At a public hearing on the only hospital in Southeast D.C., residents and hospital staff alike described dangerous conditions and demanded that the city provide better support. “Sitting here and listening to people testify was very heart wrenching. I totally empathize for all the people that were here,” said UMC’s chief executive officer, Ira Gottlieb, after more than 30 people testified on Friday.
UMC, serving more than 150,000 residents in Wards 7 and 8, will close after a new hospital is built on the St. Elizabeths Campus in Congress Heights. But the new hospital isn’t scheduled to open until December 2022, and in the meantime, staff describe the many ways UMC is struggling to get by. They say Southeast residents feel abandoned.
Compounding these struggles, it is unclear whether the city will meet this looming 2022 deadline. Health advocates are already pushing back against the company, Universal Health Services, that’s expected to operate the new hospital because of its troubled billing and anti-union practices. Moreover, advocates say, negotiations have been “shrouded in mysticism,” leaving little opportunity for community input. The Council isn’t selecting the operator but will review the agreement. Health committee chair, Ward 7 Councilmember Vince Gray, says he does not know the status of negotiations as the Council hasn’t been actively involved.
“I really think we need to bring this to a conclusion. People need to have some predictability about what’s going to happen next,” Gray tells City Desk.
If the Council doesn’t get answers soon, At-Large Councilmember Elissa Silverman says she is considering sending a letter to the mayor’s office, asking about the status of negotiations.
“We should have had a signed agreement by now,” Silverman tells City Desk.
Meanwhile, as Silverman put it, UMC is on life support. When dozens of UMC staff and their supporters, including Service Employees International Union and Moms Demand Action, a group that advocates to stop gun violence, testified before the health committee on Friday, they called on the Council to adequately fund UMC because the hospital cannot provide critical services and current staff is overworked.
“Patients are showing up even though they know we don’t have [obstetric] services [because] that is the closest hospital,” said Betty Holmon, who worked at UMC for 37 years before the maternity ward shuttered. “We need to have the OB unit open again now, not when the new hospital is coming about, because we don’t know when that is going to occur. We know UMC is open now.”
When UMC’s obstetrics unit closed in 2017 due to medical errors, Ward 8 patients and some Ward 7 patients were left without any maternity care. That means pregnant patients have had to deliver in UMC’s emergency department or travel west of the Anacostia River. The latter can sometimes be dangerous; for example, Congress Heights resident Shaquana Bates delivered a stillborn baby and nearly died herself after an ambulance took an hour to transport her to a hospital.
When Gray asked UMC’s chief executive officer if it was possible to reopen the maternity ward, Gottlieb effectively said no. “People were not coming for deliveries at our hospital… the cost of doing something like that [in 2018] was $16 million dollars to really build it,” he said.
Residents also testified to needing a trauma center. Despite seeing a disproportionate number of stabbing and gunshot victims, southeast residents lack a trauma center. The four hospitals in the District with a trauma center are concentrated in the northwest region.
“Gerald [Watson] was killed after school, shot 17 times,” said Nathan Luecking,a social worker at Anacostia High School. “I wonder still to this day, what that would have been like had he been taken to a hospital that was significantly closer. Would he have survived? That’s the kind of thing I have to think about every time a student is killed and pronounced dead at the hospital.”
Gray assured residents that the new hospital will have a trauma center, with at least a level 4 accreditation. That means the new hospital will be able to provide evaluation, stabilization, and diagnostic capabilities for injured patients. After the hearing, Gray told City Desk he had spoken to Deputy Mayor for Health and Human ServicesWayne Turnage about needing to prioritize trauma care in the new hospital.
City Desk received an advance copy of a report from the Mayor’s Commission on Healthcare Systems. Turnage and Gray serve on this commission. Mayor Muriel Bowser instructed the commission to release a set of recommendations, and a 140-page report is expected to come out this week. The report mentions the new hospital, asking for the development of a “work plan” for a successful transition. This plan should include “ways that a new health system will address prenatal and delivery needs for women East of the River.” The report modestly mentions trauma care, only asking for a “communications plan to explain to the community the level of services to be provided and how the hospital will manage deliveries for high-risk pregnancies and trauma care.”
Various nurses also testified to being understaffed and overworked even as they are still expected to serve patients that require a lot of attention, including FD-12 patients. These patients are petitioned for involuntary hospitalization because they pose a significant risk to themselves or others. UMC sometimes sees six or more FD-12 admissions in a single shift, said UMC president of the D.C. Nurses Association, Roberta LeNoir.
“We at UMC are asked to provide these services without adequate support, funding, and rationed supplies,” said LeNoir during the six-hour hearing. “Even though our budget was cut $18 million dollars, we still strive to serve the community to the best of our ability. I have 300 assignments despite objections from the nurses I work with because we are afraid of working in the continued conditions, putting our licenses at risk.”
The Council slashed the city’s subsidy to UMC to $15 million FY2020, despite the hospital requesting $40 million. After health advocates decried the cuts, the Council increased the subsidy to $22 million. During the hearing, Gray proudly announced that UMC received an extra $11 million from Medicaid Disproportionate Share Hospital (DSH) Payments. UMC didn’t qualify in 2018, but successfully applied for DSH payments in 2019. UMC was able to secure this money, and so was able to balance the budget for fiscal year 2020. That UMC had to go in search of this money means the Council was initially unrealistic about what it took to operate UMC, Silverman said.
“What I’ve heard today is, except for those who have to go to UMC, those who have any option decide to go elsewhere, and that’s a big financial problem for you and for UMC,” she told Gottlieb during the hearing. “This hearing… it’s been illuminating in a way that is causing me more anxiety about the health care system in our city.”
Gottlieb says UMC did not cut any clinical services for budgetary reasons but did lay off 30 people, nine of whom were D.C. residents. Gottlieb did his best to highlight some of UMC’s recent successes, like its partnership with George Washington Hospital. He stressed that UMC remains open and provides quality care, despite the misconception that the hospital is already closed.
But Gottlieb conceded that the uncertainty has negatively impacted patient volume, recruitment of new staff, and the morale among current staff.
“There is no intention to close the hospital before the new hospital is open,” said Gray. He stressed this point numerous times during the hearing, attempting to bring some assurance to residents who remain rattled by all the uncertainty.
In between assuaging nerves, Gray clashed with many residents who testified at various points on Friday, as many questioned his commitment to Ward 7 and 8 residents.
“We can’t get one simple councilmember who looks just like me, who should understand African American issues, to vote and to put money in a hospital that saves lives for people who are already struggling—that is a problem for me,” said Ward 8 Advisory Neighborhood Commissioner Christopher Hawthorne.
One public witness went as far as asking Gray if he wants to be remembered as the late Rep.Elijah Cummings (D-Md.) or Supreme Court Justice Clarence Thomas.
“I am a native Washingtonian … I am a product of the D.C. public schools, I have been here all my life—everything that I have ever done is on behalf of people,” said Gray in response. “I’m proud to be compared to Elijah Cummings. I don’t ever want to be compared to Clarence Thomas.”