to agree to pay a percentage of what they would owe in taxes to the city to help the schools.

This is similar to programs in Cambridge, Providence, New Haven and Pittsburgh — all cities with lots of non-profits similar to Cleveland.