Federal Control Board Asserts Authority Over D.C. General

The District of Columbia financial control board on Dec. 4 ordered the "city's elected leaders" to lay off 500 workers at D.C. General Hospital and to prepare to convert the financially struggling hospital into a 24-hour outpatient center, the Washington Post reports. The hospital's budget is scheduled to "run out" on Jan. 15, and the four-member federally appointed control board said their action was a "safeguard" in case Mayor Anthony Williams (D) and the D.C. Council cannot finalize a restructuring plan for the hospital by then. To make certain that the city's uninsured will have access to health care in the event that D.C. General is shut down, the control board also "directed the city's financial chief to identify $90 million that could be redirected from other services to provide indigent care for the balance of the fiscal year." The city is attempting to hire private firms "to deliver the indigent care now provided by" the Public Benefit Corp. which runs the hospital. But the control board said that the privatization plan "is complicated and could be delayed" (Goldstein, Washington Post, 12/5).

Save the Hospital
The future of D.C. General "is being decided recklessly," Alan Sager writes in a letter to the Washington Post. Sager, a professor of health services at Boston University's School of Public Health, states that the hospital's closure "would undermine [both] the health of 80,000 residents who lack health insurance" and the "finances of other city hospitals that are willing to care for D.C. General's displaced patients." The hospital would be the sixth to close on the eastern side of the city since 1950, leaving "little care east of the Capitol." Sager is critical of Williams' conversion proposal, saying, "Repeated assertions that this concept is well-tested ... are false. Seemingly similar arrangements involve tightly integrated networks, typically in middle-income areas." Sager argues, rather, that reforming D.C. General is the "sensible choice," but will "require that all parties -- doctors, unions, administration, the Public Benefit Corp., D.C. government and others -- pledge to do everything necessary to cut costs, raise revenues, improve quality and prepare to renew the physical plant." Congress, Sager writes, should provide "emergency cash relief to stabilize D.C. General," and if not, the Clinton administration should grant "emergency relief through a Medicaid waiver," as it has twice done for Los Angeles County Hospital. Sager concludes, "If neither is forthcoming, the Public Benefit Corp. should place the hospital in receivership so that it can reorganize under a court's protection and continue to pursue its vital mission" (Sager, Washington Post, 12/3). A list of past Washington Post stories on D.C General is available at http://www.washingtonpost.com/wp-dyn/articles/A24094-2000Dec4.html.