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What Is DCWatch?
The Committee on Human Services Of The City Council Of The District of
The D.C. Health Care Alliance
Vincent A. Keane, CEO
Unity Health Care, Inc.
June 22, 2001
Good morning Chairwoman Allen, and members of the Human Services
Committee. Thank you for holding this hearing today on the status of the
transition to the D.C. Healthcare Alliance (The Alliance). My name is
Vincent A. Keane, I am the CEO of Unity Health Care, Inc., a partner and
provider within The Alliance. Unity is honored to be chosen as a partner
in The Alliance, and we are totally committed to insuring that this
historic change in the public health care delivery system within the
District of Columbia, will truly serve the most vulnerable and medically
underserved of our citizens.
We are pleased to be partners with our fellow Alliance members, Greater
Southeast Community Hospital, D.C. Chartered Health Plan, George
Washington University Hospital, Childrens' National Medical Center and the
D.C. Department of Health. I personally have nothing but the highest
respect and admiration for my colleagues who have worked tirelessly over
the past several months in the struggle to bring this vision to reality. I
can assure you that I have spent more time with my partners here at this
witness table than I have with my wife and family. Our meetings have been
tense, and intense. They have been long and demanding but through it all
we have stuck together as partners, and all of us want to, and will make
this Alliance work.
Unity's Role and Responsibilities
Under the terms of our contract with Greater Southeast, Unity is
responsible for providing all of the primary health care services, and
other support services as defined in the RFP #D.C.FRA-00-R-039 issued in
December, 2000. Specifically Unity will staff and operate six (6)
community health centers formerly operated by the PBC, they are:
In addition Unity will staff and operate all the outpatient pharmacy
services at these clinics as well as the outpatient pharmacy at D.C.
General Hospital. While not specifically defined in the scope of services
of The Alliance, or the RFP, Unity under a grant from the Department of
Health (DOH) will also operate the WIC program formerly operated by the
PBC, and the HIV/Aids Clinic at D.C. General Hospital, known as the
Unity will make it possible for patients formerly served at PBC clinics
to have access to quality health care services in a health center that
will be attentive to the health care needs of that community as a whole.
Unity will provide a medical home for these patients.
The primary health care services that Unity will provide insure that
the same level of services formerly provided by the PBC will remain.
Unity's seventeen (17) year history of providing care to the medically
underserved in the District of Columbia allows us to bring a wealth of
experience and cultural competency in dealing with the unique health care
needs of the medically underserved. Unity started out as Health Care for
the Homeless Project, Inc. (HCHP), and today we continue to provide health
care to 15,000 homeless persons in D.C., our mission continues to be
"to provide quality, compassionate care regardless of ability to pay.
" Our staff will bring that same compassion and professional
expertise to the new patients we will be privileged to serve in The
Alliance. A list of the services we will be providing is attached as
Appendix A of this testimony.
The Transition Process
Like all of the partners in The Alliance the biggest challenge facing
Unity was to insure that we would have sufficient qualified employees to
staff the neighborhood health centers effective July 2nd. This challenge
was heightened further by the fact that the transition phase was
contracted from 3 to 2 months. This section will deal with the following
items relative to the transition:
- Development of the medical and staffing model appropriate for the
- Human Resources/Recruitment.
- Working with our Alliance partners to insure the integration of
primary care into specialty, and tertiary care systems.
A. Development of the medical and staffing model appropriate for the
In May Unity staff immediately began an assessment of each of the
health centers to determine how the same level of services previously
provided at the PBC health centers could be provided in a cost effective
and quality manner. It must be acknowledged that fiscal limitations within
this contract forced us to evaluate every position and every service and
determine how Unity could provide these services given the fixed
dollars-allowed for these services. The Board of Directors of Unity
directed me to move ahead as a partner in the D.C. Health Care Alliance on
one condition, namely "that the current mission and financial status
of Unity not be compromised."
In an attempt to maximize resources and enhance patient care, Unity
adapted a model of primary care practice that focuses heavily on the role
of the family practice physicians. The family practice physician is
capable of serving all age groups, children and adults, males and females,
and furthermore is qualified to do prenatal care and deliveries. By the
time the six (6) community health centers are fully staffed we will have
employed twelve (12) family practice physicians whereas previously there
was only one. While family practice physicians are skilled in family care
and play a diversified function, we also recognize the need for
pediatricians, internal medicine physicians and obstetricians. Unity has
hired appropriately to ensure that the full complement of services defined
in the RFP will be provided.
Not only did Unity conduct on-site assessment of the medical model
operative at the PBC clinics, but we also relied heavily on two reports
that had been conducted on the PBC/D.C. General operations. These reports
were the Cambio Report and a report by the Health Resources Services
Administration/Bureau of Primary Care (HRSA/BPHC) entitled "A Primary
Care Assessment of the D.C Health and Hospitals Public Benefit
Corporation. " The latter conducted in August, 2000 was very helpful
in assessing the strengths and weaknesses of the PBC system, making
recommendations on how productivity could be increased, and staffing
patterns adjusted to more accurately reflect utilization. This report
contained a series of recommendations that Unity has incorporated in the
development of it's staffing model for the health centers.
