Health and Safety

Dear Safety Scouts:

Over the past several issues of themail, we’ve been discussing both health and safety issues -- both hospitals and security measures. This week, both issues merged when the Inspector General’s Office of the US Department of Health and Human Services released its audit of the DC government’s spending of federal grant funds for the Bioterrorism Hospital Preparedness Program, completed on June 28 (http://www.dcwatch.com/themail/issues/health050628.htm). In many respects, the audit repeats the findings of the DHHS audit of how DC dealt with the federal funds given to it under the Public Health Preparedness and Response for Terrorism Program (http://www.dcwatch.com/themail/issues/health050621.htm), which I wrote about in themail on July 13. While DC failed to spend 48 percent of the program funds given to it under the Public Health Preparedness and Response for Terrorism Program, it did better with the funds given to it for the Bioterrorism Hospital Preparedness Program — it failed to spend only 46 percent of those funds.

The DC Appleseed Center’s report on the District’s HIV/AIDS program released today, which Dorothy discusses below, exposes the same problem — the failure of the District government to manage its health and safety programs effectively, efficiently, or even professionally. AIDS has killed more District residents than any terrorist attack is ever likely to, and we have had decades to get our AIDS public health programs working properly. If the District government can’t be bothered to operate them well after all this time, what makes us think that the threat of bioterrorism will set it straight?

Gary Imhoff
themail@dcwatch.com

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What Would Benefit Metro Riders Most?
Dennis Jaffe, DennisJaffeDC@aol.com

My impression is that many folks think the Metro system, overall, is pretty good — but that overcrowding, delays, safety, and lack of clear information are all real serious concerns. Riders may soon get an influential voice that advocates on our behalf to Metro’s policy makers and staff. The agency plans to create a volunteer Riders Advisory Council (RAC), which will be staffed. Metro has asked the public for our comments on their proposal by Tuesday, August 16.

There is a catch. Metro wants its CEO to appoint the staff who will work for the RAC. If the RAC is to be effective, it will sometimes need to challenge and disagree with Metro. For it to be credible, its staff must serve riders loyally. So it’s crucial that the staff who carry out the Council’s work be able to do so without jeopardizing their jobs. That means not owing their jobs to Metro’s CEO. The RAC — not Metro’s CEO — should lead a staff selection process to ensure that the Council staff works loyally on behalf of riders.

To get Metro to listen to us, we need to speak up. Creating a strong Riders Advisory Council presents an opportunity to empower riders to influence those who are responsible for our safety and quality of service. There’s a sample message online that you can send to Metro’s board of directors as is, or even better, that you can put into your own words to send them. There’s also more information about the proposal at: http://www.sierraclub.org/dc/sprawl/action/p011.html.

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HIV/AIDS
Dorothy Brizill, dorothy@dcwatch.com

Today, the DC Appleseed Center released a report, HIV/AIDS in the Nation’s Capital: Improving the District of Columbia’s Response to a Public Health Crisis, which is available in PDF format on Appleseed’s web site at http://www.dcappleseed.org/projects/publications/HIV.pdf. Today’s Washington Post describes the situation tersely: “The District’s rate of HIV/AIDS is probably the worst of any major US city, yet the city’s response to the epidemic remains badly understaffed, poorly coordinated and especially lacking for youths and other at-risk groups. . . ” (http://www.washingtonpost.com/wp-dyn/content/article/2005/08/09/AR2005080901343.html).

There’s a connection between the long-standing problems in the District’s HIV/AIDS programs and the ongoing Washington Teachers Union trial that hasn’t been noted in the press. Michael Martin, who has pled guilty to participating in the WTU embezzlement scheme, and who is the son-in-law of Gwendolyn Hemphill, who is currently on trial, was for several years the Chief of Operations of the DC HIV/AIDs Administration, and oversaw that office’s staff. In his trial testimony, he has admitted that he lied on his resume to get the job — he claimed to have a degree from Howard University when he has no college degree, and he claimed to live in the District of Columbia at his mother-in-law’s address though he actually lived in Prince Georges County. At the same time that he held this position, he was also receiving $49,000 a year as a salaried employee of the United Planning Organization (UPO). His third job at the same time was to assist Barbara Bullock and Gwendolyn Hemphill in their embezzlement. Along with Errol Alderman, a friend who Martin hired at the HIV/AIDS Administration, he assisted in laundering nearly a half million dollars in WTU money over three years through a paper corporation they controlled, Expressions Unlimited. And he testified that he spent a good deal of time chauffeuring Barbara Bullock, shopping with her, planning her parties, and styling her hair; and even more time assisting Gwendolyn Hemphill with the mayor’s 2002 reelection campaign. The administration has treated the DC HIV/AIDS Administration as a political plum, a place to park political allies rather than as an office that deals with one of the most serious health problems in our city. Until that attitude changes and substantial changes are made in the staffing of that office, nothing will change in the city’s mismanagement of AIDS programs.

