TESTIMONY BEFORE THE COUNCIL OF THE DISTRICT OF COLUMBIA COMMITTEE ON HEALTH REGARDING B22-0959, THE EAST END HEALTH EQUITY ACT OF 2018
President, Foggy Bottom Association
October 27, 2019
Good morning. My name is Marina Streznewski and I am here today as the president of the Foggy Bottom Association. I am here to convey the opposition of the FBA membership to B22-0959, the East End Health Equity Act of 2018.
Let me begin by stating this: there is absolutely no question that Wards 7 and 8 suffer from a deplorable lack of health care resources. Since the closing of DC General in 2001, health care options east of the Anacostia River have disappeared at an alarming rate. Clearly, we as a city must act, and we must act quickly. A crisis is not coming – it is here.
However, we do not believe that the East End Health Equity Act of 2018 proposes the best possible solution to this crisis. We are concerned that, by avoiding the Certificate of Need process, the city will not actually alleviate health care inequity. Speed may be essential – but so is care.
The bill assumes the construction of a 150-bed community hospital on the campus of St. Elizabeth’s Hospital. That is a great start. But the bill goes on to assume the construction of 270 beds in Foggy Bottom. Setting aside the question of where these beds would go, we do not understand how an additional 270 beds in Foggy Bottom helps people in Wards 7 and 8.
I have been part of discussions with hospital leadership and with Eric Goulet regarding these plans. I have asked the question directly – how do more beds in Foggy Bottom benefit Ward 7 and 8 residents – but have not received a satisfactory answer. The response I did receive is that these beds will be referral beds; Ward 7 and 8 residents will access the community hospital first, and then be transported to the GWU Hospital for more complex procedures.
First – and most important – we object to the assumption that Ward 7 and 8 residents must travel across town to access quality health care. When Metro is operating, getting from St. Elizabeth’s to GWU Hospital via transit takes approximately 40 minutes. But when Metro is closed, the same trip takes between one and two hours. This presents a high barrier to family and friends who might want to visit a patient, or bring needed items (e.g., eyeglasses or prescriptions), or participate in the patient’s care.
For those who drive, the trip is shorter – depending on traffic, generally between 20 and 35 minutes. But they must find parking, already in short supply in Foggy Bottom. There is a parking garage available – for $30 per day. That is a lot of money. A friend of mine recently had labor induced at GWU Hospital. She was in the hospital for four days. Had my husband and I not offered her the use of our driveway, she and her husband would have incurred $120 in parking costs.
I would like to share a story at this time.
About 12 years ago, my mother went to her local hospital – Doylestown Hospital – in congestive heart failure. She was dying. She needed major and complex heart surgery – a dual valve replacement and a triple bypass. But instead of sending her to Philadelphia – the nearest large city – Doylestown Hospital has a system in place to bring the heart surgeon from Temple University Hospital to the patient. Patients receive complex surgery from experienced surgeons because the doctors come to them.
I understand there is some procedures that are so complex and so infrequent that a patient must be transported to a tertiary or quaternary hospital. My father, for example, went into Doylestown Hospital four years ago for what should have been a routine gall bladder removal. Unfortunately, the surgeon at Doylestown discovered serious issues with his bile ducts. The complexity of that procedure did require him to be transported to Jefferson Hospital in Philadelphia so a surgeon with expertise in this procedure could operate. He was in Jefferson Hospital for two weeks – and my mother traveled by train to Jefferson every single day for two weeks.
Sometimes, patients must be transferred. But not always. And not if a system is in place to provide high quality care to patients where they live.
I understand that there are additional expenses involved in providing tertiary care in Wards 7 and 8. But the residents of Wards 7 and 8 deserve the same access that those of us who live in Northwest Washington have.
The Certificate of Need process will assess whether the solution proposed by District Hospital Partners is, in fact, the best solution for Ward 7 and 8 residents. Without the Certificate of Need process, the solution will be that which is best for District Hospital Partners.
Therefore, we oppose eliminating the Certificate of Need process for the potential construction of 270 beds at the GWU Hospital in Foggy Bottom.
I am pleased to answer any questions. Thank you for your consideration.