B. Human Resources/Recruitment:
As did all Alliance partners, Unity initiated it's staff recruitment by
inviting existing PBC staff to apply for positions within Unity. Our staff
have been diligently interviewing personnel, assessing qualifications and
extending offers to current PBC staff. We have also participated in all
the job fairs sponsored by the District Government relative to The
The following is a summary of Unity's recruitment efforts:
- Originally it was anticipated that Unity would hire approximately
120 staff to support The Alliance. With the addition of WIC, and the
Phoenix Center it is now expected that Unity will hire between 140 150
staff to support The Alliance.
- Approximately 215 contacts were made between Unity and PBC
- 125 interviews were conducted.
- Unity has extended 53 job offers for full-time equivalent (FTE's).
- There are currently 55 job offers pending to full-time or contract
- 4 offers were made and rejected by the applicants.
- 12 persons who applied for jobs withdrew their applications or did
not follow-up with scheduled interviews.
- 91 applications were rejected because (A) no position was available
within Unity; (B) the applicants did not meet the qualifications or
(C) Unity's pay scale did not meet the applicants pay requirements.
We should note that we have not yet completed our evaluation and
interviewing of all staff at the Phoenix Center.
In summary: Unity extended job offers to 50% of the applicants that
applied if you combine the actual offers with the pending offers. If all
PBC applicants offered positions with Unity accept, we will have hired 72%
of our Alliance staff from the PBC.
For those positions not filled by former PBC staff Unity has recruited
from a variety of difference sources.
C. Working with our Alliance partners to insure the integration of
prima care into specialty, and tertiary care systems:
Because Unity has a long history of providing care to the homeless and
medically underserved community of D.C. we are vary aware of the
challenges that they face in accessing secondary and tertiary care. In our
partnership particularly with D.C. Chartered Health Plan and Greater
Southeast we have been able to identify and articulate potential barriers
that our patients may experience in the enrollment process, and in their
efforts to access specialty care at the D.C. General Hospital clinics.
Unity's membership in the Non-Profit Clinic Consortium (NPCC) has enabled
us to share with our partners the unique needs and challenges that all of
us as non-profits on limited resources face. The overall result I believe
is excellent. We have developed through The Alliance an organized system
for insuring that patients can be referred for specialty care, and in turn
that referring physician will receive a full consult report back from the
specialist who performed the evaluation/consult. In addition pharmacy
services will be available to patients referred in for speciality care,
another significant need experienced by non-profits. We believe that The
Alliance will enhance patient care, result in better health care outcomes,
and barriers to access will be greatly reduced.
Looking To The Future
Unity's role in delivering primary care services to the members of The
Alliance is not just focused on treating sick people. We plan to expand
our preventive health care services, and to establish extensive outreach
services including community health promoters, similar to the program we
now operate at our East of the River Health Center.
Though the Community Advisory Councils at each health center we plan to
solicit community input around hours of operation, gaps in services, and
other community health care and social needs that are negatively impacting
on the health and welfare of our patients. Unity truly sees itself as a
partner with the community for better health care.
Unity has a long tradition of services to the most medically vulnerable
in D.C. We welcome the challenge of extending our compassion and care to
an even wider population. We consider it a privilege to serve those who
are most needy in our community.
Thank you and I will be glad to answer any questions.
April 8, 2001
PBC Clinics and Level and Scope of Services Provided
|Community Health Center
|Anacostia (Ward 6) 1328 W Street, NW
Hours: M, W, F
8:15 a.m. to 4:45 p.m. and T, TH, 8:15 a.m. to 8:45 p.m. and
Saturday, 9:00 a.m. to 1:00 p.m.
|Dental, Medical, OB/GYN, Midwifery, Nutrition (WIC),
Pediatrics, Social Services, Supplemental Food Program.
|Congress Heights Ward 8 3720 MLK Avenue
Hours: M, T, TH and F 8:15 a.m. to 4:45 p.m., Wednesday 8:15 a.m. to
8:45 p.m. and Saturday 9:00 a.m. to 1:00 P.M.
|Dental, HIV counseling, Medical, Nutrition, OB/GYN,
Midwifery, Pediatrics, and Social Services.
|Hunt Place (Ward 7) 4130 Hunt Place, NE
Hours: 7:30 a.m. to 4:45 p.m., M-F
|Dental, Nutrition, (WIC) OB/GYN, Midwifery,
Pediatrics, Social Services, Speech and Hearing, Stock' nest.
|Southwest (Ward 2) 850 Delaware Avenue, S.W.
Hours: 7:30 a.m. to 4:45 p.m.
|Dental, Medical, Pediatrics, OB'GYN, Podiatry, Social
Services, Nutrition, Financial Counseling, HIV Counseling, Dental,
Medical Pediatrics, OB/GYN,
|Walker Jones (Ward 2) 1100 First Street, N.W.
M, W, F 8:15 a.m. to 4:45 p.m., T, TH 7:30 a.m. to 7:30 p.m. and
Sat. 9:00 a.m. to 1:00 p.m.
|Nutrition, Social Services, HIV Counseling.
|Woodridge (Ward 5) 2146 24th Place, NE
Hours: M-F 8:15 a.m. to 4:45 p.m.
|Medical, Pediatrics, OB/GYN, Social Services,