By Tim Bonfield
The Cincinnati Enquirer

Dr. Stacy Suskauer checks on Edmund Mooney Saturday at the Drake Center. Mooney, 72, has stayed at Drake since a 2002 car crash left him a quadriplegic. The staff helped him regain his voice and some motion. The Cincinnati Enquirer/JEFF SWINGER

Drake Center supporters say they need a 31 percent tax increase to keep up with soaring health care costs.

But critics say most of the services provided by the money-losing rehabilitation center in Hartwell can be replaced by organizations that don't get any tax support.

And Hamilton County commissioners note that Drake's levy request is about 15 times higher than their goal of holding special levy tax increases to about 2 percent, or roughly the rate of inflation.

So who's being unrealistic here?

On Monday, the Hamilton County Tax Levy Review Committee will hold the first of several hearings to debate how much more voters should be asked to pay to support an institution that has been part of the Cincinnati medical system for more than 150 years.

WHAT HAPPENS NEXT

Monday: In-depth presentations to Hamilton County Tax Levy Review Committee by Drake officials and a consulting company, 5 p.m. at the Hamilton County administration building, 138 E. Court St., downtown. May 25: Question-answer session with review committee, 5 p.m., Hamilton County administration building. June 1: Public hearing on Drake levy, 5 p.m. at the Hamilton County administration building. Deadlines: The tax levy review committee plans to make its recommendation in early June. Commissioners to decide by August how much of a proposed levy to put on the ballot. Vote: Nov. 2

RELATED STORIES

• History of the Drake Center in Hartwell

Assuming a levy is placed on the ballot, Hamilton County voters will decide Drake's fate Nov. 2.

Drake's request would provide the center with about $20 million a year - up from nearly $15 million a year it gets from the current levy. That tax support accounts for about 20 percent of Drake's total budget.

For property owners, the proposed increase would make the taxes on a $100,000 home grow from about $26 a year to about $34 a year to support Drake.

For Kevin Flynn, a real estate attorney who lives in Mount Airy, there isn't much of a debate.

"I'm a property owner. I'm in the real estate business, and I certainly don't want to see taxes any higher than they need to be. But this is something that works," Flynn says.

Flynn, a 43-year-old married father of three, became a quadriplegic after breaking his spine in a car crash in February 2002. He spent eight weeks in Drake after the crash and has been going back for outpatient rehabilitation for at least three days a week ever since.

The therapy has helped Flynn regain much of the use of his arms, plus limited use of his hands and enough strength in his legs to stand in braces for half an hour at a time.

"At first, I couldn't do anything. But now, I'm driving a van. I'm back to work part-time. And even though they say you don't improve much after a year out from your injury, I'm still making progress," Flynn says.

No place else in Greater Cincinnati offers the expertise that Drake does, Flynn says. If Drake didn't exist, he would have moved to Denver or Atlanta or another city with a sophisticated rehabilitation center.

"I'm a native Cincinnatian. I remember how Drake used to be. It used to be a place to go to die. Now, it's a gem," he says.

But a consulting company hired by the county has concluded that Drake is an overpriced gem.

A 70-page report from Cleveland-based Howard Wershbale & Co. blasts the Drake Center for paying too much for salaries, pharmacy services, kidney dialysis, nursing facilities, even therapy services - the core of Drake's mission.

"We believe the level of care, given resident acuity, is in the average to above average range; however, the current cost structure and associated operating losses cannot be sustained without ongoing increases in taxpayer subsidies," the report states.

In fact, the "vast majority" of Drake's services could be provided elsewhere in the community, the report states.

The report predicts that even if Drake gets a big tax increase, it will be back asking for even more in five years unless deep changes are made in how the place runs.

The Drake Center's request comes when many potential voters have been stung by soaring college tuition, growing paycheck deductions for health benefits and record-high gas prices.

The consultant's harsh conclusions also come amid a running political battle over how fast taxes have grown for several special county levies, which support services ranging from delivering senior meals to subsidizing the local zoo.

Christopher Finney, a long-vocal antitax activist, now sits as chairman of the tax review committee. He has pledged to enforce a goal, set last year by a unanimous vote of county commissioners, to put the brakes on tax increases.

When it comes to Drake, "everything is on the table," Finney says. Even whether Drake's levy should be reduced rather than increased.

Drake leaders, however, say the voters should decide the worth of the institution.

"I don't think you can even begin to compare us to a traditional nursing home," says chief executive Bobbie Bradford.

Drake is woven into the regional health system in ways that would be extremely disruptive to stop, Bradford says.

Hospitals know they can send people to Drake to recover from brain and spinal cord injuries from car crashes, shootings, strokes and illnesses. Spending weeks or months in a hospital would be far more expensive, Bradford says.

Meanwhile, nursing homes know they can send especially tough cases to Drake, such as people who need ventilator care. Even the consultant's report praised Drake for its speed at weaning patients from ventilators.

"It's all part of an integrated system. That's what makes Drake such a unique asset," Bradford says.

While Drake would get nearly $20 million a year from the bigger levy, providing Drake's care at other hospitals and nursing homes would cost $38 million, according to a report commissioned by Drake from the UC Economics Center for Education & Research.

Beyond the costs, the UC report questions how local hospitals could take on Drake's services at all. Hospitals regularly divert ambulances to cope with overcrowding.

Bradford says Drake has made several business reforms in the past year. She says Drake does not assume it will be asking for more tax support five years from now.

Drake will consider some of the recommendations. But it has no plans to "evaluate the competitive pricing" or make any deep changes in its physical, speech or occupational therapy services.

"That's what we do," Bradford says.

History of supportThe Drake Center has been supported by countywide tax levies going back to the 1960s. Here's how voters decided the past eight levies, in percent:

	Yes	No
Nov. 1999	60	40
May 1994:	52	48
May 1989	61	39
Nov. 1983	64	36
Nov. 1976	51	49
Nov. 1971	79	21
Mar. 1966	86	14
Nov. 1960	62	38

E-mail tbonfield@enquirer.com