MIDDLETOWN, Ohio — This small heartland city, situated almost halfway between Dayton and Cincinnati, has long had a heart. In good times and bad, it has offered a generous network of privately funded homeless shelters, drug rehabilitation facilities and soup kitchens, plus a library that promotes access for all.

Yet in recent months, officials and residents have begun to question whom those services are benefiting and how to shoulder the cost. The police chief was the most prominent voice, accusing other communities of increasingly using Middletown as a dumping ground for their own problems.

“It is inhumane and it is irresponsible,” Rodney Muterspaw wrote in a lengthy Facebook post just before ending a 30-year police career. He recounted the “many times” officers had responded “to a person wandering around downtown only to find they were given a voucher for a cab from another city and sent here.”

The issues raised by Muterspaw’s self-described “rant” — which went viral, locally speaking — have only become more pressing with the arrival of winter. The homeless here, whether homegrown or from somewhere else, are estimated to number in the low hundreds. They may not attract White House attention, as homeless populations in Los Angeles and San Francisco have, but providing for them is as significant a challenge for Middletown, population 48,861, as for any major metropolitan area.

Steve Berg, vice president for programs and policy at the National Alliance to End Homelessness, says the problem has the same root causes regardless of location: “There is a disconnect between the incomes of people with the lowest incomes and rents for the most modest houses or apartments.”

Middletown’s gritty self-reliance and economic vulnerabilities have drawn attention before, chronicled in local author J.D. Vance’s best-selling memoir, “Hillbilly Elegy.” And just five years ago, its Rust Belt downtown was still marked by shuttered storefronts and cash-for-gold outlets.

While there has since been a rebound, with an arts center, wine bar, yoga studio and even a boutique hotel now open along Central Avenue, the renewed sense of hope seems tenuous and the emergence of homeless people wandering around downtown has unnerved some businesses.

The local government has already begun making tough financial decisions, likely tapping the 2020 street paving budget to put additional police on the beat to engage with homeless individuals who need help. And the continuing fallout from Muterspaw’s social media post claimed the city manager, who the City Council felt hadn’t handled the homeless situation effectively.

The men and women at the center of the discussion cobble together a fragile existence. Their stories are as varied as those who tell them: addiction, failed marriages, prison, disability. One man lives in a donated car and eats at local charity kitchens, scrounging enough money to pay $10 a month for a Planet Fitness membership that gives him access to a hot shower. Another leaves a homeless encampment along the banks of the Great Miami River for hot meals at a day program called the Mission on Main.

Sterling Seiler found himself on Middletown’s streets in early December. The 26-year-old is candid about his past, most of which was spent in Greenville, Ohio, about 40 miles away. His unsavory years gradually escalated to breaking and entering and finally dealing meth; since 2014, he has often been behind bars. But after an adverse reaction to meth in November, he was transported from jail to a hospital in Troy, Ohio.

“The jails want to send you to the hospital to get rid of you,” Seiler said, adding that hospitals are eager to do the same. A few days later, he was taken to a shelter in Dayton; a second drug episode got him transferred farther south to Middletown’s Atrium Medical Center. The cycle repeated itself when he was again released: He was put in a cab that left him at a downtown shelter run by Shalom, a church-led network that provides homeless people with home-cooked suppers and overnight beds from December through April.

“I was dumped twice in 10 days,” said Seiler, who’d never before been to Middletown. “I didn’t know anything about [its] shelter. I didn’t even know where the door was.”

Shortly after Seiler showed up, a cab dropped off a man who said he was from Cleveland — four hours away. He started going through Shalom’s intake process but then changed his mind and went across the street to the library.

“That happens quite often,” said Bill Fugate, who directs the 30-bed program with a generous but firm hand. He followed the new arrival to the library and pleaded unsuccessfully for the man to come back for a hot meal, bed and help.

“Where he went after that, I don’t know,” Fugate said, adding that for many homeless in southwest Ohio, Shalom is their last best hope. It’s the only overnight program in the region that doesn’t test for drugs, a significant draw in a part of the country ravaged by the opioid epidemic.

Shalom cared for 129 individuals last winter and has already served 59 people since reopening its doors in December. Hope House, the city’s main shelter, will soon complete an $11.5 million, 41,000-square-foot location with 50 beds for men’s temporary housing and a collection of apartments. (A separate shelter welcomes women.)

According to Fugate, Seiler is hardly the only out-of-towner dropped off by the city’s own hospital, which sits five miles from town along Interstate 75. But hospitals throughout the region are also discharging patients to Shalom with no advance warning, he contended, as are other jurisdictions’ police departments and social service agencies.

Neighboring police officials deny that. “We try to help them. We don’t take them to Middletown and leave them,” said Franklin Chief Russ Whitman, whose city is six miles up the highway.

In a statement, Atrium’s parent company, Premier Health, said the medical center “takes very seriously its responsibility to discharge these patients safely.” It pointed out that “although patients might have accepted the discharge plan at the time of discharge, they have the right to change their minds and/or make their own decisions once they leave the hospital.”

Middletown Council member Ami Vitori has been among the most outspoken about the “homeless dumping” issue. She would like to see a coordinated regional response that tackles the root causes of homelessness: lack of housing, jobs and mental health care. She’d also like a more vigorous police presence augmented by a network of cameras to catch dumpers, with penalties for the ones doing it.

“People come here because we are doing a good job of taking care of them, and the word spreads on the street, but at the same time there isn’t enough funding to help people from outside of our community,” said Vitori, a downtown business owner who described several bizarre encounters she’s had with homeless people since moving back from Washington in 2015.

Muterspaw estimated in his Facebook post from October that 75 percent of Middletown’s homeless are from somewhere else, though confirming that is difficult.

“Many of them feel a sense of shame that no one in their home community wants them, and they find acceptance here, so they quickly identify as being from Middletown,” explained Kathy Becker, an area homeless advocate and caseworker for Access Counseling, a local agency that helps homeless individuals find shelter and work.

After only a week here — much of it spent by day at the public library — Seiler had enough of a foothold in the city’s social services system that he didn’t plan to leave.

He’d scored a job interview for maintenance work at a factory and said he was staying clean and trying to fend off his legal troubles back in Greenville.

“I know this is my last chance. I need to document everything I am doing and show the judge that I’m trying to get on the right track,” Seiler said.

Once again, that track runs right through Middletown.