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PBC may delay D.C. General layoffs
(Published September 25, 2000)
By OSCAR ABEYTA
Workers and patients of D.C. General Hospital protest in front of One Judiciary Square Sept. 18 to voice their opposition to plans that would eliminate in-patient care at the hospital.
D.C. General Hospital’s governing board will meet Sept. 29 to vote on whether to begin the planned layoffs of 550 doctors, nurses and support staff beginning Oct. 1, but city council and community concerns over the fast pace of the reorganization of the hospital could delay those layoffs.
A spokeswoman for the Public Benefit Corp. (PBC), which oversees the hospital, the city’s health clinics and school nurses, said the board could vote to delay the layoffs which were announced at the end of July. She said part of the reason for the possible delay arose during a recent two-day council oversight hearing at which council members and residents complained about the scope and the pace of the changes proposed for the hospital.
But Chief Financial Officer Natwar Ghandi warned the council that whatever course of action is chosen, the hospital needs $60-80 million more than was budgeted for the next fiscal year. He told the council that right now the hospital doesn’t even have enough money to shut down.
Ghandi’s testimony came during two marathon days of testimony Sept. 18 and 19 when council members chastised city officials for excluding them from the planning process. Councilman Kevin P. Chavous, D-Ward 7, excoriated the administration of Mayor Anthony A. Williams for how officials have dealt with the financial crisis at the hospital, accusing them of "secretly trying to close this hospital."
"I think there was a conscious decision to delay dealing with this for the past two years," Chavous said. "At a minimum, there was a clear decision to deal with this out of public view."
At-large Republican David Catania criticized the lack of details in the planned downsizing of the hospital and the haste with which it was put together, saying, "at this point we have a hope and a prayer that this plan will work."
The PBC board voted July 28 to eliminate most hospital services from D.C. General, turning it into an Emergency Stabilization and Access Center. Patients needing in-patient care would be sent to other private hospitals and trauma cases would be stabilized and transferred.
Public outcry over the proposal has been furious as activists and residents have denounced plans to remove health care services from some of the poorest areas in town. The hospital, like most public hospitals in the country, is the primary source of medical care for uninsured patients.
PBC board chairman Julius Hobson, described in his testimony how the board developed its plan based solely on financial concerns.
"I say this with sadness…that the vote in favor of (the restructuring of the hospital) was not based upon the best possible health delivery system model," he said. "It was policymaking at it’s worst – creating a system solely determined by the amount of dollars available."
The D.C. budget bill for fiscal 2001, which is currently working its way through the House and the Senate, contains a provision that prohibits the city from giving PBC any more than the $45 million budgeted for next year. The PBC is expected to come up about $67 million short for the current year ending Sept. 30, according to Ghandi. Shortfalls like these over the past three years have been covered by the D.C. government through loans which the PBC has not paid back. It is the government’s practice of floating these loans to the PBC that Congress sought to end.
Ghandi told the council that it needs to begin crafting a supplemental appropriation bill that would pump an additional $60-80 million into the PBC to get it through the restructuring period. According to Hunter R. Clarke, general counsel for the CFO’s office, a supplemental appropriation is the proper way to put money into the PBC’s budget.
Clarke said that even though Congress could ultimately reject a supplemental appropriation, he said he is confident that the politicians on the Hill would approve it if the city could show in good faith that officials are trying to fix the PBC’s problems.
"It’s a political problem only to the extent that we have to come up with a really good plan and sell it to Congress," Clarke said.