Bill to accelerate timetable for new Ward 8 hospital draws objections over provision to authorize GW Hospital expansion

A DC Council move might speed up construction of a new hospital in Southeast Washington on the site of St. Elizabeths.

Current plans call for George Washington University Hospital to run the new facility, which the city intends to serve as a replacement for its troubled public hospital, the United Medical Center. Both sites are in Ward 8.

The new hospital is scheduled to open in 2023, but Ward 7 DC Council member Vincent Gray believes that’s too late given urgent health care needs. A bill he’s introduced, the East End Health Equity Act of 2018, would expedite the approval process to jump-start construction of the new facility.

The council’s Health Committee, which Gray chairs, passed that bill unanimously Nov. 1 despite opposition from Foggy Bottom community leaders and their council member to a provision that would facilitate GW Hospital’s expansion plans there.

During the committee’s markup session, Ward 4 Council member Brandon Todd and at-large member David Grosso expressed concerns about other aspects of the legislation — namely potential negative impacts on Howard University Hospital and lessened opportunity for community input — but voted to proceed based on the expectation of further discussions as part of the legislative process. Gray has also pledged to hold more hearings on the issue, according to the committee report.

The bill heads next to the Committee of the Whole and the full council, where it’s scheduled for initial votes on Tuesday.

Gray, who argues that the new hospital is critical for preserving health care access for residents east of the Anacostia River, hopes to see the facility up and running by Dec. 31, 2021. He notes this gives the city three years and two months to complete the project — the same time it took to build and open Nationals Park.

“It’s time for the city’s leadership to show the same urgency for the new hospital as was done for Major League Baseball,” Gray said at his committee’s Oct. 26 hearing on the legislation.

The bill would waive the Certificate of Need requirement for construction on the new hospital at St. Elizabeths with 150 licensed beds and space to add 50 more in the future. Typically, any health care provider seeking to establish new facilities or services in the District must undergo a review to demonstrate a substantial public need for the project — a costly process that can take months.

“The exemption for the Certificate of Need may seem like a small gesture, but on closer examination, becomes a significant element in the construction timeline,” said Ambrose Lane, chair of the Health Alliance Network, a local group that works on health equity issues in DC.

Gray introduced the bill in September along with Todd, Ward 2’s Jack Evans, Ward 8’s Trayon White and Ward 6’s Charles Allen.

The new hospital is slated for the campus of St. Elizabeths, an expansive 19th-century psychiatric facility in Congress Heights that today includes a small public hospital for the mentally ill and a large swath of city land slated for redevelopment around the newly opened Sports and Entertainment Arena.

In August, Mayor Muriel Bowser signed an agreement that would allow George Washington University Hospital to run, and perhaps eventually own, the new hospital. GW Hospital is jointly owned and operated by a partnership between George Washington University and a subsidiary of Universal Health Services Inc., a for-profit company.

Many have argued for the need for a new facility serving wards 7 and 8 to take the place of the failing United Medical Center, the city’s only public hospital. Regulators shut down the hospital’s obstetrics ward in August 2017, and reports also circulated last year about several preventable deaths at the center.

Jimmie Williams, chair of the Ward 7 Democrats, testified in support of the bill at the Oct. 26 hearing. tadults about [the need for a] viable health care system that addresses and focuses on them and their families and difficulties they face,” Williams said. “The end result is that we see undiagnosed conditions, poor health maintenance and cynicism about the health care.”

City Administrator Rashad Young offered general support of the bill on behalf of Mayor Muriel Bowser but asked that the council refrain from incorporating terms that would impede  negotiations with GW Hospital on the terms of the deal.

“While our general preference is that new health care facilities be reviewed and approved through the traditional process, we believe that there is a great urgency for us to move forward with all due speed to advance this project so that we can establish a robust system of care east of the river, ” Young said.

Gray’s bill also includes plans for GW Hospital to open urgent care and ambulatory care facilities at other sites around wards 7 and 8.

At the Oct. 26 hearing, one issue caused some waves: a clause in the bill that would increase the number of inpatient beds at the GW Hospital in Foggy Bottom by about 40 percent.

Evans — who represents that area as the Ward 2 council member — joined several community members in speaking against the current legislation, which as written allows for “construction, equipment acquisition, and operation by GWU Hospital of a new bed tower on or adjacent to the existing GWU Hospital campus, which shall increase the licensed bed capacity of GWU Hospital by 270 beds.”

Evans said he agreed to co-introduce Gray’s bill based on his support for expediting construction of the new hospital in Southeast, but added that he felt “side-swiped” by the inclusion of the clause about the Foggy Bottom hospital.

“Now we’re being confronted with something that is a bridge too far: building a new tower with 270 beds in a community that is one of the most densely populated communities in the region, where you have already traffic nightmares going on, where you already have already enormous noise, pollution, etc. going on,” Evans said. “I think [it’s] asking just too much.”

Noting that construction of the current 385-bed GW Hospital building was also controversial in Foggy Bottom, Evans said that proceeding with the bill as is would undermine the trust of the community. “Once that trust gets destroyed, which is where we’re headed right now … the university and the hospital are going to have a heck of a time getting anything done in this community ever again,” he said.

Kimberly Russo, CEO of GW Hospital, testified in support of council action on the Foggy Bottom facility’s expansion, which she described as necessary to meet the District’s needs.

“The District does not have enough operational inpatient hospital beds to meet the growing population and medical needs of the city. While there are almost 2,000 licensed hospital beds in the city, only about two-thirds of these beds are actually operational,” Russo said. “GW Hospital is the only hospital in the District that is operating at its full licensed bed capacity. GW Hospital also continues to be at or above capacity daily.”

Neighborhood leaders in Foggy Bottom-West End came out strongly against the bill, citing a number of objections.

Marina Streznewski, president of the Foggy Bottom Association, questioned GW Hospital’s justification of needing “referral beds” at the Foggy Bottom facility for ward 7 and 8 residents seeking complex care.

“I understand that there are additional expenses involved in providing tertiary care in wards 7 and 8, but residents [there]… deserve the same access that those of us in Northwest Washington have,” she said.

Barbara Kahlow, secretary-treasurer of West End Citizens Association, said that the bill “helps the East End at the expense of dramatically and adversely affecting Foggy Bottom-West End.”

William Kennedy Smith, chair of Advisory Neighborhood Commission 2A and a physician, emphasized the importance of the Certificate of Need process for new medical services of this scale. “No new hospital construction of this size has ever been exempted in this manner before,” he said.