A Range of Disorders Tamed by the Beat

Mayor Seeks Millions for Health Needs

24.10.2006 - Mayor Anthony A. Williams will propose today that the city dedicate at least $245 million in tobacco settlement funds to an array of major health initiatives, from cancer prevention to new comprehensive clinics east of the Anacostia River to significant improvements in hospital emergency care.

The sweep of Williams's plan in many ways exceeds the government's previous commitment to residents' health needs. It would buy bricks and mortar as well as services, all aimed at reversing the District's acute rates of chronic disease and making care more accessible across the city. More than half of the money would be directed to poorer eastern communities.

"We have never invested this kind of money in the health-care infrastructure of the city," D.C. Council member and Health Committee Chairman David A. Catania (I-At Large) said yesterday. "This is the way you address the health disparities."

If approved, the legislation would mark the first time that any District tobacco settlement funds have gone specifically toward health efforts in the city. The dollars come from a 1998 national settlement between states and tobacco companies that required the latter to compensate governments for the costs of treating people with smoking-related ills.

"It's really a major breakthrough," said Susan Lowell Butler, executive director of the DC Cancer Consortium. "It takes the District of Columbia from doing perhaps the least in the country for cancer control and prevention to [being] one of the better. . . . There are states not making efforts equal to this."

The proposal addresses one of the city's most immediate health concerns, the future of Greater Southeast Community Hospital. It would allocate tens of millions of dollars to shoring up the emergency department, contingent on a change in the facility's ownership. Williams (D) indicated that without a sale, he would exercise eminent domain and have the city acquire the hospital to ensure that it provided "adequate health care."

Prince George's County businessman Carl D. Jones confirmed yesterday that he is negotiating with Greater Southeast owner Doctors Community Healthcare Corp. to buy the troubled hospital and has a letter of intent to continue those discussions exclusively. Jones, who parlayed asphalt and paving contracts into a multimillion-dollar construction company, said he would turn to a hospital management group to run the facility.

"I don't intend to be an operator," he said, declining to comment further.

Council support for the mayor's bill is unclear. A spokeswoman said Chairman Linda W. Cropp (D) is considering the most effective ways to improve the health of residents in Southeast and far Northeast Washington. "She's not signed on," Denise Reed said.

Cropp's colleagues -- including Vincent C. Gray (D-Ward 7), his party's nominee for council chairman, and Marion Barry (D-Ward 8) -- could not be reached for comment last night. Their wards cover the city east of the Anacostia.

A spokesman for Williams said his announcement this morning will emphasize the "historic opportunity" before the city with the tobacco money. "The mayor sees this as one of the last remaining priorities he really wants to accomplish," Vince Morris said.

As specified in the mayor's plan, the city would establish a Community Health Care Financing Fund in which the tobacco money would be deposited. Among the projects it would support:

· $112 million for construction of three or more sophisticated health facilities in Wards 6, 7 and 8 -- what a health-care task force recommended instead of the city's intended partnership with Howard University on a new 250-bed hospital.

Of that, $72 million would build a "healthplex" with 24-hour emergency services, primary and specialty care, day surgeries and diagnostic imaging on the grounds of the former D.C. General Hospital at 19th Street and Massachusetts Avenue SE.

The remaining $40 million would provide for at least two ambulatory-care centers in the wards east of the Anacostia, each offering primary and specialty care, as well as pharmacy, laboratory and radiology services.

· $10 million for smoking cessation programs and $20 million for cancer prevention. Statistics show high incidences of breast, cervical, colorectal and prostate cancers locally, and D.C. cancer death rates are among the worst in the country.

· $10 million for a program to manage and prevent such chronic diseases as asthma, diabetes and hypertension. In some neighborhoods in Wards 7 and 8, more than 40 percent of adults suffer from these and other persistent conditions.

· $83 million to strengthen emergency care, with $2 million for new ambulances and $1 million for an assessment of the city's system. Based on that evaluation, the rest would be divided between Greater Southeast Community Hospital and Howard University Hospital to expand their emergency room capacities.

Health-care activist Vanessa Dixon immediately derided the provision as "throwing Howard a bone" for the mayor's abandonment this spring of the medical center that the city and university had planned for more than two years.

"The best proposal has already been made, which is the National Capital Medical Center," she said. "You can't look at an area of the city with a quarter-million people, with one crippled hospital, and say they don't need another hospital."

Others took equally vigorous positions on the other side. Robert A. Malson, president of the D.C. Hospital Association, called the plan a major step forward. The association would head the assessment of the emergency system.

"It makes a lot of sense for the city," Malson said, noting that most of the specifics closely followed the health-care task force's recent conclusions. "And it is about time that [District] tobacco money is used in a way that the settlement intended."