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DC Health Care Coalition
Suggested Questions for Mayor Williams
November 20, 2002




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DC Health Care Coalition

Contacts: Devin Walker, 202/285-1921 Crystal Sylvia, 202/421-8596

(Greater Southeast Hospital, DC General, & the Alliance)

Q: Greater Southeast Hospital is responsible for managing indigent health care since DC General closed. It appears that Greater Southeast is trying to make it appear that its current financial problems are primarily related to National Century Financial Enterprises, which is its lender. However, the financial woes of Greater Southeast started more than four years ago when it filed bankruptcy. In addition, Greater Southeast has a history of poor payments to its vendors, and last year it received a $20 million tax break from paying DC taxes even though it would still lose $6 million per year after this generous tax break. Clearly, Greater Southeast was financially insolvent before its current problems with National Century. The problem with National Century has only added to Greater Southeast's history of financial instability. Can you defend the City continuing to entrust a nearly $500 million contract to such an unstable company?

Q: The financial stability of Greater Southeast Hospital, which manages the health care safety net since DC General closed, is connected to its ability to deliver effective patient care. Physicians have reported that patient care is being compromised when vendors won't deliver needed medical supplies because Greater Southeast has not paid its bills. Is it accurate to claim that health care has improved under the management of Greater Southeast Hospital which is - once more - in dire financial condition and this in turn affects its ability to deliver good patient care?

Q: The Inspector General recently issued a report on the effectiveness of the health care safety net, which is managed by Greater Southeast Hospital. The report noted problems with the staffing and administration of the new system that may be costing the city tens of millions of dollars. Will Greater Southeast be held responsible for returning those overpayments to the City that are noted in the Inspector General's report, and how can you assure that this waste of taxpayer dollars will not continue to occur?

Q: All hospitals are rated on their quality of care by the Joint Commission on Accreditation of Healthcare Organizations. Georgetown University Hospital recently received a 91 quality of care rating, and DC General Hospital had received a 94 quality of care rating before it was closed. Can you continue to state that the new health care system is better than DC General in light of the fact that the new system is managed by Greater Southeast Hospital, and yet Greater Southeast has not been able to pass the fundamental quality of care review?

Q: Greater Southeast, which manages the health care safety net since DC General Hospital closed, recently announced that it has closed the clinics for pediatrics and women's services. In addition, prescription services for indigent senior citizens have been discontinued, which results in potentially lifesaving drugs being denied to seniors. Does your continued defense of this new health care system feed into perceptions that you don't care about the City's most vulnerable residents - in this case women, children, and senior citizens?

Q: How do you explain that the closure rate for emergency rooms at private hospitals has increased significantly since DC General closed? It has been reported by employees that Greater Southeast Hospital is planning to charge indigent patients $200 for healthcare. However, according to the City's contract with Greater Southeast, it is responsible for providing free health care for up to sixty days to all who require care until it is determined whether persons are eligible for free care. For Greater Southeast to charge an up front fee of $200 would violate its contract with the City. Are you aware of reports that Greater Southeast intends to violate its contract with the City by breaching the fundamental principle upon which the health care safety net is founded-free care to those who qualify?

Q: The City Council recently voted on legislation to build another hospital at the DC General site. This action was taken, in part, as a result of an independent report that recommended the need for a hospital at the DC General site. Mr. Mayor, you wrote a letter to the City Council supporting a new private hospital at the DC General site. Would it have been better to improve any problems at the now closed DC General Hospital, rather than to close it and then support building another hospital at the same location only one year later?

Q: Firefighters have complained about the liability of taking high-risk patients to the DC General Emergency Room, which is now being managed by Greater Southeast Hospital. Since DC General is no longer a hospital, it does not have the resources to handle high-risk patients. Some firefighters have expressed the view that this situation is just an accident waiting to happen with the lives of DC residents. What are you prepared to do to address this concern?

Q: In advocating for the closure of DC General Hospital, you went against the established medical community including the American Medical Association, the Medical Society of DC, and the National Medical Association. Given significant problems with the new health care system- including the negative report by the Inspector General, and Greater Southeast Hospital not yet able to pass the fundamental quality of care review (by the Joint Commission on Accreditation of Healthcare Organizations) -- do you believe you should have heeded the advice of the medical community (and the unanimous City Council) for DC General Hospital to remain open?

Q: In order to legitimately claim that no one has died since DC General closed would require the examination of documents such as patient medical records. What specific evidence do you provide to support your statement that no one has died since DC General closed, and what specific evidence do you provide to support your claim that the new health care system is providing better care than when DC General Hospital was open?

Q: DC General Hospital was accused of "bleeding" money as one of the reasons for its closure. However, DC General was allotted only $45 million per year that had to be used for both patient care and repairs to an old building. In addition, DC General had to provide care to everyone regardless of ability to pay, yet Greater Southeast has the decreased responsibility of providing free care to those who fall within 200% of the federal poverty level - this is only a fraction of those who were seen at DC General. And, Greater Southeast subcontracts services to seven other healthcare providers, who are asking the City for more money. The costs of the new health care system are spiraling although it provides services to fewer people than DC General Hospital did. Would it have been better to increase the budget to DC General rather than the current arrangement of paying eight health care facilities to provide services to fewer people than when DC General was open?

The DC Health Care Coalition includes community members, patients, and caregivers.

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