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Video Minutes from a Community Meeting
Phil Shapiro, pshapiro@his.com

Have you ever attended a community meeting and wished other community members were there to hear and see what was being said? These days it’s possible, without too much effort and almost no expense, to archive community meetings on the web at the Internet Archive. Here are the "video minutes" of a community meeting I recently attended (http://mytvstation.blogspot.com). This meeting is the July 2005 meeting of the Robotics Special Interest Group within the Capital PC User Group (CPCUG.) I have to admit, I don’t have a strong interest in robotics, but I was fascinated by what I heard at this meeting. The annual FIRST (For Inspiration and Recognition of Science and Technology) robotics competition is opening doors of learning and opportunity for tens of thousands of teens across the country. The kind of project-based learning that goes on in these competitions is exactly what our youth need. If you have an interest in youth development, you might want to view the video minutes of this meeting. Regardless, thanks for passing along the word about this to others you know.

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Sanitation Workers
Paul Wilson, dcmcrider at gmail dot com

I once lived in a much bigger city than our cozy little commonwealth of DC. In this sprawling lakeside city of the big shoulders, trash collection fell under the authority of a city department called “streets and sanitation.” This moniker seems to me to be a little more accurate than the impressive-sounding “Dept. of Public Works,” a name that evokes grand bridges, canals, parks, schools, and whatnot. In any event, DPW might want to try on the “sanitation” label one of these days. About three weeks ago, contractor crews dropped off bright new recycling and trash “supercans” on our block. This block has no alleys, so trash is picked up curbside. In their generosity, the contractor even dropped them off at adjacent multiunit properties that have private trash hauling. Our block is now lined with vibrant blue and more somber dark green cans. We’re now faced with what to do with two city-supplied cans from the last "upgrade."

Presumably, the considerable cost of city-supplied trash cans could be justified in that uniform trash receptacles make trash collection faster and easier, with less toil for city workers. I’m all for less toil. Far from being an improvement, though, Mondays and Thursday mornings have become a scene of unsightly, smelly clutter. The crews appear to collect the trash in two waves. In the first wave men on foot fling open the nifty new supercans and dump the bags — and occasionally loose contents — into the parking lane, between parked cars. At some point (perhaps hours later?) a second wave comes through, collecting the stinking bags so carefully stowed in cans the night before, and throwing them into the trucks. Woe to anyone leaving a parking spot. If you’re not lucky, you need to do some personal trash hauling of your own to move your car.

I’ve seen this all over Capitol Hill in the past month or so, during my early morning exercise and inspection tours. It appears the new improved trash collection system is just another wasteful debacle.

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Play Architect for the Ballpark
Almina Khorakiwala, Almina@walkermarchant.com

The DC Sports and Entertainment Commission (DCSEC) has added a new section to its recently revised web site, http://www.WashDCSports.com. “Your DC Ball Park” is an interactive section that has been added to allow DC residents and baseball fans everywhere to have their say about how the new baseball stadium in the nation’s capital should look and what features it should have. Just click on the link from the http://www.WashDCSports.com home page. The “Your DC Ballpark” section features information on plans for the new stadium that will be updated from pre-development through groundbreaking, construction and the home opener in March 2008.

The arrival of the Washington Nationals baseball team, together with the excitement of DC United Soccer, brings more attention than ever to the DC Sports and Entertainment Commission. The new web site not only showcases the home of two of Washington’s great sports teams, but also the DCSEC’s programs that encourage involvement by Washington, DC residents in organized team sports, recreational activities, youth athletics, and healthy lifestyles. The site is also a portal for all things sports in the District of Columbia and is the first place to look if you’re trying to find a sport or recreational activity, want health information or a quick link to local school, college or professional sports teams.

