Government and People
NORTON SUGGESTS OPTIONS NECESSARY TO AVOID RISK OF LOSS OF HOSPITAL SERVICES TO WARDS 7 AND 8
Washington, DC-Congresswoman Eleanor Holmes Norton (D-DC) today expressed concern that Greater Southeast Community Hospital may not survive as a viable and credible hospital and suggested that the city and other hospitals in the District should begin looking at all options that would assure hospital and emergency services to residents in Wards 7 and 8. In a letter to Mayor Anthony Williams, Norton suggested that the new D.C. Healthcare Alliance, that allows low income and uninsured patients to go to private physicians and health care organizations as insured people do, could become a public health model if attached to appropriate hospitals citywide, including, of course, Southeast. Norton said that the Congress would almost surely be uninterested but that the federal government might be approached to replicate such a model for low income and uninsured people, opening the door for discussions concerning hospital care in Southeast. Norton said that she was concerned that "there appears to be no credible health care or other expert institution enlisted to assist Greater Southeast become viable and no ready alternative to this hospital if it fails yet another test." She said that while hospitals are a matter for local governments and that the Williams administration has been hard at work on hospital care for Southeast, the federal government should look at the Alliance model that might open the door for discussions concerning hospital care.
"Leaving Southeast without hospital and emergency services is simply inconceivable," Norton said, and "although the Congress does not regard health care, much less public hospitals, as a priority, I do not write off approaches to the federal government. I stand ready to be of whatever assistance I can."
The Congresswoman's full letter follows.
August 21, 2003
Mayor Anthony Williams
Dear Mayor Williams:
I write out of increasing concern that the loss of Joint Commission on Accreditation accreditation for Greater Southeast Community Hospital pushes the District closer to the absence of decent hospital and emergency care in Southeast neighborhoods. While this particular loss was not unexpected and does not keep the hospital from operating, it makes the institution totally dependent on Medicare and Medicaid reimbursements, adding to its already acute financial troubles. However, the record of the hospital in claiming Medicare and Medicaid reimbursements does not inspire confidence that it can struggle to its feet on that income alone.
As you might imagine, my office is receiving calls from constituents concerning hospital and emergency room care in Southeast. I recognize, of course, that this is a home rule matter for the D.C. government on which your administration has been hard at work and that the Congress has been inhospitable, even hostile, to the continued existence of publicly supported hospitals in the District and across the nation.
I know you are doing what you can and that there is nothing I can or need to say about the importance of hospital services to residents in Wards 7 and 8, who are at risk of being left without these critical services. Leaving Southeast without hospital and emergency services is simply inconceivable.
Yet we cannot ignore the possibility that this would happen. I write now out of concern that the present Greater Southeast strategy could be unsuccessful and to inquire about options in that event. For example, even if the city decided to build a new hospital-and I recognize you are not considering that option-there would still be a need for hospital and emergency services in the meantime.
The failure of Greater Southeast to improve during the most recent period of visits cannot help but be distressing and discouraging. A turnaround perhaps was not expected but neither was such a steep decline and the documented serious effects on the health and lives of residents. The indications to the public are that left to its own devices, Greater Southeast is failing to respond. If as the hospital alleges, improvements were made after the most recent Joint Accreditation visit, the hospital needs to come forward, set the record straight, and reassure the public.
Sitting in the Congress, I do not pretend to have an answer, but I would like to suggest that leaving Greater Southeast to its own devices has not worked until now and may not work in the future. Without significant expert assistance, can this seriously inadequate hospital be saved, or, if so, what quality of service could be expected and what effort would it take to encourage publicly supported or private patients to seek services there sufficient to sustain the hospital?
I am concerned that there appears to be no credible health care or other expert institution enlisted to assist Greater Southeast become viable and no ready alternative to this hospital if it fails yet another test. The chairs of the congressional committees spoke out in favor of closing D.C. General at the time, and Congress has grown worse not better on that score. However, with another credible institution in the picture, with or without Greater Southeast, grants from the Department of Health and Human Services might be explored. My office has not investigated this possibility because it would depend on ideas from the city. However, I have thought about whether the District might qualify as a new public health model or test case. For example, the D.C. Healthcare Alliance that allows low-income and uninsured residents to go to private physicians, HMOs and clinics just as insured people do appears to have satisfied many residents and may have potential as a new public health model. Some of my colleagues here in Congress from districts similar to ours also have shown some interest in the Alliance idea. This feature, including preventative care, seeing physicians when ill instead of waiting until the matter becomes serious, and affording the dignity of a personal physician or health care group instead of long waits in an emergency room should be available to low-income people as they are to Members of Congress, D.C. government employees and middle-income and insured Americans. If in addition, the District can show that this model is cost efficient, the federal government should look more closely at encouraging its replication. What is indispensable if the Alliance is to be fully successful, of course, is a set of affiliated hospitals everywhere in the city, especially in Southeast, where the health indicators are the most serious in the District and where hospital and emergency services are therefore particularly necessary. Any federal discussion of such a model would automatically have to include hospital and emergency care services.
Other than our residents, the private hospitals in the District will be the biggest losers if Southeast is left without a hospital that is both viable and credible. I believe that the city's hospital officials and D.C. officials should begin looking into all the options. Although the Congress does not regard health care, much less public hospitals, as a priority, I do not write off approaches to the federal government. I stand ready to be of whatever assistance I can.
Eleanor Holmes Norton
cc: John Koskinen
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