COUNCIL OF THE DISTRICT OF COLUMBIA
WASHINGTON, D.C. 20001
The Honorable Anthony A. Williams
441 4th Street, NW
Washington, DC 20001
Dear Mayor Williams:
We request that the Executive submit to the Council a supplemental budget for FY2OOl to
maintain operations of the PBC through September 30, 2001. This will guarantee no loss of
patient care access for our most vulnerable residents or loss of critical staffing during
the transition period. The amount needed to cover the period between March 17, 2001 and
September30, 2001, is $52 million. Whether or not a contract is entered into between the
Financial Authority and Greater Southeast Community Hospital, the supplemental funds will
be needed to continue operations.
Moreover, by stabilizing patient care and PBC staffing for the balance of the current
fiscal year, the Executive is given an opportunity to respond to the unanimous sense of
the Council in a measured way. The Council's action strongly suggests that the Financial
Authority and Executive are moving too swiftly to privatization while an alternative --
public health -- plan is available.
During this period, we encourage you to review The Urban Health Care Campus Plan as an
alternative. The Urban Health Care Campus on Capitol Hill would replace the PBC with a
public sector, fully integrated health system that includes all of the traditional
providers of care uninsured and under-insured District residents. It is worth a pause in
the rush to sign a contract, which appears in any event to be a difficult process, given
all the delays that have occurred. The Executive can join the Council in a
"win-win" achievement for our citizens, by recognizing the value of Urban Health
Care Campus as an alternative to Greater Southeast.
The virtue of the Urban Health Care Campus or PBC2 plan is that it preserves the health
care safety net in the District, enhances neighborhood primary care and continues all
current pbc services to the community and public schools at a lesser cost to D.C.
taxpayers than the contract being considered with Greater Southeast.
The Urban Health Care Campus includes the basic core focus on primary care, specialty
services and a continuum of care for patients of the city's entire safety net. Also
included is a firm commitment to build a new central hospital on the current grounds of
The limited information available to the Council indicates that the proposed Greater
Southeast contract will cost the city much more than the $75 million a year that PBC2
requires -- and PBC2 would retain all services, such as correctional care and school
health, at no additional cost. Likewise, PBC2's access for patients and referrals for
specialty/inpatient care will be superior; the high quality of care at PBC has been
validated by the Joint Commission on Accreditation of Healthcare Organization (JCAHO).
PBC2 maintains public health as a responsibility of government -- rather than a business
to be contracted out. The Council has long supported the view that the least among our
fellow citizens deserve nothing less than a full city commitment to their health and well
The tool to achieve the goals of both the Executive and Council would be the existing
PBC law, which can be amended to reflect the Urban Health Care Campus mission, and changes
in governance structure and financial independence. The amendment will also reflect the
award of a $75 million annual contract in exchange for health services provided to city
wards and residents under supervision of the Department of Health.
The starting point for restructuring would be the "current level of service"
at the PBC, recognizing that the PBC already has eliminated 500 positions and reduced,
eliminated or consolidated a variety of services. PBC management would be empowered to
embark on the full reforms planned for the Urban Health Care Campus, including relocation
of Med Link Hospital to the D.C. General campus in the immediate future, to bring in new
revenues. There will also be a collaboration between the PBC and the Department of Health
to provide evidence-based measures of health outcomes to help DOH in managing citywide
There is much common ground between the Council and the Executive on emphasizing
primary care in the neighborhoods and the essential restructuring of the public health
delivery system. But moving toward the Urban Health Care Campus and seeking a much
enlarged role for Federal Government collaboration is a more rational approach than the
course of privatization, which would break the current system into little parts and make a
rebuilding process costly and time-consuming.
The Executive and The Authority should pause and respond to the sense of the Council
and the wide range of community concerns in a measured way. Providing a FY 2001
supplemental budget to maintain PBC operations will enable this collaboration as well as a
smoother transition. We all agree that this is a matter of great public impact, and the
Executive and Legislative branches ought to be working together.
Kevin P. Chavous