As the new web site grows, additional features and links will be added. To submit a sports or entertainment related link or activity for posting to the web site, please send information to Tony Robinson, Director of Public Affairs, RFK Stadium, 2400 East Capital Street, SE, Washington, DC 20003 or E-mail to Arobinson@dcsec.com.

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National Capital Medical Center
Eric Rosenthal, eric.rosenthal@mac.com

Washington has awful health statistics. Infant mortality, asthma, diabetes and life expectancy, especially among black Washingtonians, are terrible. What is most tragic is that we could do better. We know how to prevent most infant mortality, most asthma and diabetes complications and most premature death. In other places, people do not get sick and die early at the rates we do in DC. Every Washingtonian should be outraged that it happens here. That is why the discussion over the city’s proposal to build the National Capital Medical Center is vital. The proposal represents a once-in-a-generation opportunity to address our health needs. It should be judged in terms of whether it would make Washingtonians healthier, whether it would reduce our rates of disease and death. In that light, the NCMC is the wrong approach and it should be rejected.

Greg Rhett, writing in themail on behalf of the DC Federation of Civic Associations [themail, August 7], is correct in saying most major medical centers are west of North Capitol Street. However, that is not proof that residents east of North Capitol Street lack emergency and acute care or proof that Washington needs another hospital. We live in a tiny city of 69 square miles, and our half a million people are served by nine acute care hospitals, nine emergency rooms, and five Level I trauma centers. Cars and ambulances cross North Capitol Street all the time. Washingtonians already use twice the national average of emergency and hospital care, and 25 percent of our hospital beds on average sit empty each day. Can the proponents of the new hospital demonstrate Washingtonians lack emergency and hospital care and the NCMC would remedy that? They have yet to do so.

A recent JAMA study found that Washington is the only state in which every resident lives within 45 minutes of a high-level trauma center. Only 69.2 percent of people in the US live that close. As a caution for those who think we need another, the JAMA article also reviewed the downsides of too many trauma centers concentrated in a region: inefficiency and decreased quality of patient care (probably due to too few patients per center). The city’s consultant, Stroudwater Associates, found that even with several hundred million city dollars in startup subsidies, the NCMC’s finances would be shaky. Mr. Rhett is correct that Stroudwater said one necessary condition for financial viability would be for Howard to move its hospital and other medical services away from Georgia Avenue to the new site. Howard has yet to say if it plans to do that and the city suggests it would not, justifying its proposal in terms of the need for additional hospital beds.

Stroudwater noted several other conditions necessary for the NCMC to reach financial viability. These conditions include receiving federal grants of more than $42 million each year, attracting a relatively wealthy patient payer mix and limiting the amount of medical care it provides to poor Washingtonians without health insurance. There is no evidence any of this would happen. Finally, the city proposal makes a number of unsupported and unrealistic assumptions in an attempt to project the NCMC would require no additional operating subsidy. For example, it projects an 80 percent hospital occupancy rate, a rate much higher than Howard University’s and much higher than the average for all DC hospitals.

Perhaps Stroudwater Associates is correct when it reaches the following conclusion in a report to the city: “The needs of the population may be better served with a focus on providing access to ambulatory care and integration of the ambulatory care system with other District hospitals to create a continuum of care. Such a system would benefit the District as a payer by improving access to lower cost alternatives and improving the programs to address the serious chronic diseases in the District, thereby reducing unnecessary hospitalizations.”

The results of these discussions are critical, especially for black people in Washington. The advocates of any proposal must demonstrate it would ease the health burdens that actually plague DC and it would be the most effective way to accomplish that task. Those supporting the NCMC have not done so. We must go forward only with a plan that would yield significant health improvements. The stakes are too high to do otherwise.

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National Capital Medical Center
Martha Ross, mross@brookings.edu

I am in complete agreement with Mr. Rhett (themail, August 7) that the inequity in health status and access to high-quality medical care among District residents is unacceptable. But I don’t think a new hospital is the way to fix the problem. A lot of health problems in this city are driven by chronic diseases — things like asthma, diabetes, hypertension. In some areas east of the Anacostia River, almost half the adult population has a chronic disease. With these conditions, you shouldn’t need to go to a hospital, as long as you have regular access to primary medical care. It’s like changing the oil in your car — if you do this routine maintenance, you won’t burn out your engine and you won’t spend a fortune at the car repair shop. Lest you think something like, “Oh, diabetes, that’s not such a big deal. All you have to do is watch your sugar,” here are some of the effects of diabetes: blindness, kidney failure, and amputations. For example, people with diabetes are at particular risk for foot-related problems. But if they learn how to take care of their feet and go for treatment in the early stages of a problem, they are much less likely to have a foot amputated. Sounds like a good advertisement for primary care to me!

