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The DC Voter
League of Women Voters of the District of Columbia
Vol. 82, No. 3, March 2006

A Voice for Citizens — A Force for Change

1717 Massachusetts Avenue, NW, Suite 600, Washington, DC 20036-2008
202-222-0710
Website: http://www.dcwatch.com/lwvdc, E-mail: LWVDC@aol.com

Balancing Homeland Security and Civil Liberties
Clarence Darrow — The Search for Justice
Transportation
President's Message
Bed and Breakfast
National Program Planning
Travel with the League
In Memoriam
Unit Meetings March 21-23
International Relations
Naturalization Ceremony Reception
LWVDC Membership Form
Calendar, March 2006
Background on Proposed National Capital Medical Center

Balancing Homeland Security and Civil Liberties

Saturday, March 25, 2006 10:30 a.m. to 12:30 p.m.
Martin Luther King Memorial Library, Room 443 (top floor)
901 G Street, NW, Washington, DC 20001

Program: Reception, panel presentation and audience question and answer session.

Panelists:

Lisa Graves, American Civil Liberties Union (ACLU) lawyer
Dr. Patrice McDermott, American Library Association spokesperson on PATRIOT Act, privacy issues
Steve O'Brien, American Red Cross (National Capital Area) Manager, Disaster Operations
Dave Robertson, Metropolitan Washington Council on Governments' Executive Director
Lee Ruck, Metropolitan Washington Council on Governments' Legal Counsel
Dr. Stephen D. Prior, Bioterrorism Expert, Potomac Institute of Policy Studies

Co-sponsored by League of Women Voters of the National Capital Area and the District of Columbia Public Library System, Division of Sociology, Education, and Government.

See February issue of DC VOTER for article entitled: Homeland Security: Emergency Management Agency of the District of Columbia.

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SAVE THE DATE: TUESDAY, APRIL 18, 2006 at 7:30 p.m.

Clarence Darrow ...The Search for Justice
Enacted by Gary Anderson

Scopes 'Monkey Trial' Revisited:  Reenactment described as "provocative, immediate and inspiring," ... "Acting is in the same league as Hal Holbrook's Mark Twain." ...

National Presbyterian Center
4101 Nebraska Ave. NW at Van Ness
(Parking available behind church) 

Presented by
League of Women Voters of the District of Columbia Education Fund 
District of Columbia Bar Association Litigation Section

Admission: $15 if reserved in advance.
Payable at the door or in advance to LWVDC, 1717 Massachusetts Ave. NW #600, Washington, DC 20036-2008. Checks payable to LWVDC Ed Fund. No refund for cancellations due to illness or weather.

For reservations, call (202) 222-0711
$20 if paid at door without advance reservation.

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TRANSPORTATION

At the farewell for Dan Tanglerini as D.C. Dept. of Transportation Director it was announced that Michelle Pourciau will take over his responsibilities at least while he is on trial as the new boss of the Washington Metropolitan Transit Authority.

Allen Mutchnik, of the CAC, reported on the result of the Arlington protest on the proposed widening of 1-66 which I mentioned in the VOTER last month, as follows:

`The Associated Press report on the authorization by the National Capital Region Transportation Planning Board (TPB) of VDOT's $9.6 million 1-66 "spot-improvement" study on January 18 ...Due to the advocacy of the Arlington Coalition for Sensible Transportation (ACST), supported by regional Sierra Club representatives and the Coalition for Smarter Growth, VDOT substantially clarified its study proposal, and Arlington County Board Chairman Chris Zimmerman got the Northern Virginia Transportation Authority and the TPB to incorporate several key conditions into their authorizations, including to:

  • keep "any proposed construction... within the existing right-of-way",
  • "maintain any adjacent parkland or the Custis Trail",
  • not "degrade safety" or "preclude a third Metrorail track and expressbus operations" and
  • evaluate a continuous 12-foot shoulder and HOV enforcement areas.

If VDOT actually complies with the TPB's conditions, the currently proposed addition of three segments of a third westbound lane--from threel-66 on-ramps to the following off-ramps--should not be feasible. We shall see. Between SAFETEA-LU and Gov. Warner's proposed state budget for FY07, $50.5 million is currently earmarked to construct these segments of a third westbound lane.

Meanwhile, the quote below--if accurate--from VDOT's Dennis Morrison that public transit improvements in this corridor segment should not take precedent because public transit is already overcrowded and must be accessed primarily by auto is particularly myopic, uninformed, and disturbing. I hope Mr. Morrison was just badly misquoted. ACST will monitor this study closely and will be actively engaged in its public involvement and technical evaluation processes.

