Update, 9:50 p.m.

Well, that was anticlimactic: Late in today’s legislative meeting, Vince Gray moved to postpone a vote on his bill to Dec. 18, after a flurry of amendments appeared to blindside him.

Ward 8 Councilmember Trayon White and At-Large Councilmember Elissa Silverman successfully added amendments against Gray’s wishes. In a moment of confusion, White introduced an amendment that would, in his words, require GW Hospital to work with medical students and staff from Howard University Hospital. Circulated earlier Tuesday with the support of Howard University, it would help ensure “Howard College of Medicine to meet its applicable accreditation requirements,” according to White’s office.

Gray and Ward 4 Councilmember Brandon Toddwere expecting to co-introduce, with White, a weaker amendment that would have asked the city to conduct a feasibility study of creating some sort of partnership between GW Hospital and Howard.

Before White made his move, an amendment from Silverman passed to guarantee unionized nurses and other staff at United Medical Center jobs at the new hospital at St. Elizabeths. The addition passed 8-3, but was opposed by Gray, who called it a “poison pill.”

The discussion fired up several councilmembers. “Anybody who votes against this is voting against the unions,” Ward 2 Councilmember Jack Evans said, frequently saying he was surprised to agree with his more liberal colleague Silverman.

Gray successfully amended his bill to add 50 more beds at the Ward 8 hospital, bringing its capacity to 200, and shrink the size of the Foggy Bottom expansion. The latter amendment envisions a 170-bed tower at GW, with 50 additional beds being added within the hospital’s current footprint.

Howard celebrated the addition of White’s amendment, which passed by acclamation, but Evans was cautious.

“I just don’t know if you can make a private company partner with somebody else. … Good luck, it may work. I just don’t see how it works,” Evans said, nonetheless supporting it along with Council Chairman Phil Mendelson.

Moments later, Gray successfully postponed the bill.

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District officials have already dismissed Howard University Hospital’s proposal to run a new $325 million hospital east of the Anacostia River, but university leaders are riled up and want another shot at the project.

It’s a matter of survival, according to the university: Howard University medical officials and students say that not having a chance to train and employ its physicians at the new project could put the 156-year-old hospital out of business. Heading into today’s vote on a D.C. Council bill to accelerate George Washington University Hospital’s deal with the city to operate that new hospital in Ward 8, students and hospital officials led a #HowardMedicineMatters campaign. Howard supporters have gathered at the Wilson Building to reiterate their message.

Ward 7 Councilmember Vince Gray, who wrote the bill, plans to submit an amendment today that adds more beds to the proposed Ward 8 facility and asks the District to study the “feasibility of an academic affiliation for Howard,” according to an aide.

Howard’s opposition to the deal is the latest plotline in the city’s path to building a new hospital for underserved Wards 7 and 8. When the District evaluated proposals from hospital providers to manage the Ward 8 hospital, GW Hospital and Howard’s bid were the top offers. The city found the bid from GW Hospital to be superior, while the Howard proposal was “thin” and “demanded more of the city and offered little in return,” as one top city official put it to City Paper last month.

Howard officials now say they filed a 24-page proposal that included plans to move their Northwest hospital to Ward 8, along with its medical education schools and colleges.

“We planned out a pretty comprehensive medical zone,” says Dr. Hugh Mighty, the dean of the College of Medicine.

Howard University Hospital has faced its share of issues over the past decade: financial mismanagement and the highest death rate per bed among District hospitals, according to a 2017Washington Postreport. Mighty says the hospital has posted surpluses in the past three years, and it draws 35 percent of its revenue from patients who live in Wards 7 and 8.

The procurement process has also drawn the attention of Foggy Bottom’s Advisory Neighborhood Commission 2A, which opposes a proposed expansion of GW Hospital in their neighborhood that was part of the hospital’s bid to fund the less lucrative Ward 8 hospital. The District did not pursue a formal request for proposals to seek vendors for the Ward 8 project, instead opting to directly negotiate with interested operators like GW Hospital and Howard, which submitted a joint bid with Sibley Memorial Hospital, a part of Johns Hopkins Medicine.

In doing so, ANC 2A chair William Kennedy Smithis questioning whether the District violated procurement policy. When the District enlisted the healthcare consulting firm Huron to begin planning for the hospital, the firm noted that a request for proposals may be needed due to “legal requirements,” despite recommending that direct negotiations would be the fastest option.

Smith sought the opinion of white-shoe law firm Covington, which, based on the scarce available information, wrote this: “[T]he District appears to have skirted fundamental principles of competitive procurement law for a major public-private partnership” by allowing GW Hospital to modify its bid with a proposal to add a new bed tower in Foggy Bottom and subsequently not allowing an opportunity for other bidders to modify their proposals.

The Bowser administration signed a letter of intent with GW Hospital in August for the project, after meetings with hospital providers throughout 2018. Last month, Councilmember Gray wrote a bill to waive the Certificate of Need to speed up the construction of the new facility and a more than 200 bed expansion at GW Hospital in Foggy Bottom, opposed by community groups and even GW University, which owns 20 percent of the hospital that bears its name.

Gray’s office plans to amend the bill Tuesday, taking 50 beds from the Foggy Bottom expansion and adding it to the Ward 8 facility, bringing the total number of beds at the new hospital to 200. The Foggy Bottom expansion is envisioned to add between 170 and 220 beds. GW University said last week it opposed building that expansion.

Smith wrote to his ANC colleagues on Monday that he has forwarded Covington’s opinion to the D.C. Inspector General and the Office of Attorney General.

“Moreover, if the District reaches a final public-private partnership agreement with [GW Hospital] conditioned on waiving the Certificate of Need for the Tower, without having evaluated such a condition when selecting [GW Hospital] from among other interested parties, the resulting agreement could be challenged as contrary to the District’s procurement laws and bedrock principles of competitive procurement,” Covington’s E. Sanderson Hoe, an expert in contracting law, wrote in a pro-bono 7-page opinion to ANC 2A. (Read the full opinion below.)

Howard University would have liked to modify its proposal, Mighty said in an interview. In their bid to the city, officials from Johns Hopkins would have made up the management ranks of the new hospital—its CEO and other top officials—while Howard would have provided the doctors and care physicians. “Hopkins had certain stipulations to the city, and I think the city did not find that they wanted to do it that way,” Mighty said, adding that the District didn’t notify Howard about its issues with the bid in order to work out changes.

Mighty said that Howard, which has by far more black medical students than any other area school, would be shut out of training new generations of black doctors if it didn’t get a piece of the new hospital.

“It’s important that people understand that Howard trains black physicians and many of our physicians … who come to medical school at Howard would have had no other opportunity to train elsewhere,” he said.

In a statement, Gray’s spokesperson, T.N. Tate, said that Gray is “confident in the fairness” of the selection process for GW Hospital.

“George Washington University Hospital was deemed the best partner for this project. Moreover, George Washington University Hospital, which is operated by Universal Health Services, has a stellar reputation and has served patients citywide for many years,” Tate wrote. “Councilmember Gray has committed to working with Howard University Hospital on viable solutions to ensure its sustainability.”

But the president of Howard University, Wayne Frederick, is blasting Gray. He said in a Tuesday radio appearance on Joe Madison’s Sirius XM show that the legislation to waive the Certificate of Need came as a “bombshell.”

“The repercussions here are massive.”

Photo by NCinDC on Flickr, used under the Creative Commons BY-ND 2.0 license.