Sense of the Council on the District of Columbia Health and Hospitals Public Benefit Corporation (“PBC”) and D.C. General Hospital Emergency Resolution of 2001
PR 14-55

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Note: This resolution was passed by a vote of 13-0 at the City Council Committee of the Whole meeting on March 6, 2001. There was one amendment passed on the dias; that amendment is not included in this text.

Chairman Linda W. Cropp

A PROPOSED RESOLUTION IN THE COUNCIL OF THE DISTRICT OF COLUMBIA

Chairman Linda W. Cropp introduced the following resolution, which was retained by the Committee on the Whole.

To declare, on an emergency basis, the sense of the Council with respect to its position on the District of Columbia Health and Hospitals Public Benefit Corporation and the District of Columbia General Hospital particularly.

RESOLVED BY THE COUNCIL OF THE DISTRICT OF COLUMBIA, That this resolution may be cited as the "Sense of the Council on the District of Columbia Health and Hospitals Public Benefit Corporation ("PBC") and D.C. General Hospital Emergency Resolution of 2001 ".

Sec. 2. The Council finds that:

(1) The Mayor, Financial Authority, and Council agree that:

(A) there is a need to expand health insurance coverage to more District residents;

(B) the District must ensure the provision of quality health services, and

(C) the PBC cannot continue to function as it has in the past.

(2) The PBC is expected to exhaust its Fiscal Year 2001 appropriated subsidy by mid-March.

(3) There exists an immediate need to address the health care and financial crisis involving the PBC, particularly D.C. General Hospital, and to ensure a safety net for the District's medically uninsured residents.

(4) The Council does not have the ability by law to initiate a reprogramming of funds; the Council may only approve a reprogramming submitted by the Mayor.

(5) The District of Columbia Appropriations Act, 2001, permits the transfer of a limited amount of non-federal funds for the purpose of restructuring the delivery of health services in the District provided it is pursuant to a plan approved by the Mayor, the Council, the District of Columbia Financial Responsibility and Management Assistance Authority ("Authority"), and the Board of Directors of the PBC ("PBC Board"), and submitted to Congress.

(6) On December 5, 2000, the Authority adopted a resolution containing recommendations and orders concerning the PBC which recommends that the Council work with the Mayor to prepare and approve a plan to establish an alternative publicly-financed health care delivery system that (a) is consistent with the current mufti-year financial plan and budget for the District, (b) provides for equivalent volumes and types of services currently provided by the PBC to the uninsured, and (c) ensures that the services meet standards of quality and accessibility.

(7) The Authority further recommended that the Council enact legislation and/or approve regulations and reprogrammings, and undertake all other actions necessary to authorize and implement the alternative health care delivery system.

(8) The Council, in collaboration with the Mayor, the Authority, and the PBC Board issued a Request for Proposals ("RFP") to obtain, through a competitive process, a qualified provider or team of providers to deliver comprehensive, integrated, and coordinated health care services to the District's uninsured residents.

(9) The goal of the Council was to obtain a number of proposals, and to build partnerships between federal entities and local health care providers, to ensure that the health needs of the District's most vulnerable residents are met, preferably while retaining inpatient and trauma services on the D.C. General Hospital campus.

(10) That RFP process resulted in the submission of 2 proposals, one of which would maintain a hospital at D.C. General Hospital's current location, and the other which would maintain outpatient services on the hospital's campus while providing inpatient services at Greater Southeast Community Hospital and other facilities.

(11) The evaluators selected to assist with the RFP process have recommended the acceptance of Greater Southeast Community Hospital's proposal, and the negotiation of a letter contract with the same is underway.

(12) The Council has expressed, and continues to voice, concerns regarding such issues as:

(A) the resulting lack of trauma services in the eastern section of the District given that D.C. General Hospital is the only Level I trauma center serving that location and the high volume of cases it handles;

(B) the resulting lack of inpatient beds on the D.C. General Hospital site, exacerbating an existing imbalance in the geographic location of hospitals;

(C) the need for detailed performance measures that were not a part of the RFP but are imperative to determining the efficacy of the contract;

(D) the need to require a performance bond to ensure that monies are available should the contractor fail to comply with the requirements of the contract;

(E) the need to conduct due diligence on the proposed contractor's experience, ability, and financial stability to meet the specifications of the contract; and

(F) the timeframe and resources needed for a transition.

(13) In an effort to have these concerns addressed, the Council has raised questions at public hearings, in correspondence, and through representation on the Collaborative.

(14) The proposal which contained a budgeted amount of at least $75 million would cost more than the current appropriated subsidy, with services now provided by the PBC to the Department of Corrections and other District agencies not included.

(15) The PBC subsidy of $45 million was under-budgeted and the Council is prepared to increase the subsidy for a streamlined hospital and an appropriate number of community-based clinics to no more than $100 million, which appears consistent with the proposal.

(16) There is great concern that the out-year costs of contracting for services will increase and it will be too late and too costly to re-establish D.C. General Hospital.

(17) Past experience has demonstrated that the District's liberal social policies attract persons from other jurisdictions and threaten the District's ability to serve its citizens.

(18) This contract has the potential to increase well beyond what is fiscally responsible given the District's limited tax base.

Sec. 3. It is the sense of the Council that significant concerns exist with the proposal submitted by Greater Southeast Community Hospital based on the unresolved issues and other considerations articulated in section 2, and that any alternative to the PBC, and D.C. General Hospital particularly, must address those issues adequately. It is further the sense of the Council that a streamlined version of the current health care system, appropriately funded, could provide the necessary care at less than the cost of contracting for services.

Sec. 4. This resolution shall take effect immediately upon publication in the D.C. Register.