I have been reappointed to the Transportation Planning Board Citizens Advisory Committee (CAC). — Grace Malakoff

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PRESIDENT'S MESSAGE

We will soon be mailing a fundraising letter to our members and supporters. More annual meeting committees are at work: budget - Liz Martin and Naomi Glass; Geri Whitley on the proposed speaker. The National Capital Area League Annual Convention will be May 13, 2006; Anna Marsh has joined their nominating committee. — Grace Malakoff

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Bed and Breakfast

Let your out of town friends and relatives know we offer Bed and Breakfast. Or, if you have a spare bedroom, volunteer as a League hostess. Contact Chris Matthews at 202 269-3890 for more information.

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NATIONAL PROGRAM PLANNING

Our consensus on program planning for the League of Women Voters of the United States 2006-2008 was reached at an all-member meeting on January 26, 2006. The consensus states:

"D.C. League members agreed that the League of Women Voters should expend our collective energy and funds emphasizing action on our core issues of participatory democracy, voting and elections, rather than mounting a new study or program."

— Kathryn Ray, 3rd Vice President

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TRAVEL WITH THE LEAGUE

The DC League will be sent $100 for each person who mentions the DC League when booking their travel. Contact:

Travel Concepts International Inc.
5550 Bucks Bar Rd., Placerville, CA 95667
Telephone: 1800 762-4216 or 1530-621-3007
Email:   gwen@travelwiththeLeague.com
Web site: www.travelwiththeleague.com

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IN MEMORIAM

Former League member Rodney Shaw died in early February; he will be remembered by his many friends in the United Methodist Church, where as a minister he was actively involved in the population control and nuclear disarmament movements. In the DC League, he worked with the International Relations Committee on UN issues. His wife Mary was active in the Capitol Hill Unit. See his obituary in the Washington Post of February 14. — Sheila Keeny

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UNIT MEETINGS MARCH 21-23
Discussion Topic: Comprehensive Plan

The Office of Planning Draft Plans are being posted on the Web. For Environmental Protection and Sustainability (60 pp) and Housing (40 pp) much detail is included. For Parks, Recreation and Open Space a new descriptive framework is proposed, as well as inclusion in the Plan of the river shorelines.

To view the draft plans on the web, go to http://www.inclusivecity.org/docs.php and scroll down to Draft Comp Plan Working Documents; then, click on the document you wish to view.

We will try to have some briefings by Planning staff or task force members, as well as the Draft Plans for inspection and discussion.

UNIT MEETING SCHEDULE

TUESDAY, MARCH 21
9:45 am, Southwest Unit will meet in the Home of Anna Marsh (554-7719), 1253 Delaware Ave. SW 
12:45 pm, Northwest Day will meet at IONA Senior Services, 4125 Albemarle St. NW, Tenleytown Metro (red line), Barbara Yeomans (363-8940) 
6:30 pm, Capitol Hill, For meeting place call Betty Pierce (544-5547) 

WEDNESDAY, MARCH 22
9:45 am, Upper 16th St. will meet at the home of Natalie Howard (237-2163), 3001 Veazey Terrace NW #434 

THURSDAY, MARCH 23
9:45 am, Chevy Chase/Ingleside will meet in the Theatre at the Ingleside Apartments, 3050 Military Rd, NW; Ruth Allen (362-8953)
7:30 pm, Northwest Evening will meet in the home of Geri Albers (362-2605), 4000 Mass. Ave. NW #1510

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LIBRARY STUDY

The Library Study Committee will meet on Thursday, March 9 from 9:30 - 11:00 am at Ingleside Apartments, 3050 Military Rd., NW The Committee will share their reports on the library visits.

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INTERNATIONAL RELATIONS
GREAT DECISIONS

The DC League's Great Decisions discussion group will tackle key topics this month. We will meet from 2 - 4 PM in the LWVUS Board Room, 1730 M St., NW, 10th Flr.

March 13, Human rights in an age of terrorism 
March 27, India and China: competition and cooperation.

All LWVDC members welcome; call me for further information. — Sheila Keeny, Great Decisions facilitator

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NATURALIZATION CEREMONY RECEPTION
Tuesday, April 11th Can You Help? 

Again this year, we will cater the reception for new citizens ourselves. That means that we need to have willing bakers to produce cookies, cakes or brownies, or provide crackers and cheese or fresh fruit. If you can help provide food, please call Judy Smith (882-3021) or Amy Proft (320-7722).

