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On an unseasonably warm mid-February morning, five people are plopped down on the two benches outside Building 25 of D.C. General Hospital. One of them, a man with enormous buckteeth and a white knit skicap, is quietly talking to himself, anxiously lowering his head into his hands before lifting it up and doing it again. The others sit in silence, listening to the preternaturally early chirps of birds, which dart from rooftop to rooftop inside the sprawling campus.
By and by, a cab rolls up.
As the taxi idles, three of the bench-sitters begin to stir. The 5-foot walk to the potholed driveway is a slow shuffle of baby steps. The driver, meanwhile, gets out for a minute, leaving his light-blue ride in front of the benches. By now, the self-conversationalist has been joined by two women in puffy black jackets and a man whose fidgety hands and bag of prescription drugs quickly add a rattling percussion to the morning as he drops his pills again and again.
The people waiting for rides outside Building 25 are clients of the Region 3 Community Mental Health Center, which administers outpatient services for 1,500 District residents. About 150 mentally ill patients visit the center every day. The visits take place far from the public eye: The D.C. General campus is shielded from the surrounding community by yards and fences, and Building 25 sits back by the Anacostia River, set off from the complex’s main hospital.
The D.C. Commission on Mental Health Services is under orders from regulatory and insurance agencies to vacate the increasingly dilapidated structure, which is threatened by numerous life-threatening ailments, to say nothing of flickering hallway lights, peeling paint, and an ineffable air of gloom. And the commission is proposing to move the outpatient center to a less secluded locale: Capitol Hill’s Stanton Park neighborhood.
News of the plan has some Stanton Park residents bracing for an invasion of mental patients wandering the streets, waiting for rides, anddepending on who’s interpreting their complaintseither menacing the neighborhood or innocently getting in the way of snooty residents. Replete with the standard charges of NIMBY elitism on one side and wheeler-dealer bad faith on the other, the squabble threatens to leave the center with new neighbors even more hostile than its current onethe D.C. Jail.
Capitol Hill Hospital is just 11 blocks up Massachusetts Avenue from the gates of D.C. General. Unlike the city’s one public hospital, however, the small private institution is an oasis of calm amid the imposing Victorians and wide boulevards of Stanton Park. In fact, much of the building is not in use. Dr. Peter Shin’s Medlink Co., which bought the dormant hospital in 1992, uses parts of it to operate a nursing home and an acute-care hospital, as well as a small primary-care center.
That’s just the way a lot of neighbors would like it to stay. But the dictates of the health care economy appear to be getting in the way. In an age when even highly regarded small hospitals like D.C.’s Columbia Hospital for Women are in financial peril, returning Medlink to its former incarnation as a conventional hospital is an impossibility. Eager to expand the amount of its space in use, last spring Shin began negotiating with Mental Health Services to relocate a community mental health center to his underutilized facility. “We use only a certain portion of the space, and we need to lease out another portion,” explains Medlink’s Linda Grigsby.
And D.C. was the logical lessee. According to Johnny Allem of the D.C. Commission on Mental Health Services, by the time Shin began looking to lease out his new hospital, Building 25 was just about done for. “We haven’t invested in that building,” says Allem. “When you ignore something long enough, you pay for it.”
Commission director of community systems Evette Jackson says the decay has made the lives of outpatients miserable. “You name it: heating, plumbingeverything. We have a flood in the basement. There’s problems with the ventilation. Ceilings are falling down. In the summer they suffer, and in the winter they suffer.”
But what was good for a medical businessman and for a beleaguered city agency wasn’t happy news for the neighbors. Patrick Lally, who lives on Capitol Hill, says his community has absorbed its fill of shelters and other such public services. “You have the potential of 1,500 outpatients coming into the Stanton Park neighborhood, which is a very, very stable neighborhood,” explains Lally. “…Something stinks.”
The area around Capitol Hill already houses such well-known institutions as the Community for Creative Nonviolence and Sasha Bruce House, as well as numerous other facilities serving D.C.’s at-risk population. “There’s a sense that the Capitol Hill community has reached a saturation point,” says Brad Braden of the Capitol Hill Restoration Society. “We believe in doing our fair share, but there’s a sense of overburdening our neighborhood, so we need to hear the specifics first.”
