March 28, 2001

Dear District Resident:

I am writing to you because there is a health crisis in our city, and I'd like to share with you my determination to address the challenge.

With the help of elected officials, health care experts, and community representatives, I'm building a better health care system that puts the health of you and your family at the top of the city's agenda.

The nation's capital should be the healthiest city in America. Instead, the life expectancy of its African American men is 10 years lower than the national average. Our city has the country's highest rates of infant mortality, diabetes, and HIV infection. Obviously, the District's health care system is failing and needs reform.

Unfounded rumors have left some residents fearful and angry about the future of medical care and services in our city. Please allow me to set the record straight.

DC General will not be closing. It will be placed under new management. Its emergency room will maintain 24–hour, full–service capability for most of the more than 50,000 annual visits, which include more than 12,000 ambulance runs. Two advanced cardiac-life-support ambulances will support this emergency center.

Of the 140,000 annual visits to DC General Hospital, only about 10,000 are inpatient admissions. About 4,000 of the patients admitted are uninsured, and local taxpayer dollars must pay for their care.

Most of the patients who obtain medical services at DC General do not require hospitalization. This shows that many patients are using the emergency room as a substitute for their primary care provider. This is an expensive and ineffective way to provide health care. Emergency rooms are not equipped to provide the care people need to live healthier lives.

The centerpiece of our health services reform plan is to change this practice by providing a network of more than 100 primary care locations throughout the city. These locations will provide 30 percent more primary care, specialty, and inpatient services than the current system. For the first time, thousands of uninsured residents will have ready access to regular health care. Inpatient and trauma care for the most seriously injured will be maintained at DC General, until Greater Southeast Community Hospital is capable of delivering these services.

DC General staff, including trauma staff, will be offered hiring preference by Greater Southeast. And let me be clear — Greater Southeast will be held to its commitment to provide the same level of trauma services now offered at DC General within three months. Only then will trauma services move from DC General to Greater Southeast.

The new management for DC General was supported by the Public Benefits Corporation, which has been operating DC General, was fully reviewed by evaluators appointed by the DC Council, my office, and the financial control board. The unanimous decision of these evaluators was to select the Greater Southeast proposal, which included the commitment to build the network of neighborhood-based primary care providers. The Greater Southeast proposal received more than twice the points of the Public Benefits Corporation plan, which would have continued inpatient operations at DC General.

Our health initiative places the responsibility for the reform plan with the District's Department of Health, not with any for-profit company. The health department has proven expertise in the management and oversight of large health services contracts.

The management of Greater Southeast has been in place for more than a year. They have turned a failed institution into a safe and effective facility. However, the District will have specific contractual power to conduct reviews of this contractor's ability to deliver upon its commitments in order to protect the interests of patients and taxpayers. The land on which DC General sits is federally owned and designated for the provision of heath care and human services. I am committed to maintaining this site as a health care campus.

I am confident that our community will come together to ensure that this reform leads to a substantially improved health care system for the District's neediest citizens.

I look forward to your suggestions. If you need more information or would like to help put our Health Care Services Reform Plan into action, please call the Department of Health at (202) 442-9195, weekdays from 9 am to 4 pm. You may also learn more about health reform by visiting our website at www.washingtondc.gov.