We hope that many of you can attend this impressive ceremony. Plan to be seated in the front left or right sections by 9:45 am in the ceremonial courtroom (20) on the 6th floor of U.S. District Courthouse, located at the corner of 3rd St and Constitution Ave. NW. — Judy Smith

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MEMBERSHIP FORM TO JOIN OR RENEW

Questions concerning League membership can be directed to the League office at 222-0710. See the LWVDC MEMBERSHIP FORM.

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CALENDAR — MARCH 2006

SUN MON TUES WED THURS FRI SAT
      1 10:00 am, LWVDC Board Mtg. 2 3 10:00 am, NCA Board Mtg 4
5 6 7 April DC Voter deadline 8 9 9:30-11:00 am, Library Study Cmte Mtg 10 11
12 13 14 9:45-11:00 am, voter registration at naturalization ceremony for new US citizens 15 16 17 18
19 20 21 9:45 am, Southwest
12:45 pm, Northwest Day
6:30 pm, Capitol Hill
22 9:45 am, Upper 16th St. 23 9:45 am, Chevy Chase/Ingleside
7:30 pm, Northwest evening
24 April DC Voter mailing 25 10:30 am-12:30 pm, Balancing Homeland Security and Civil Liberties
26 27 28 29 30 31  

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BACKGROUND ON PROPOSED NATIONAL CAPITAL MEDICAL CENTER

Prepared by Goody Braun, Co-chair Health Committee

The Issue

A Memorandum of Understanding was announced January 5, 2006, by Mayor Anthony Williams and Howard University President Patrick Swygert, for a hospital to be built on the D.C. General site (nine acres south of RFK Stadium called Reservation 13). It will be called the National Capital Medical Center. The proposal must be approved by City Council.

"The nucleus of the NCMC would be a new, fullservice, world-class, Trauma Level hospital that would contain between 200-300 beds," says the MOU. "It is the intent of the University and the overarching goal of The NCMC to ensure that all residents of the District have access to high-quality healthcare. Accordingly, the University pledges that the proposed NCMC will be unambiguously committed to serving all citizens of the District."

The estimated cost is $400 million. The District and Howard would split construction costs, with a cap of $212 million for each partner, and the university would be responsible for its first three years of operation. Starting in the fourth year, any operating deficits would be covered by a new nonprofit corporation that would run the medical center and Howard's existing hospital on Georgia Avenue NW. The proposed hospital will have 250 beds, largely transferred from the current Howard University Hospital on Georgia Avenue so the total beds in the city will remain the same.

Certificate of Need

The District has a certificate of need process for all major health care expansions, which is designed to prevent a community from building an excess of expensive health care facilities. The District proposes waiving its CON for the project.

The University expects to pay for most of its share of the NCMC's cost, as much as $212 million, through tax-exempt revenue bonds backed by the Federal Housing Administration. The mortgage insurance would help Howard obtain a lower interest rate on its borrowing.

Though the District would waive its CON, the mortgage insurance, might require a CON.

Those who support the CON argue: The certificate of need is intended to encourage accountability within health care and to discourage unnecessary duplication of services.

FHA considers it a fundamental element of the FHA review process, said spokesman Lemar Wooley in a Washington Post article.

"We cannot imagine a D.C. Council charged with stewardship over the city's treasury approving such an enormously expensive major health facility that bypasses the certificate-of-need process... The review process is the taxpayer's principal means of ensuring -through the work of independent experts - that the proposed hospital is needed, does not duplicate existing services, is cost effective and well financed, and has well-thought-out management and operational plans"-Washington Post editorial Jan 10

Those who are aqainst the CON argue: Certificate of Need is not required because Howard already produced certificate of need for its beds, which will be transferred.

Arguments Against the Hospital

The city needs access to primary care doctors, of which there is a severe shortage in three-quarters of the city.

The District already has plenty of hospitals. The District has more than twice as many beds per capita as the national average; and there are currently more than a thousand beds licensed which are not in use by current hospitals. Even Howard can fill only slightly more than half of its 482 beds. Washington Hospital Center is licensed for more than 900 beds and has a suite of 21 operating rooms.

The District paid for a consulting report on the financial viability of a proposed hospital, which was completed by Stroudwater and Associates. The report found a new hospital would require subsidies, and recommended the city build an ambulatory care/urgent care center on the site.

The healthcare industry in general is moving away from its historical hospital-based model toward ambulatory care (outpatient visits), wellness centers, and in-home care (end-oflife and hospice). This move is caused by an increase in chronic illnesses caused by poor diets and sedentary lifestyles, increased medication options to treat illness, a shift to prevention and illness management, and consumer demand. By building a hospital, the District is investing in a shrinking industry.

