Washington, D.C., Mayor’s Proposed FY 2003 Budget Would Cut Funds for Indigent Care System

Washington, D.C., Mayor Anthony Williams' (D) budget plan for the fiscal year beginning Oct. 1 includes an $11.6 million reduction in funding for the Health Care Safety Net Administration, which manages the D.C. HealthCare Alliance, a private organization that provides health services for low-income and uninsured city residents. The fiscal year 2002 budget for the Health Care Safety Net Administration was $80.45 million; Williams has proposed a FY 2003 budget of $68.76 million (Silva, Washington Business Journal, 3/29). Last April, the District transferred management of the city's indigent health system from the bankrupt Public Benefit Corp. to the D.C. HealthCare Alliance and began to phase out inpatient and trauma services at D.C. General Hospital, the city's safety-net hospital. Under the new indigent care system, the D.C. HealthCare Alliance manages a network of more than 20 clinics that contract with private physicians, and Greater Southeast Community Hospital treats patients requiring hospitalization or trauma care. Residents may participate in the system if they have a permanent District address and annual incomes less than 200% of the poverty level, or $17,720 for an individual (Kaiser Daily Health Policy Report, 12/18/01). As of December 2001, 17,000 individuals had enrolled in the system, short of an expected 25,000. Because of the low enrollment, the system at that time had not spent the entire allotment of funds it received from the District (Kaiser Daily Health Policy Report, 12/4/01). Rene Wallis, deputy director for the D.C. Primary Care Association, said the reduction in funding proposed by Williams would harm indigent patient care, adding, "We haven't seen a justification at all for this cut, and it's a huge cut." But D.C. HealthCare Alliance CEO Ana Raley said, "The budget is not final, and I don't want to speculate on it. I don't know whether they're going to cut or not, and nothing is final until it's final" (Washington Business Journal, 3/29).