jonetta rose barras: Health care rescue

What took them so long?

DC Council members finally got serious this week about disrupting the plan to close Providence Hospital in Ward 5. They unanimously passed the Clarification of Hospital Procedure Emergency Amendment Act of 2018. That bill makes clear the DC Department of Health’s State Health Planning Development Agency (SHPDA) has the power to approve or disapprove the closure of any health care facility in the city.

“We have a health equity crisis right now in the District that threatens the quality and access to care for our residents. There is no possibility that the complete closure of Providence on December 14, 2018, would not have an adverse impact on the District’s emergency health care system,” Ward 7 Council member Vincent Gray, who chairs the Committee on Health, said in a prepared statement after the legislature’s vote.

“The sheer volume of emergency room patients cannot be transitioned in an orderly fashion to other hospitals [by that date],” added Gray, noting that nearby Washington Hospital Center’s emergency room “has already experienced increased wait times and overcrowding.”

Washington Hospital Center reportedly provides care to more than 75,000 people each year in its emergency room. Providence has seen as many as 50,000 emergency room patients annually in recent years.

Representatives of Ascension, the Catholic-based nonprofit that owns Providence, did not respond to my request for comment about what action the company may take as a result of the council’s vote.

Gray and his colleagues said they were prompted to introduce the measure after it appeared that LaQuandra Nesbitt, M.D., who heads the city’s Health Department, was confused about her authority. They were being kind.

Actually, Nesbitt, who should be the bulwark against the erosion of any health care services in the city, apparently signed off on the closing earlier this year. A statement issued by the hospital quoted her as saying that Providence’s plan to create a “health care village” was a “positive step towards creating a comprehensive, accessible, equitable healthcare system capable of providing the highest quality services in a cost-effective manner to those who live and work in DC.”

Trust me, I am not making up this stuff. That is a statement from a person pulling down a six-figure salary paid for by District taxpayers on whose behalf she is supposed to be working. Did Nesbitt bother to speak with residents who use the hospital before she made that statement and gave the closure of a vital hospital the executive’s seal of approval? Probably not.

While Providence’s parents and staff have praised the council’s rescue, legislators ought to have acted long ago. It’s not as if the folks at Ascension hadn’t signaled its intentions. To use a cliché, even a blind man could see where things were headed.

In 2017, Ascension terminated obstetrics services at the Ward 5 facility that had served tens of thousands of District residents from all over the city.

That same year, the hospital also stopped providing inpatient psychiatric services. This happened at a time when mental health care has become critical throughout the country. Not only are suicides up; the number of attempted suicides is equally troubling. In the District, the Office of the State Superintendent of Education released the 2017 Youth Risk Behavioral Survey, which indicates that 11.8 percent of high school males and 19.1 percent of females thought of killing themselves.

Ascension said then that it intended to create a “health care village.” The definition for such a development was not forthcoming, however.

This summer Ascension announced it would be terminating acute-care services at the end of this year. It reiterated its intention to build a health care village. Ward 5 Council member Kenyan McDuffie declared himself “deeply alarmed.” Gray said he was “deeply troubled.” At-large member Elissa Silverman described the termination of services as “very worrisome. We want to make sure people have access to health care facilities close to their homes.”

And then they all went back to running their political campaigns or enjoying their summer vacations.

No one appeared too concerned — until board members were fired. The majority of the 12-member board received walking papers in August after they sought to prevent the closing, according to the Washington City Paper, which first reported the story. With that news lawmakers publicly jumped into action — not fast enough, however.

Gray didn’t hold a public hearing until Oct. 10. That was a full 15 months after Ascension began downgrading essential health care services. In my book, that is an extremely slow response to what is a looming crisis.

This week Gray urged Mayor Muriel Bowser to sign the legislation immediately. Given Nesbitt’s fawning over the Providence plan, no one should expect any swift action from the executive. Meanwhile, the Dec. 15 date looms.

jonetta rose barras is a DC-based freelance writer and host of The Barras Report television show. She can be reached at thebarrasreport@gmail.com.