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Volume 13, Issue 6, September 2007
3710 S Street, NW, Washington, DC 20007
(202) 338-5164 phone/fax
|President's Message, George Clark
Officers and Board
"Third Service” for DC? Don't Bet on It This Time!, Anne Renshaw
Community Benefits Agreements, Sylvia Brown
Best Practices, Carroll Green
Fix the Water, Gail Barron Black
Historical Counterpoint on LSBDs, Dino Drudi
Assembly Meeting Dates
Tuesday, September 25, 6:45 pm
THE CHARLES SUMNER SCHOOL
|Patrick Allen, Esq.
Association of Oldest Inhabitants
Allen E. Beach, Treasurer
Gale B. Black, Esq.
George R. Clark, Esq., President
Dino J. Drudi
Kathryn A. Eckles
Carroll Green. Past President
Ann Loikow, Esq.
Sally MacDonald, Secretary
Ann Renshaw, First Vice President
A.L. Wheeler, Esq.
Regrettably, DC does not now have (and may never have the guts and wisdom to establish) a “Third Service.” However, if this change does not take place now, the next patient (who could be a friend, neighbor or family member) may be the ultimate victim.
“Third service” refers to a pre-hospital, professionally operated, medically driven, and patient-centric Emergency Medical Services (EMS) Department equal to, but independent of, the DC Fire Department (where EMS is now interred) and the Metropolitan Police Department. Having testified before City Council over the years about the urgent need to overhaul and restructure the city’s beleaguered EMS system, the Citizens Federation enthusiastically endorsed Mayor Adrian Fenty’s election pledge, published in the 8/22/06 Washington Times, to create a “Third Service” “(to) end the city’s 15-year troubled effort to combine EMS operations with those of the fire department.”
One outcome of the tragic death of New York Times editor, David E. Rosenbaum in January 2006, who purportedly received substandard emergency medical care at the hands of DCFD, was the creation of the “Rosenbaum EMS Task Force” (TF) in April 2007. The TF, which was part of the settlement agreement between the District and the Rosenbaum Family, had as its sole purpose the transformation and ultimate improvement of the city’s struggling and dysfunctional EMS system. Final recommendations from the Rosenbaum EMS Task Force are due out on September 20, 2007.
The thirteen-member Rosenbaum Task Force was comprised of nine city representatives (including the Mayor who attended the inaugural Task Force meeting, City Administrator, selected City Council members or their representatives, DC Fire Chief who chaired the sessions plus DCFEMS’s Medical Director and an out-of-town fire chief). The tenth Task Force member was Boston’s nationally renowned EMS Chief, Richard Serino and its one and only urban EMS expert. Filling out the ranks were a doctor from GW University Hospital and two representatives of the Rosenbaum Family. One of which was Toby Halliday, son-in-law of David Rosenbaum, who, by default, served as the ‘de facto’ citizen representative. Incredibly, there was no citizen representation on the panel and no representatives of the DC Department of Health and DC Hospital Association.
The Citizens Federation covered every task force meeting. It soon became evident that with a predominantly fire department-oriented Task Force, the EMS train, albeit with some delivery improvements, was heading back to its station deep in the DC Fire Department. The TF’s monthly meetings were little more than an on-going venue for the District’s new fire chief and his unvetted medical director to espouse their (“fire” the Third Service service) biased perspectives, allegiances and obvious desires. This fact led many of the observers to decry that these two individuals’ dominant role was a clear and unsupportable conflict of interest. The Citizens Federation, representing DC residents, was allocated only 5 minutes during one Task Force meeting to present an opposing (“don’t go that route”) view. Our words (and many others’s) seem to have fallen on deaf ears.