The same areas east of the Anacostia River with high chronic disease rates also have high rates of avoidable hospitalizations — much higher than other parts of the city. An avoidable hospitalization is a hospital admission for a health condition that should only rarely require hospitalization (like the chronic diseases mentioned above). Such hospitalizations point to the failure of primary care either in terms of accessibility or quality. People in Ward 3 have the lowest rates of these types of hospitalizations. And they have plenty of hospitals nearby. So it’s not because they don’t have access to a hospital that they’re not going. They have lower rates of avoidable hospitalizations because their asthma, diabetes, hypertension, etc. rarely gets to a crisis point where they require hospitalization, which means in turn that they’re getting the kind of primary care they need to manage their chronic condition.

Mr. Rhett also correctly notes the east-west divide in hospital services. But there’s also a divide in the location and number of doctors’ offices. Nonprofit community health centers are located where you expect them to be — in areas with moderate to high poverty so they can serve people without insurance or who otherwise would have problems getting medical care. They do heroic work, but there’s not that many of them and some are pretty small. Take a look at the location of doctors’ offices overall. They are overwhelmingly in Ward 3 and downtown. According to tax data, there are a total of about 30 offices of physicians in Wards 7 and 8 together, compared to 30 in Ward 1, 252 in Ward 2 (downtown), 126 in Ward 3, 59 in Ward 4, 131 in Ward 5, and 38 in Ward 6. (I can give the fine print on the data if folks are interested, but it tends to make peoples’ eyes glaze over.) It’s just not clear how a new hospital would help improve DC’s health indicators. We do have lousy health indicators. Something is wrong with the health care system here in DC. But our biggest health problems, the ones that cause the most premature deaths and unnecessary suffering, are things like chronic diseases and low birth-weight infants. A hospital, old or new, is not the right place to address these problems.

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Secure in Their Persons
Mike Gottert, lt_gottert@hotmail.com

Mr. Cowan recently wrote [themail, August 7] discussing the need for random searches on Metro. He stated Mr. Imhoff’s essential point was “that there must be a reason to investigate, search, and detain. That is the traditional way of law enforcement in the United States: stopping, searching, arresting only for probable cause, usually after the commission of a crime.” This is exactly correct; not only is it the traditional way of law enforcement in the US, it is the only constitutional way for law enforcement to function. Mr. Cowan wrote: “The problem posed by terrorism is that we seek to prevent the crime from happening lest it claim large numbers of victims.” This is more or less the problem posed by most crime, the difference is the number of victims.

“If a man wearing a bulky, buttoned coat approached a Metro subway entrance on a hot August day, that would be reasonable grounds for a Metro officer to stop that rider and ask him to open his coat.” That is correct, it would be reasonable grounds to ask; however, barring any additional circumstances, it is not enough to require it. “Or suppose a young man is carrying an obviously heavy canvas bag or suitcase.” What about an old man? Or a woman? “I see no harm in asking him to open it.” Again, asking is not the problem, requiring it is. Fortunately, the Founders did see the harm in this.

“In both these scenarios, there is a reason for the officer to suspect criminal intent.” Is there really? The vast majority of people with heavy bags are travelers, not terrorists. Thus far no one in this country has blown up or attempted to blow up a subway train, therefore it is unreasonable to assume that individuals are engaged in criminal activity. “Gary Imhoff objects to purely random searches as unwarranted invasions of privacy, and ineffective. They do, briefly, invade privacy. . . . These are transient ills.” The recent terrorist attacks in London killed more then fifty people. In 2004, 198 were killed in the District. Therefore should we allow the police to briefly invade the privacy of people on the street; it will only be a transient ill.

“What will Mr. Imhoff say about combating terrorism when the first suicide bomber blows himself up in a Washington subway station?” While I would not think to speak for Mr. Imhoff, I will speak for myself. I would say that no number of terrorist attacks can allow us to allow our government to intrude on our natural rights. “Amendment IV. The right of the people to be secure in their persons, houses, papers, and effects, against unreasonable searches and seizures, shall not be violated, and no Warrants shall issue, but upon probable cause, supported by Oath or affirmation, and particularly describing the place to be searched, and the persons or things to be seized.”

