Children's National Medical Center
111 Michigan Avenue, N.W.
Washington, DC 20010-2)70
Testimony of Children's National Medical Center
Before the Committee on Human Services
Jacqueline D. Bowens
Vice President of Government and Public Affairs
James Chamberlain, MD
Chair, Emergency Medicine
June 22, 2001
Chairwoman Allen, members of the Committee, I am Jacqueline Bowens,
Vice President of Government and Public Affairs for Children's Hospital.
Accompanying me today is Dr. James Chamberlain, who is the Chair of our
Emergency Medicine department. We appreciate your invitation to present
our testimony to you today about recent events affecting the DC health
care system and our participation. As the leading pediatric health care
provider in this region. we have been guided throughout this process by
our mission to protect the health and lives of the children.
Today's testimony will focus on three areas: A current summary of
services we have agreed to provide as partners in the DC Healthcare
Alliance; our progress with respect to the transition of those services;
and the impact to date on Children's Hospital from the changes in the
District's public healthcare system.
Children's and the Alliance
Children's is pleased to have the opportunity to participate as a
member of the DC Healthcare Alliance, and recognizes the important role
that the Alliance will play in delivering health care services to the
citizens of this city. As part of our agreement, Children's has assumed
responsibility for three areas of care: inpatient pediatric care,
pediatric specialty care, and the school health program.
With the closure of inpatient pediatrics services at DC General
Hospital on May 15, 2001, Children's began providing those services to the
children who had previously received their care at DC General. Since May
15, we have received 3 children who were transferred directly from DC
General. In addition, there have been 13 children that were seen at
Greater Southeast Community Hospital and then transferred to Children's.
In all cases, their care resulted in excellent outcomes.
Children's has historically provided the full range of pediatric health
care services to children from throughout the District, including wards 7
and 8. In FY 2000, we had 2,555 inpatient admissions and 61,281 specialty
care visits from children of the District of Columbia. Because of the
relatively low volume of pediatric inpatients at DC General Hospital, we
have been able to absorb this service with minimal impact.
Regarding the school health program, we have aggressively prepared for
the assumption of this program, and we are ready to begin. We have named
the program Children's School Health, Inc. Already, we have designed
compensation structures, transition plans, and have met with the school
health nurses on several occasions to provide them with an overview of our
transition plan. We have encouraged all school nurses to apply for
employment with Children's. To date we have received applications from 95
staff, including former PBC nurses and contract nurses. Offers have been
made to 50 RNs. Another 38 applicants are under consideration. 7 have
decided to remain as contract nurses. We are fully prepared for the start
of summer school on Monday.
Children's has contracted to provide all DC public schools with 20
hours of nursing coverage per week, as mandated by law and the terms of
our agreement. We have also contracted to provide 20 hours of nursing
coverage to 21 charter schools at 21 locations. In addition, as part of
the maintenance of effort, 14 high schools will be provided full coverage
of 40 hours per week. These schools are in addition to the full coverage
of 40 hours that will be provided to the school based health and wellness
center at Ballou Senior High School, and the educational centers at
Fletcher Johnson and Patricia Robert Harris.
While we expect the transition and management of the school health
program to be challenging, we fully intend to rely on the experience of
those from the program who join our team to help ensure that things run as
smoothly as possible. While we plan to act in a measured, judicious
manner, we are enthusiastic about our plans to enhance the program. Our
We believe that the school health program is the perfect program to join
forces with our Goldberg Center for Community and Pediatric Health, which
includes an extensive network of primary care centers, and our two mobile
medical units. Our assumption of the school health program meshes quite
well with our efforts to ensure that every child has a medical home. The
linkage with Children's will enhance school health nurses' ability to
make-appropriate referrals for primary care services throughout the
community, be it to our own primary care network. a non-profit clinic, one
of the former PBC clinics, or another primary care location.
- A comprehensive needs assessment of the program, utilizing input
from the parents of DC public school students, current school nurses
and school health advocates.
- The development of a strategic plan. This plan will certainly
include the utilization of Children's existing telemedicine technology
for patient care and distance learning opportunities. It will also
call for the enhancement and strengthening of the nurses' skills and
training, specifically in the areas of CPR and conflict
- New and innovative programs for parents and families designed to
keep kids well.
- Establishment of benchmarks to enable us to conduct appropriate
evaluation of school health services.
I would like to now turn to my colleague, Dr. Chamberlain, who can give
you some illustration of what we believe has been the global impact of the
closure of DC General on our own hospital. specifically in the emergency
Impact of DC General Closure on the Emergency Department
Chairwoman Allen and other council members, I would like to give you a
brief synopsis of what we believe the impact has been on our hospital
since the closure of DC General. As an emergency room physician at
Children's, I can tell you that we have certainly seen an increasing
number of patients over the last several months. To what this increase can
be attributed is a complex question.
It is possible that some of the increase can simply be attributed to
seasonal illness. The winter flu season always causes an influx of
patients. Springtime brings allergy problems. Both winter flu and
springtime allergies contribute to asthma, which continues to be our
number one diagnosis in the emergency room. Summer time results in more
accidents and trauma. Most of these things are normal healthcare trends
that are seen in emergency rooms across the country. You may also remember
intense media attention given a Scarlet Fever outbreak last winter. that
while essentially much ado about nothing, caused alarmed parents to flock
to the emergency room in droves. It is difficult to say if we have
experienced more of these visits because of DC General or because the
seasons have been particularly bad.
However, we did recently analyze zip code data to see if we were
treating more patients from the zip codes surrounding DC General Hospital.
According to these data, we have seen a 33°/0 increase in the number of
patients seen in our emergency department per month from the zip codes
near DC General Hospital since July 2000.
Interestingly, the increase in patient visits from these zip codes
actually began appearing in October and November, 2000. This leads us to
believe that the migration of patients from DC General Hospital began to
occur many months ago, when media coverage of the Mayor's plan
intensified. We have seen a steady increase since. We will continue to
monitor these trends as the DC General Hospital situation stabilizes.
In conclusion, Children's is very pleased to have the opportunity to
serve the children of this city through our participation in the Alliance.
We have easily assumed the inpatient and specialty pediatric care for this
population, and we look forward to the full implementation of the
Children's School Health program. We believe we have already weathered'
any major impact that this transition in our health care system might have
sent our way.
While it is sad that a Washington institution's time is coming to an
end, I can only assure you that Children's National Medical Center is
poised and ready to put the resources built by our 130 year history behind
the children who traditionally received their care from DC General. It
will be our privilege to care for these children.
Thank you again for the opportunity to share our testimony with you
today, and we would be happy to answer any questions you might have.