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Councilmember David Catania
Statement to the Committee on Human Services on DC General Hospital
April 27, 2001




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A Few Reasons Not To Support Mayor Williams's Efforts To Contract With Greater Southeast Community Hospital

Promise Made #1: Expanded Access to Heath Care.
In his 2001-2001 Policy Agenda, Mayor Williams wrote, "I am committed to ensuring access to quality health care to every man, woman and child in the District -- no matter their ability to pay."

Promise Broken: Fewer individuals will be covered under the proposed contract.

  • According to the latest data available, about one-third of all uninsured individuals have incomes above 200 percent of the Federal Poverty Line, and the contract does not provide coverage for such individuals (Exhibit A, Clause 1).
  • There are an estimated 80,400 uninsured residents in the District. Therefore, at least 24,000 DC residents who currently have access to the PBC Health Care System (comprised of DC General Hospital and the six neighborhood health clinics) will not have access to health care under Mayor Williams's plan.

Promise Made #2: Expanded Number of Services.
In a March 28 press release, Mayor Williams wrote, "I'm building a better health care system."

Promise Broken: The flawed contract allows Greater Southeast Hospital to provide fewer services.

  • The Contract's estimates of how many residents will use its services and, consequently, its cost estimates, are based on the present level provided by PBC, guaranteeing than an increase will not occur within the budget estimates.
  • Clause 1.10.8 eliminates corrections health care once the money is gone: "The Contractor shall not be required to provide Corrections Health Care Services or Administrative Services in excess of the amounts set forth in Exhibit G."
  • Clause 3 to Exhibit A states, "[T]he Contractor shall not be required to provide any health care services that were not previously provided by the PBC ...."
  • Emergency room care will be "consistent with the level and scope of emergency room services provided by the PBC" (Clause 4.3.1).
  • Ambulatory care will be "consistent with the level and scope of services provided by D.C. General Hospital ..." (Clause 4.4). Emergency dental services will be "in the same scope as provided by the PBC." (Clause 4.5). 
  • The Contract does not guarantee its own pharmacy services: "In the event that the Contractor determines that it is unable to provide the Pharmacy Services for the amounts set forth herein, the parties shall attempt to renegotiate such amounts in good faith. If the parties fail to reach agreement on the amounts required to provide the Pharmacy Services with thirty (30) days of the expiration of the Evaluation Period, the Contractor shall discontinue the provision of Pharmacy Services hereunder. Discontinuation of the provision of Pharmacy Services pursuant to this Section 1.11 shall not be deemed to be a default under this agreement" (Contract Clause 1.11.4).

Promise Made #3: Access to a Greater Number of Health Care Providers.
On March 28, 2001, Mayor William issued a press release claiming that "the centerpiece of our health services reform plan ... provide[s] a network of more than 100 primary care

Promise Broken: The contract does not protect the Community Health Centers and does not guarantee that providers will be found.
  • According to the Contract, "the Contractor shall initially maintain and manage no more than the six neighborhood health centers ... [and] may recommend to the Authority the closure, consolidation or relocation of neighborhood health centers" Exhibit A, Clause 4.2.
  • The Williams Plan's Physician Services payments (Exhibit E) are so far below industry standards that some experts believe it will be almost impossible to find doctors to provide care. '

Promise Made #4: Less waste.
In a March 12, "Health Services Reform Update," Mayor William wrote, "The current health care delivery system is not using millions of dollars each year in available resources wisely."

Promise Broken: The Mayor's plan spend too much on administration and too little on care.

  • The contract allocates $7,604,730 for administrative fees (according to the totals from Exhibits E, F and G) versus $6,139,233 allocated for physicians' fees (according to the totals from Exhibits E and G).
  • The contract's total estimate for all services is $83.3 million. FY2001 allocation for PBC: $66.8 million. 
  • According to experts, the fee schedule in Exhibit E is incomplete and thus encourages fraud. Key terms are left undefined, leaving a table that lacks the necessary complexity to define key medical procedures.

Promise Made #5: An Enhanced Safety Net for Uninsured Individuals 
A health care flyer on the Mayor's website states, "The Mayor is committed to health care as a right."

Promise Broken: The Mayor's plan does not provide guarantees to health care.
Page 2 of the Contract notes that, "This Agreement does not create an entitlement to health care in the recipients of health care hereunder."

If you are concerned about access to health care service and an expanded number of health care services, about fording doctors to care for our needs, about the quantity of health care, and if you care about an enhanced safety net for our most vulnerable neighbors, you must oppose this flawed contract.

Keep the promise.

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