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Random Searches Are Effective and Necessary
Bryce Suderow, streetstories@juno.com

I agree with Ed Cowan [themail, August 7] about the usefulness of searches. I think random searchers protect densely populated areas like subways by diverting terrorists to softer targets.

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Personal Privacy Rights
Michael Bindner, mikeybdc at yahoo dot com

Just to clarify the debate, there is no right not to be photographed when in public. Anywhere a cop can see you a camera can photograph you. I would note that the use of cameras in London and the arrest of the second round of bombers probably stopped a continuing bombing campaign, so, yes, cameras do work. Cameras in public areas are not big brother. Big brother is not associated with mere police surveillance but with attempts to control thought — i.e., Orwell’s thought police. You will find the thought police in totalitarian states such as Iran and Saudi Arabia and among the denizens of Al Queda. We have nothing like that here.

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Backlash at Bonilla
Lars H. Hydle, larshhydle@aol.com

Perhaps Bonilla was surprised by the backlash among DC residents against his proposal to rename 16th Street, NW, after Ronald Reagan. Last year during the late President’s funeral, liberals and Democrats claimed to be nostalgic about President Reagan’s conservative yet amiable presidency, which they contrasted with the current one, but in retrospect they were just looking for another way to bash Bush.

The bill offers DC residents a chance to remind Congressman Bonilla and others that although the Constitution gives the Congress jurisdiction over the District, the District lacks voting representation in the Congress. Maybe Bonilla could be persuaded to cosponsor legislation for DC voting rights in the Congress.

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Ronald Reagan Boulevard
Esteban Guzman, regimechangenow@yahoo.com

I agree with Gary Imhoff [themail, August 7] that we should lie back and stop complaining about Henry Bonilla’s attention-seeking proposal to rename 16th Street “Ronald Reagan Boulevard.” In fact, we should embrace the idea. Mayor Williams, that nattering nabob of negativity, complained that it would be costly to change the signage and so forth. Think outside the box, Mayor. We could recruit Lt. Col. Oliver North to help us finance the transition by selling some weapons to terrorists and diverting the proceeds. What better way to honor dear President Reagan’s legacy?

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CLASSIFIEDS — EVENTS AND CLASSES

Arts Workshop Classes
Jonathan Darr, jonathan@chaw.org

The Capitol Hill Arts Workshop, a nonprofit community arts center near Eastern Market, is announcing our thirty-third season of classes in the visual and performing arts. The Arts Workshop features a ceramics studio, dance and exercise studio, art studio, gallery, black box theater and programs for early childhood, youth, and adults. If you are interested in learning more about our Fall semester please visit http://www.chaw.org.

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CLASSIFIEDS — HELP WANTED

DCFPI Is Looking for a Public Policy Analyst
Ann Pierre, pierre@dcfpi.org

The DC Fiscal Policy Institute is looking for a Public Policy Analyst. The DC Fiscal Policy Institute conducts research and public education on budget and tax issues in the District of Columbia, with a particular emphasis on issues that affect low- and moderate-income residents. Our current issue focus includes the DC Earned Income Tax Credit, affordable housing, progressive tax reform, income and poverty trends, welfare reform, and efforts to improve the transparency of the District’s budget.

The posting for DCFPI’s policy analyst position can be found on our web site at http://www.dcfpi.org/8-9-05dcfpi-analystjob.htm.

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CLASSIFIEDS — DONATIONS

School Supplies Are Still Needed
Susie Cambria, scambria@dckids.org

DC Action for Children is collecting school supplies — and we particularly need backpacks to put the supplies in. We hope to fill an additional 150 backpacks with paper, pens, pencils, markers, rulers, crayons, etc. We need your help to outfit DC students! And if you are not able to make it to your local supply store, we will gladly accept monetary donations in order to purchase the supplies needed. If you would rather make a monetary donation, please make checks out to DC Action for Children/School Supplies Drive.

Donations may be delivered to DC Action for Children, 1616 P Street, NW, Suite 420, by Thursday, August 25. Let’s make sure that DC children and youth have everything they need to be successful this school year! Call Kim Bell at 234-9404 for more information.

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