Last Wednesday, Lally and a couple of other residents took the District’s mental health receiver, Dr. Scott Nelson, on a tour through the neighborhood’s many service facilities. “The west side of Capitol Hill has over 2,700 beds of transitional and homeless shelters. Maybe they should know how many beds we already have. Put it in the context of how many we have in comparison to the rest of the city….We have a proven record of bearing the city’s burden.”
But according to Allem, arguments like Lally’swhich, he says, equate mentally ill outpatients with homeless people and drug addictsare the real burden. Allem claims that as many neighbors support the proposal as oppose it. “There’s a pocket of people [in the neighborhood],” he says, “and I think they have a problem with the mentally ill.”
Medlink’s Grigsby, meanwhile, has a name for that pocket: NIMBY. “In the meetings, they have said that this is a NIMBY project,” she says. “They said they didn’t want it in their neighborhood. They said they didn’t think Region 3 Mental Health was indicative of their community.”
If Capitol Hill has an oversupply of service providers, the neighborhood has also had its fair share of quarrels about them. In the wake of other such quarrels, allegations of civic elitism are like poison pills, carrying far more weight than they do in a lot of other D.C. neighborhoods. The allegation makes neighbors bridle.
Longtime Capitol Hill resident Al Getz says neither Shin nor most of the Mental Health Commission officials working on the proposal live in D.C. or understand its neighborhoods. “To be called NIMBY by folks who have no stake in the cityit’s infuriating. Why do they use a pejorative for people who take pride in their community?” Getz says the real problem this time is Medlink’s unwillingness to be upfront about the project.
When Shin purchased the hospital, part of the deal included an 1890s row house across the street, surrounded by parking lots. Grigsby says Medlink initially wanted to tear it down to expand parking. But after the city’s Historic Preservation Review Board turned down a request to wreck the historic building, and the mayor’s agent rejected Medlink’s appeal, the hospital company simply let the building decay, according to Lally. Today, the shuttered building has a few open windows that offer a view of crumbling ceilings and broken floorboardsquite a contrast to the well-kept structures around it.
Grigsby and Allem say the building is a side issue, but Lally says the issue is all about trust. “Most people would take a look at the building and think, ‘Oh my God, what a hunk of junk,’” he says. “But that’s not the issue. The building and the 8,000 people around it are protected by the historic preservation act. There’s not many laws that do so much to protect neighborhoods. So, yeah, it’s just a typical Capitol Hill row house. But Shin has disregarded keeping it up. In protest after he lost his appeal, he decided not to keep it up at all. So you have this very tangible evidence of his presence in the community, and that has made people very suspicious.”
“That’s one of the things that undermines the community’s comfort level in terms of making deals with Dr. Shin,” says Ward 6 Councilmember Sharon Ambrose.
Medlink has done everything in the book to alienate the Hill’s activist-heavy community. The Capitol Hill Restoration Society’s Braden claims Medlink failed to answer basic questionsabout how many patients had drug problems, about how many came from Ward 6, about what public transportation patients could use to get to the harder-to-reach Medlink site, as well as about the financial parameters and site-selection criteriaat a Feb. 4 meeting between Medlink officials and community members.
“It was the old soft-sell approach,” says Braden. “‘This is what we’re going to do; we’re just letting you know.’ Nothing more substantial than that. In a community like Capitol Hill, which is pretty politically savvy, that’s not wise.”
Ambrose, too, has criticized Medlink for not providing enough information, but she also notes that working with the mental health receiver might give citizens leverage they’d never have over a private hospital company scrambling for tenants.
Braden says Ambrose asked Medlink to come back in three weeks with answers to those questions. His own group’s members, too, will wait until after a Feb. 25 meeting to make up their minds. Likewise, a lot of other neighbors seem to be waiting for a decisionboth about trusting Medlink and about being comfortable with quiet faces of sickness, like the folks hanging around in front of Building 25.
For the time being, those people will stay put. The deal between Medlink and the city’s mental health receiver hasn’t been finalized, and if it ever is, the old hospital building will have to undergo some serious renovating before the move. “Nobody, as far as I know, has been saying stop it at all costs,” says Braden. “What they’re saying is we need more information.”CP