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District of Columbia Financial Responsibility And Management
FOR IMMEDIATE RELEASE
April 18, 2001
D.C. Financial Authority Transmits Proposed Contract
for Health Care Services for Uninsured District Residents to Mayor
Washington, D.C. - The District of Columbia Financial Responsibility and
Management Assistance Authority ("Authority") has transmitted
the proposed contract for health care services for uninsured District
residents to Mayor Anthony Williams for his consideration and for
transmittal to the Council of the District of Columbia for action. The
Authority formally agreed in principle to the proposed contract with
Greater Southeast Community Hospital Corporation on April 11, 2001.
"We are very confident that the proposed contract will improve
access to high quality services for uninsured residents with the added
advantage of providing the Mayor and the Council with the information and
flexibility to continue further reforms into the future," said
Authority Chairman, Alice Rivlin.
The proposed contract is the product of a process that began in
December of last year when local District government officials and the
Authority agreed to solicit bids from the private sector to manage safety
net, health care services. The process began as a response to the
management and financial breakdown of the Public Benefit Corporation and
DC General Hospital.
The proposed contract is for an initial 5-year term (with two 2-year
options). Highlights of the proposed contract include:
- Health services for District residents without health insurance
whose family income is at or below 200 percent of the federal poverty
- An average increase in service volume of more than 30 percent over
the current PBC level of direct health care services and
administration, at a base operational cost of no more than $66.3
- A requirement to provide monthly, quarterly, and annual reports on
volume, utilization, quality and costs;
- Significant protections for District taxpayers require that; the
contractor maintain a performance bond, that payments are made only
for delivered services, and the District retain the right to assign
any part of the contract to another provider if any party to the
proposed agreement fails to perform.
Following several months of discussions aimed at building consensus,
Dr. Rivlin recommended that the Council respond expeditiously. "It is
in the best interests of the patients that have been traditionally served
by the PBC, the taxpayers and Home Rule that local elected officials take
the necessary steps to support the implementation of the proposed contract
as soon as possible."
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Summary of Contract with
Greater Southeast Community Hospital
D.C. Healthcare Alliance
- Greater Southeast Community Hospital (hospital-based care; operation
of DC General-based emergency services)
Contract Period: 5-year initial term; 2 2-year option periods
- D.C. Chartered Health Plan (patient information / care management;
primary care services)
- Children's National Medical Center (pediatric health services ;
school health program)
- George Washington University Hospital (additional specialty and
- Unity Health Care (primary care services; operation of public
- Other practitioners (primary and specialty care services; diagnostic
and ancillary services)
Contract Price (annual):
Health care services and administration:
- upper limit: $66,276,043 (20% above base service volume)
- middle range: $60,250,949 (base service volume)
- lower range: $54,225,854 (20% below base service volume)
- School Health Program: $7,010,522
- Corrections: $3,715,858
- Trauma capacity: $1,399,525
- District grant programs: $1,081,000 (potential)
- Pharmacy Services: $3,400,000
- Capital funding: $11,800,000
- Start-up support: $1,500,000
Medically necessary health care services, including:
- Primary and preventive health services
- Emergency and Level 1 trauma services
- Inpatient and outpatient hospital services
- Specialty physician services
- Language translation services
- Disease management
- Diagnostic testing and evaluation
- Dental care
Program enrollment and data management.
Excluded Services: Tertiary care services not currently provided
at D.C. General Hospital to the extent services are not available at
Greater Southeast Community Hospital (e.g., open heart surgery.)
District residents without health insurance coverage whose family
income is at or below 200 percent of the federal poverty level.
- Family of one: maximum income of $17,180
- Family of two: maximum income of $23,220
Volume of Services (annual):
- Inpatient hospital services: 4,560 admissions
- Emergency room services: 40,280 visits
- Ambulatory surgery: 2,144 procedures
- Outpatient-hospital services: 46,015 visits
- Primary care services:. 39,192 visits
- Physician services: 169,668 encounters
- Dental services: 15,820 visits
Volume Adjustments: Contractor may adjust the volume of services
provided across service categories depending upon the needs of the
eligible population, subject to the total value of the contract. For
example, reducing hospital admissions by five percent (5%) of the
contracted amount will permit a twenty-five percent (25%) increase in
primary care services under the Contract.
The volume of care purchased through the Contract will be adjusted
periodically based on actual experience and expansions in insurance
coverage for the eligible population.
Cultural Competence The Contractor is to develop a plan to
educate, monitor and evaluate the cultural appropriateness of outreach and
health care interventions.
Contract Limitations: Subject to requests for services, the
Contractor is obligated to provide health care services to eligible
residents up to the value of health care services specified in the
Maintenance of Effort: The Contractor and subcontractors are
required to maintain their current level of services to uninsured District
residents as a condition of receiving compensation through this Contract.
Financial Protections: The Contractor is obligated to maintain a
performance bond equivalent to two months of payments under the Contract.
In addition, funds advanced by the District will be maintained in a
segregated account and are only to be disbursed for the purposes specified
in the Contract. Contractor is to indemnify the District for Contractor's
negligent acts. Standards have been established for timely payment of
Reporting Requirements: The Contractor is required to provide
monthly, quarterly, and annual reports regarding volume, costs, quality,
and access to services, as specified by the District.