Photo By The Drake Center

Most of the county's health and hospitalization property tax goes to the Drake Center. Even critics acknowledge the facility's excellent patient care, but they question its spending practices.

Is the Drake Center a tremendous asset to Hamilton County or a tremendous waste of taxpayer money? Parties to the heated debate over the health and hospitalization levy draw their arguments along those lines. Casting an informed vote will be harder for those who see Drake as a bit of both.

The rehabilitation hospital has received some form of public funding since 1926. Passage of Issue 43 on Nov. 2 would funnel about $68 million to Drake over five years, an increase over previous levy amounts but much less than the center requested.

The Drake Center opened in 1821 as a hospital for the indigent. Since then it has navigated through many permutations of mission and public outrage over the "Angel of Death," a nurse who in 1986 and 1987 killed 23 patients there.

Today the Drake Center offers inpatient and outpatient services, skilled nursing care, long-term acute care and rehabilitation for patients who have experienced catastrophic illness or injury.

As the election nears, a discussion of Drake's spending seems to have devolved to a pretty complicated game of "he said, she said."

The Hamilton County Tax Levy Review Committee recommended that the county commissioners put a $93 million levy on the ballot rather than the $99 million Drake initially requested. The county commissioners reduced the amount to $81 million, with about $68 million expected to go to Drake.

People on both sides of the issue cite an array of statistics and studies to bolster their arguments -- sometimes even the same ones, spun differently. Part of the problem is finding valid bases of comparison and adjusting the correct data sets correctly for analysis.

Is Drake a nursing home or not? Are its patients getting better sooner -- a claim Drake supports with studies -- primarily because many are young and healthy, with better ability to heal?

'It's up to Drake'
Kathy Graham, the facility's director of corporate communications, compares Drake to Children's Hospital.

"We've become a regional, if not national, center of excellence," she says.

But while Drake might be unique in this region, it's not so far above standard that it's above question, according to Christopher Finney of Hyde Park, an attorney and former head of the Coalition Opposed to Additional Spending and Taxes (COAST).

Finney is a wealth of information about Drake, having left COAST to chair the Tax Levy Review Committee.

"Drake is not a world-class or national-class facility," he says.

At best it's a regional facility, Finney says. Patients with every resource and choice, such as actor Christopher Reeve or Arab sheiks, aren't patronizing Drake, he says.

The hospital reports that 74 percent of its patients live in Hamilton County, so it behooves voters to support it. But Finney says Drake is playing with that statistic by counting patients who stay there 30 days or more as county residents, regardless of where their home is.

Graham is skeptical.

"I don't think it's 30 days, no," she says. "That doesn't sound right to me. I think it's five years."

Sixty patients in Drake's skilled nursing facility have been there more than five years, Finney says. Two have been there a quarter century.

"Figures lie and liars figure," he says.

He'd like to see a reverse statistical analysis that adjusts for Drake's unique patient population, but Drake isn't doing it.

"I don't think it's up to taxpayers to disprove why they don't need money," Finney says. "It's up to (Drake) to prove why they do."

A May 2004 study by the University of Cincinnati Economics Center concluded that having Drake saves taxpayers money. But the center's own director discredited the study by admitting he didn't take Medicare or Medicaid into account, according to County Commissioner Phil Heimlich.

That's not true, Graham says; the study remains viable and respected.

A second study by Howard, Wershbale & Co. cast Drake in a much harsher light. But critics overlook that study's positive findings, Graham says.

Finney asks why Drake engages in marketing for more customers when, according to his numbers, it loses money on every category of patient. Graham says Drake's overhead costs are fixed, so the more patients the lower the average cost for each.

Drake's annual marketing budget is $1.4 million to $1.7 million, depending, of course, on the source. But 75 percent of its patients are referred from local Health Alliance hospitals that already know about the facility.

That's not true, according to Graham. Drake has expanded its outpatient services and has a duty to educate county residents about them, she says.

Her response to a reporter's inquiry was less than accommodating. Graham asked to have questions submitted by e-mail. The next day she asked that the story be delayed so she would have more time to answer. The questions put Drake "on the defensive," she said.

'Just cut them off'
Few find fault with the quality of Drake's services. But both critics and supporters question its financial responsibility.

Drake pays the county yearly rent of $1 and no property taxes. Other facilities manage to operate in the black without such deals. Finney says the facility chosen by Christopher Reeve spends 60 percent less than Drake. Drake's physicians corporation loses more than $2 million a year, Finney says.

"I would say that this is one of the worst examples of misuse of taxpayer money that I have ever seen," Heimlich says. "There's a critical need, no question, but everybody else is doing it without taxpayer money. We had public hearings on this, we had people come forward, a number of very respected managers of nursing homes who said they'd jump at the chance to have that facility with no rent, no real estate taxes, without a dime of taxpayer money."

Heimlich and Finney are campaigning to defeat the levy, but they reject the suggestion that they oppose taxpayer-supported social services across the board. They cite the Hamilton County Board of Mental Retardation and Developmental Disability as an organization deserving taxpayer support.

Some of Drake's critics, including Finney, want to cut all its public funding, with the possible exception of $2 million a year for indigent care. Finney suggests voters turn down this year's levy until a new health care financing task force has a chance to examine it further.

Waiting for that commission's findings would be ideal, but that's just not an option, according to County Commissioner Todd Portune. What it boils down to, he continues, is healing Drake, not killing it.

Reducing Drake's spending is paramount, Portune says; making Drake self-sufficient is the goal. But to yank all funding would be irresponsible, he says. Because Drake has operated for so long, local hospitals haven't needed to focus on the same services it offers and so are ill-equipped to absorb its patients.

"Those who are arguing, 'No money now, just cut them off completely,' will kill this facility," Portune says. "And it is truly a wonderful asset for a certain type of patient in our community who has sustained severe brain or spinal cord injuries."

Portune is one of those patients. He spent several months at Drake last year after tumors on his spinal chord left him in the wheelchair he still uses. ©