Reducing long emergency room lines and caring for the uninsured are more urgent problems for the city, which could be more easily solved by using the money to build a network of smaller primary care clinics and/or urgent care centers in lowincome areas. Many lower income people use the hospital emergency room for primary care visits (for example, medication refills), and many people of all incomes use the emergency room for significant but non-life-threatening illnesses (for example, cuts that require stitches).

"I don't think the National Capital Medical Center will do much to help us in terms of bottom-line health outcomes," said Dr. Eric Rosenthal, an emergency room physician and Capitol Hill resident, to the DC Examiner. "The advocates haven't put out any evidence suggesting that it will."

Though the NCMC project is touted as a way to bring health care to the poor, it is actually located on the west side of the Anacostia, and would probably force the closure of Greater Southeast Community Hospital, the only acute-care medical facility now serving patients east of the Anacostia River. And if Greater Southeast is forced to close, there won't be any hospitals in the city's poorest neighborhoods.

Howard University Hospital on Georgia Avenue already operates at a deficit, and many of its medical teaching programs have lost national accreditation over the past ten years, demonstrating a lack of management capacity for a new hospital.

Transfer of beds from Howard U Hosp will free up a portion of the school's land at the heart of the District's gentrification boom, a potential windfall to Howard.

The city's experience with DC General and the Public Benefit Corporation, both of which were private non-profits, is that these nonprofit entities do not operate in the black, offer poor quality care, and are difficult to shut down once they are operating.

Mayor Williams and the Council have redirected funds that used to support DC General into the Health Care Alliance and expansions to Medicaid, a health benefit programs for low income residents. A new hospital would divert funding from these important projects that pay for the entire range of health care services. Both programs pay for hospitalization, and, after investing $200 million plus, the city might take Alliance funding and give it to the new hospital, forcing low-income patients to that facility.

The agreement does not guarantee free care to uninsured District residents.

While the District's involvement would be capped at $212 million for half the hospital's construction, construction costs often increase dramatically once a project has begun. With a major investment in schools planned, and a baseball stadium, the District cannot afford the debt.

Comments in the Press

Residents of the Georgia Avenue corridor have expressed concern that Howard University is not financially capable of handling two massive operations simultaneously, and would eventually close Howard University Hospital in favor of the NCMC.

DC Examiner, Jan 16, 2006, wrote, "D.C. Mayor Anthony Williams recently signed an exclusive contract with Howard University Hospital to build a new $400 million National Capital Medical Center and trauma facility on the old D.C. General site. But this joint-venture should be DOA when it arrives at the D.C. Council's swinging doors."

The Hill, Hillscape, Jan. 11, 2006: "The real deal in the DC-Howard pact to build the $242 million National Capital Medical Center is that Howard gets to dump its money-losing hospital ($17.3 million in the red last year) into the new facility, where someone else will pick up the inevitable deficits.

"There is nothing in the exclusive rights agreement about the problem of District health care: that some 70,000 residents are without insurance, and they mostly live east of Rock Creek Park, and they'll come in numbers to the emergency room of the new hospital because that's what they have done in the past for anything from a nosebleed to a brain injury. The NCMC will eliminate any chance of Greater Southeast Hospital's financial viability, hinting of the nightmare of not one but two public hospitals asking for perpetual handouts."

Arguments In Favor of the Hospital

Howard University contends: "District hospitals services are poorly distributed geographically

'There is a need for additional hospital capacity as the District grows.

"Forty two percent of the District's population lives in the Eastern quadrants; and the District needs a hub for its new community health network, where doctors can refer patients for diagnostic testing, specialty care and medical procedures.

"The current clustering of District hospitals could be problematic in the event of a major disaster."

"The NCMC will be an important part of a communitybased system of care with a focus on prevention and wellness, and it will also have the capacity to support the District's new primary care network known as Medical Homes. If approved, this significant project will serve as an economic engine to enhance the transformation of S. Reservation 13 into the planned mixed-use Hill East Neighborhood."

There was been a hospital on the DC General site for more than 100 years, and there is a strong emotional attachment to having a hospital there (similar to the emotional belief that having a Major League Baseball team makes DC a "real city".). Many residents of that quadrant of the city perceive they are unequal to other quadrants, and believe a new hospital will equalize their standing.

Many residents east of the Anacostia River, and others who live adjacent to the D.C. General property, say people are dying because hospitals are too far and doctors' offices are too few. Build the hospital and lure additional primary care providers, supporters say - the east has for too long been neglected - this according to the DC Examiner.

Howard University Hospital on Georgia Avenue needs a new facility; this could reduce the costs of that facility.


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