Here’s a quick review of DC’s present-day EMS system:
Primarily a separate civilian component of the DC Fire & EMS Department;
EMS, part of the department’s title, but with the civilian EMS ranks now substantially reduced;
Between 75%-80% of all emergency calls are medical in nature;
Managed primarily by fire-service personnel with limited EMS experience;
Heavy reliance on cross-trained firefighters who must become (part-time) emergency medical technicians (EMTs) in order to join the DC Fire Department whether or not they have the desire, skills, compassion and level of interest sufficient to treat patients well and on an on-going basis;
Profound reliance on paramedic engine companies (PECs) as a neighborhood first responder even though residents have said, for years, that ambulances, not large, expensive fire trucks, should respond to the great majority of the medical calls. Dispatching of ambulances is handled by the Office of Unified Communication. About 70% of ambulance transports in the District are low severity level medical calls (referred to as Priority 3 calls), leaving few (if any) ambulances for critical cases, e.g., cardiac or stroke, especially since DC patients are now permitted to be transported to Virginia or Maryland hospitals because DC’s emergency rooms are overcrowded and temporarily closed;
Newly-minted, novice EMTs are being sent directly to firehouses to staff ambulances without adequate supervision or benefit from a period of field training; Over 700 of 1,750 DC firefighters have not been certified in DC’s most current medical protocols published in 2002, five years ago;
Intense, long standing cultural differences, as well as large pay and benefit disparities between the uniformed firefighters and the non-uniformed civilian EMS personnel remain imbedded within the DCF&EMS Department causing workplace tension, animosity and low morale.
Benefits of a “Third Service” would include, in part:
Attraction and retention of top-flight, fully certified paramedics and EMTs under the direction of board certified emergency medicine physicians;
Full-time medical specialists trained, developed and promoted from within the EMS Department, exclusively;
Better, stronger and nationally-recognized EMS management; emphasis on community health care education and injury/disease prevention;
Cost controls and savings. (Presently, the DC EMS budget is a mystery as it is co-mingled with that of the DC fire service activities and programs.)
Stronger affiliation with all hospitals, the DC Medical Society and Homeland Security agencies;
EMS system designed to be compatible and coordinated with, not usurping, DCFD’s EMS role.
A “Third Service” type organization for the nation’s capital should be a reality, not a dream or another empty promise of what could be, but “don’t hold your breath.” The Citizens Federation will continue its advocacy of a professionally operated and specialized EMS Agency as it closely follows DCFEMS’s implementation and orchestration of professed improvements in DC’s critical, but fragile, emergency medical response system.
Samuel Jordan, community activist and former Ward 7 Council candidate, is working to raise the profile of Community Benefits Agreements (CBA) and will present his effort and this concept at the September 25 Federation Assembly.
CBAs are legally enforceable agreements that guarantee community-directed neighborhood benefits. Traditionally, developers have offered first-source hiring for DC residents, job training and access, and some monetary contribution to community organizations (e.g., schools, civic groups, etc.). However, these “benefits” are the baseline and more importantly several are already required by law.
As neighborhoods and Wards in the District of Columbia undergo tremendous changes, residents are perking up and pushing for citizen-led and directed development. Often it is reported that the private sector will reap millions of dollars for quite some time on their real estate and land development deals. Left in a vulnerable position are residents. In response to their feeling of exclusion residents are looking to CBAs as a way to hold developers and the city accountable while ensuring residents have meaningful involvement and receive long-lasting positive impacts from the development in their neighborhoods. The CBA movement also aims to lessen the “wheeling and dealing” nature of real estateand land development.
Subsequent to winning the General Election in November 2006, Mayor-elect Fenty announced that he planned to implement the management concept of best practices to our municipal government; long awaited and welcome news to our citizens, especially following the campaign promise to create a separate emergency medical service.
Mr. Fenty then traveled to several major cities to review their uses of methods and processes, reported to be responsible for measurable success of desired outcomes.
The mayor-elect was particularly impressed with the method of organization utilized in the mayor’s office in New York, and the fact that control of the public school system was also resident in that office.
To his credit, Mayor Fenty was able to import and implement these concepts in our government without delay; much to the delight of many and much to the chagrin of others. To be fair, those who profess chagrin were clearly dismayed over the process of implementation.
The Fenty administration is still quite new, having been in office a mere nine months. Yet we eagerly await, and hope for, the continued implementation of best practices comprehensively, in our municipal government.
Kudos are in order for the Department of Public Works in establishing an on line permitting process, the Department of Motor Vehicles for creating a seniors line for vehicle inspections, on Tuesdays thru Friday, and the Department of Transportations’ Frederick Douglass Memorial Bridge project.
However, we would hope that the Mayor moves equally as expeditiously, to end the nearly 16 year failed experiment for cross-trained fire & emergency medical technicians, and to honor his campaign promise to establish a separate emergency medical service.
