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Public Benefit Corporation 2
A New Beginning: The Urban Health Care Campus on Capitol Hill
March 2001




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For nearly two centuries, DC General Hospital has stood on the campus at 1900 Massachusetts Avenue SE in silent testimony to the caring and compassion of a humane society which guarantees health care as a right to all of its citizens, regardless of ability to pay.

In the Winter of 2000-2001, this pivotal safety net provider faced a financial crisis concurrent with efforts to privatize health care services to the medically indigent. During the same tumultuous time, an extraordinary opportunity appeared on the horizon to shape DC General Hospital -- including its inpatient facilities, specialty clinics, Emergency Care Center, and Level 1 Trauma Center -- into the centerpiece of a national model for an urban health campus. Fueled by an impassioned sense of mission and the support of its patients, the general public, the faith community, and potential local and federal partners, three members of the Council of the District of Columbia, Sandy Allen, David Catania and Kevin Chavous, have proposed that DC General Hospital could be transformed into an Urban Health Campus on Capitol Hill and become a center for academic and clinical initiatives to eliminate disparities in access to care and health care outcomes. A new management team of D. C. Health & Hospitals Public Benefit Corporation (PBC), headed by veteran healthcare leader Michael Barch, took this concept and built the plan for PBC2.

The Urban Health Care Campus on Capitol Hill

Expanded Services

The new medical campus will add vitally needed services to the array of primary, specialty, emergency, trauma care, and inpatient services now located on the grounds of DC General Hospital. Long-term care, home health services, substance treatment services, and mental health services all will be integrated into all levels of the PBC2 care continuum. Centers of Excellence will be created to address the needs of special populations and manage chronic illnesses such as diabetes, HIV/AIDS and cardiovascular disease. Local and federal partners--including the National Institutes of Health and the Health Resources and Services Administration-would join in building the Urban Health Campus on Capitol Hill, which will serve as the specialty/acute care hub for primary care centers located in neighborhoods throughout the nation's capital city.

New Revenue Streams

The newly updated list of fees will increase revenues by more than $26 million annually and allow the PBC to be fully cost reimbursed for Medicaid. In addition, new profit centers will be added in areas such as ambulatory surgery and dialysis, and available space will be leased to services that will add to the vibrancy of the new Urban Health Campus.

A New Medical Center

A modern hospital will replace DC General Hospital in two years with no investment needed on the part of the District. A strategic alliance with Howard University Hospital, the College of Medicine and other healthcare partners such as Children's Hospital will build on DC General's traditional role as a center of academic medicine.

School Health

We will partner with the National School Nurses Association to enhance our school nursing for all students in DC Public Schools, including the Charter Schools, with physician back-up provided by nearby Community Health Centers and members of the Nonprofit Clinic Consortium, emphasizing health education, preventive medicine, immunizations and health screenings.

A New Computer Network

A new network will join all sites in the PBC2 -- at least 33 primary care health centers, the Level I Trauma and Emergency Care Center, inpatient floors, and administrative offices. The resulting efficiencies will be most evident in the areas of in patient registration, charge capture, medical records, tracking, and billing.

Focus on Community-Based Primary Prevention and Early Intervention

The PBC's six Community Health Centers will partner with the Non-Profit Clinic Consortium's 13 members and 27 clinics--including -- several Federally Qualified Health Centers -- to expand access to primary prevention and early intervention. Outreach activities will extend deeply into at-risk neighborhoods through the use of mobile vans and health educators whose mission will be to engage the medically vulnerable in primary care medical homes. The expanded primary care network will be the point of entry for many patients newly brought into the PBC2 system of care. Once registered, they will have access to an enriched, expanded and comprehensive continuum of primary, specialty and inpatient care.

Map of PBC2 full-service health centers

New Private Sector Efficiencies

Profound changes in organizational structure will set the stage for the new integrated delivery system. Every point of entry for a patient-ER, dental office, health center, etc. -- will serve as an enrollment center into the primary care system. A physician practice plan, single set of work rules for consolidated bargaining units, and efficiency and accountability mandates will form the building blocks of the healthcare organization. Governance will be expanded to include public and private partners and communities of interest.

Building on the PBC's Many Strengths


  • Historic safety net
  • Uncompensated care policy
  • Commitment to medical education


  • Three years of network integration experience spanning primary, specialty and acute care
  • Decades of primary and acute care experience in unique/medical/dental needs of the uninsured
  • Culturally competent providers and staff


  • Established relationships in the provider community
  • Provider role in corporate governance
  • Experienced new leadership in management

Clinical and Support Services

  • Emphasis on primary care and clinical outcomes
  • 94% score awarded by the Joint Commission for the Accreditation of Healthcare Organizations in November of 2000
  • 97% score awarded to the Community Health Centers
  • Availability of social services, nutrition, care management, translation services, transportation, mobile outreach, and other enabling and support services
  • Level 1 Trauma Center
  • Board-certified Hospitalists trained in efficient critical care of in-patients
  • Level 3 Neonatal Intensive Care Unit experienced in caring for the city's most critical newborns
  • Pediatric emergency care team assuring care 24/7 to parents who lack transportation to Children's or Howard University Hospital
  • Defined pharmacy benefit
  • Programs of care for local, federal and juvenile correctional populations, wards of the court, and persons in custody
  • Culturally relevant, evidence-based disease management programs
  • Population-specific quality indicators targeting the District's leading causes of morbidity and mortality

The PBC Present and Future

2283 personnel 1783 personnel (22% reduction)
Outdated schedule of fees Fee schedules that cover costs (+$26,million/year)
Excessive Number of Labor Units One system-wide set of work rules for union workers;
Consolidation of bargaining units
Six community health centers Primary care network includes 33 health centers
No Federally Qualified Health Centers Federally Qualified Health Centers
Few public/private partnerships Expanded public/private partnerships, including HRSA and NIH
Medical Education Academic center and nationally recognized teaching program
No outpatient psychiatric or substance abuse services On-campus partnerships delivering mental health and substance treatment services
Annual operating deficits Operates within $75 million annual DC contract
250 beds 190 beds
No home health or long-care Home health and long-term care
Limited disease management program Three to four new Centers of Excellence
Aging facility New, $100 million facility
Few leased spaces Spaces leased to complementary services
Physician's Union Physician Practice Plan
MIS network only partially installed Universal MIS network throughout PBC2
No bond or borrowing authority Bond and borrowing authority
No provider representation on board Provider, partnership representation on board

During Fiscal Year 2002:

Revenues and expenses will be in balance for PBC2, because we will realize the full RIF savings begun in FY2001, benefit from Medicaid/Medicare reimbursements that more closely match costs, and realize lease income —

Patient Care Revenues $74 million
DC Contract $75 million
Other Revenues $5 million
Contract, Grant Revenues $14 million
Total Revenues $168 million
Expenses $168 million

For more information, contact:

William H. Jones
Director of Public Affairs
Public Benefit Corporation 2
1900 Massachusetts SE
Washington, DC 20003
(202) 698-5469

The Urban Health Care Campus on Capitol Hill
© Public Benefit Corporation, 2001

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