A forum last week on health equity in D.C. brought a unified call for a full-service hospital east of the Anacostia River able to offer specialty services such as neurology, kidney care, and HIV screening and treatment.
More than 30 health care professionals and community members attended the discussion, hosted by the advocacy group D.C. Health Justice Coalition and held at the United Medical Center (UMC) on Southern Avenue SE. Attendees discussed what they would want a new hospital to look like.
UMC, the only hospital in wards 7 and 8, is slated to close in 2023, coinciding with the planned opening of a new city-owned medical center at the St. Elizabeths East campus in Ward 8 that would be operated by George Washington University Hospital. No deal is final, however. Negotiations were complicated by the D.C. Council’s push for job protections for union workers and the ability of Howard University to have its medical students work at the new facility — ideas rebuffed by GWU Hospital officials. The proposed site also presents construction-related issues, with environmental cleanup work expected once the city relocates the men’s homeless shelter there now to another location on the campus.
The 2020 subsidy for UMC was a major point of contention during the council’s review of the budget. The mayor had requested a $40 million subsidy while the council, concerned about spiraling costs despite service cutbacks at the hospital such as the closure of the maternity ward, had initially approved a $15 million cap but ultimately settled on $22.5 million. Ward 7 Councilmember Vincent Gray, who chairs the Committee on Health and has stressed the need for improved health care services east of the Anacostia River, subsequently held a series of hearings on UMC’s finances amid plans to establish a control board to oversee spending.
Thursday’s forum at UMC focused largely on the services needed in wards 7 and 8, an area geographically removed from health care services clustered in Northwest D.C. Some participants said they would like to see UMC stay open even with the opening of another hospital east of the river. Others said they should be “realistic” and focus on crafting their demands for just one hospital.
Roberta LeNoir, who leads the District of Columbia Nurses Association unit for UMC employees, said the closure of United Medical Center would be the sixth hospital closure she’s seen since moving to the District in the 1980s.
With fewer facilities, LeNoir explained, wait times at some medical facilities are sometimes three days. She said patients now participate in “hospital hopping”: going from hospital to hospital to see how long the wait time will be.
“The population has continued to increase, and the hospitals that were closed were not replaced,” LeNoir said during the meeting. “Hospitals all over the city are bursting at the seams.”
She added that, based on her experience as a nurse at UMC and information from her colleagues, hospital resources and supplies are “rationed” at the Ward 8 hospital because of a lack of funding and investment from the city.
“We need to stand up and say this is not acceptable, we need access to health care,” she said about the community she both lives and works in. “Time is life — if we don’t have access to health care, it could very well mean our very lives.”
Ambrose Lane Jr., the chair of the advocacy group Health Alliance Network, asked participants what kind of hospital they would like to see east of the Anacostia River. He noted that Gray and other government officials envision the new facility as a “community hospital” — a model that typically does not include specialty services. Lane said residents who need specialty care should not have to go west of the river to receive medical services. During the D.C. Council’s consideration of the new hospital, Gray explained that GWU Hospital’s plans are premised on the ability to use its Foggy Bottom location for this kind of care, although at-large Councilmember Elissa Silverman pushed for on-site access to specialized care such as cancer treatment.
Concerns about health equity aren’t limited to specialty services, however. Almost 70 percent of retail health clinics and urgent care facilities in the District are located in wards 2 and 3, according to the 2018 DC Public Health Case Challenge report. With six of the District’s seven acute care hospitals located in Northwest, the approximately 160,000 residents of affluent Ward 2 and Ward 3 have convenient access to most of them. The equivalent number of Ward 7 and Ward 8 residents only have access to one nearby.
Lane added that there are currently fewer than five medical buildings in wards 7 and 8, with the city having done little to improve the lack of health care infrastructure in there.
A new urgent care center — operated by MBI Health Services — will open later this year in Ward 7. The health facility will be the first urgent care center located east of the Anacostia River.
“I have no qualms to say I have no faith that the mayor or the council will invest in the infrastructure to bring physicians, specialty care, and specialty services here,” Lane said.
Chris Hawthorne — a member of Advisory Neighborhood Commission 8E, which represents the neighborhoods of Congress Heights, Valley Green and Washington Highlands — said he had testified in front of Gray’s Committee on Health the day before to highlight the medical needs of residents in wards 7 and 8. He said he intends to continue presenting these issues to government officials until the city meets the needs of the many residents who cannot make it across the bridge to any other hospitals in the District.
“Now is not the time to cut funds or close the door or take shortages on a hospital that’s needed right now,” Hawthorne said.
This article was co-published with TheDCLine.org.