While the Mayor is intently focused on schools, the DC vote, crime, and stadium completion, the Council has introduced legislation, B-17-0336, to mandate the use of performance based evaluation factors for contract awards; and B- 17- 0337, to mandate a reporting requirement to analyze the current state of small businesses participating in the socioeconomic contracting program. The irony of these proposed Bills is to legislate the use of best practices, by the office of Contracting and Procurement.
The DC Contracting and Procurement Task Force Report, of December 2006, concludes in part; that the many problems, inherent in the system, stems in part from the lack of training, disregard of rules/regulations/laws, the acute absence of best practices and a broken management structure.
The Mayor is on the right track and we wish him well; if he succeeds, we all win. We simply ask that he spread his wings of reform wider, a more comprehensive approach to upright this leaning bureaucracy.
The District of Columbia has an antiquated sewer system. Many are trying to fix it. Congress is considering the 2007 Water Resources Development Act that would prevent raw sewage from flowing into Rock Creek, the Anacostia River and the Potomac River. Meanwhile, the Water and Sewer Authority (WASA) is the recipient of project grants from the U.S. Environmental Protection Agency to assist public water systems to finance improvements to protect public health. The WASA project is being done in conjunction with the D.C. Department of the Environment (DDOE) and its agent, the U.S. Army Corps of Engineers Office at Blue Plains.
One-third of the city is served by a system of combined sanitary and storm sewers. According to documents released at the public meetings about the city’s Combined Sewer System Long Term Control Plan, during heavy rains, these sewers can overflow and discharge raw, untreated sewage directly into Piney Branch and Rock Creek. These combined sewer overflows can contribute to high bacteria levels and other water contaminants, like lead and zinc and there are more CSOs near Rock Creek and Piney Branch than elsewhere. WASA has said that this is harmful to certain aquatic life and a potential danger to humans. City and Rock Creek Park officials recognized long ago that there is a serious source of pollution in the southern section of Rock Creek Park, and there are warning signs posted near Rock Creek.
The City’s Combined Sewer System Long Term Control Plan specifically provided for the separation of the combined sewers and the consolidation and elimination of 13 outfalls. Yet, the EPA’s recent release of funding projects only referenced 4 outfalls and did not include those that abut the neighborhoods along Rock Creek, near where people actually live. Each year, there are about thirty storm sewer overflows near Rock Creek, which flows directly into the Potomac. This is a matter of national, regional and community concern. It’s time to fix the water for all of us.
In 1977 the District of Columbia city council enacted legislation setting aside 35% of public works contracts for female and minority-owned firms, alleging a history of past discrimination. Minority contractors argued their firms had to put up more money for surety bonds to bid on projects and weren’t big enough to underbid larger firms. Contracts are normally given to the lowest bidder, but under the set-aside program a higher-bidding firm could be given a contract solely because it was owned by a woman or minority. Contractor Arnold O’Donnell sued, claiming the program was “deplorable, costs a fortune, and benefits only a few people who don’t live in the city.” In 1989, the Supreme Court struck down a similar program in Richmond. The Council ordered a disparity study after the Richmond ruling, setting a late-1991 deadline for awarding the study contract, but no contract had been awarded by spring 1992 when the US Court of Appeals struck down the District’s program, finding no evidence of past discrimination.
Mayor Sharon Pratt-Kelly threatened to ignore the court ruling. In a carefully crafted letter to Mayor Pratt-Kelly and the Council, the Federation opposed ignoring the court ruling and argued against emergency legislation because “an issue of this sensitivity requires the utmost public scrutiny only a full hearing process can provide.”
Cooler heads prevailed. Councilmember William Lightfoot introduced a measure that instead awarded 35% of all city contracts to “local, small, disadvantaged businesses,” the program we still have today. Although the Federation believed Councilmember Lightfoot’s measure represented “a reasonable alternative to Mayor Pratt-Kelly’s threat to ignore the court ruling,” the Federation expressed reservations about “channelling 35 percent of the city’s construction dollars to firms whose bids are higher than other firms’ bids.”
Many city agencies did not fully comply with the 35% set-aside for local, small, disadvantaged businesses until Mayor Williams’ second term.
Sources: “Measure Would Shift Criteria for Set-asides,” Washington Times, 19 May 1992; 29 May 1992 Federation Letter to Councilmember William Lightfoot from Federation President Dino Drudi.
September 25, October 23, November 27
January 22, February 26, March 25, April 22, June 24
Federation Awards Banquet May 13, 2008
Holiday luncheon tentative December 18, 2007
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