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Monday, February 26, 2024

The Landscape of Health Care in Wards 7 and 8

Advisory Neighborhood Commission (ANC) 8C Chair Salim Adofo (8C07) hears all sorts of responses when he asks where his constituents get their health care. Some travel to Virginia or Maryland, or to the west side of the city. Others lack resources to pay for care, time to travel that distance, or simply don’t see the need for regular doctor visits at all.

“Honestly, unfortunately there’s just some that are skipping healthcare altogether,” he said.

While the 2017 Community Health Assessment Survey found there were enough providers in the District, it is estimated that 210,000 low-income residents who live in these underserved areas lack sufficient medical services.

The health landscape in communities east of the Anacostia River is undergirded by a series of government-funded clinics that provide primary care, anchored by the troubled United Medical Center (UMC). Things are about to change. UMC is soon to be replaced by a $375 million full-service hospital at St. Elizabeth’s East that comes with two urgent care centers, one for each of wards 7 and 8.

What does health care east of the river look like today? What are the holes in that landscape of care? And how will the St. Elizabeth’s East Hospital project change what exists today?

Community Clinics
Much of the available primary care on the east side of DC is provided by community clinics, many funded by both the District and federal government in order to ensure access to care. These include federally qualified health centers (FQHCs) such as the Elaine Ellis Center of Health, Community of Hope and seven separate Unity Health Clinics.

Founded in 1984 to provide health care to the homeless, Unity is now the largest primary health agency in the District, serving 60 percent of the District’s FQHC clients and offering service ranging from regular checkups to dentistry and a nurse navigator who coordinates cancer services in collaboration with Sibley Memorial Hospital at their Parkside Health Center

Concept Designs for the new hospital at St. Elizabeth’s were submitted to the US Commission on Fine Arts (CFA) July 9. UHS, Courtesy Office of Ward 7 Councilmember Vincent C. Gray (D)

Unity Health Care President and CEO Vincent Keane said that Unity seeks to be a medical home for patients. “It’s our job to help improve the lives and health of the people,” he said, “and that’s not just done in the individual encounter with the doctor as a provider. It’s kind of a complementary support service.”

That coordination is critical, said Marc Berg, founder of Bluerock Care (3230 Pennsylvania Ave, SE), a senior-focused primary care clinic that opened in early April. “Currently, the fragmentation of medical, behavioral health and social is enormous from the patient perspective: the more different types of help a patient needs, the more the burden is on the patient to coordinate all that care,” Berg said. “That, of course, doesn’t work and is wrong, especially for seniors.”

Closure of UMC
Residents living in wards 7 and 8 have the highest levels of chronic disease in the District, including diabetes, hypertension and cancer. But while many of the community clinics can refer patients to specialist care, often through partnerships, few specialty services are in the area. Patients seeking dialysis or cancer treatment often must travel several hours by public transit to get to their appointments two or three miles away.

For years, many depended on United Medical Center (UMC) for a wide variety of services, from obstetrics and infant delivery, surgery and dialysis to mammograms and diabetes care. Citing concerns with patient safety, the Department of Health shut down prenatal care and delivery services in April 2017.

The hospital emergency room has provided many with their basic medical care. But between accusations of mismanagement and the pandemic, the hospital faced a steep decline in patient visits over the last year, leading to a decline in revenue. In May, DC Council refused to increase the cap on subsidies for the troubled hospital, triggering a fiscal management control board which could make additional cuts to services.

Residents say that there is a need to augment these services now. They say urgent care facilities are needed across both wards to reduce the burden on emergency rooms.

“We are in desperate need of more facilities for women to give birth—a birthing center would be great as well as primary care doctors’ offices,” said Commissioner Cydne Nash (7B04). “There are no hospitals East of the River where a woman can have a baby.” Services such as physical therapy, mental health support and addiction services are also sorely needed.

New Facilities on the Way
Some of those services are on the way. In May, ground was broken on the new Whitman Walker Health building at St. Elizabeth’s, which will house comprehensive primary care and a broad spectrum of services from radiology, psychotherapy to dental, nutrition and a pharmacy on the ground floor.

Many additional needs will be addressed by the opening of the new hospital at St. Elizabeth’s (1100 Alabama Ave. SE), slated to open in late 2024. The $365 million project includes two urgent care centers, one for each ward, administered by United Health Care (UHC) who will also run the hospital together with George Washington University. In early July, concept designs were submitted to the US Commission of Fine Arts (CFA) for review.

“With each of these milestones, we get closer to transforming our health care system and delivering a state-of-the-art hospital that advances health equity and makes our community more resilient for the challenges that lie ahead,” said Mayor Muriel Bowser.

The proposed hospital will also have a verified trauma center with 24/7 general and orthopedic surgical availability, community-based ambulatory care and a full range of specialty services, said Councilmember Vincent Gray (D), who has been working on the project for more than a decade. District officials said that the proposed trauma center can treat 89 percent of trauma cases that arise in Wards 7 and 8, and 85 percent of gunshot injuries.

The hospital will also provide maternal care and newborn delivery services, with a Level 2 Newborn Intensive Care Unit (NICU), and a partnership with Children’s National Hospital.

District officials said once the new hospital at St. Elizabeth’s is open to patients, the United Medical Center will close through the established DC Health regulatory process for closing inpatient facilities.

“There’s things in the works, but they haven’t arrived yet, and there’s no guarantee that they will arrive,” said ANC 8C Chair Adofo. He said he wants to see the new hospital and urgent care facilities come online, but said they need to be accompanied by education on what the facilities offer and when to use them.

Other residents are excited, but skeptical. Commissioner Nash said the new hospital is long overdue. “I just hope that the hospital can meet the needs of my neighbors,” she said. “Making a dent in health disparities takes more than just new medical facilities but it is definitely a move in the right direction.”

Just the Beginning
Councilmember Gray knows people still have difficulty believing the new hospital is finally going to be a reality.

“There were days when I just thought this wasn’t going to happen,” he admitted. “But you have to demonstrate that you’ve got a plan to get this done, and that’s what we have done and what we continue to do.”

The hospital is just the beginning, Gray said. He hopes it will be the cornerstone on which a whole new interconnected healthcare system will be built for residents on the east side of the city.

“I think that councilmember Gray is pushing the need for a health infrastructure very hard,” Lane said, “and I support what it is that he’s doing.”

Parts of that system are being championed already. The first urgent care clinic is set to open shortly in Ward 7. MBI Health has received certification from the DC Department of Health to open at 5140 Nanny Burroughs Ave, said MBI CEO Marie Morilus-Black.

Gray is working with developers to bring specialty care services to Skyland Town Center. In January, At-Large Councilmember Christina Henderson introduced legislation requiring a feasibility study for a birthing center east of the Anacostia. Lane and the DC Health Alliance Network is organizing to get a full-service treatment center focused on opioid addiction located east of the river, where need is greatest.

St. Elizabeth’s will be a community hospital, Gray said. He anticipates that it will continue to grow once initial construction is complete. “I can’t even say what, at the end of this, it will look like,” Gray said. “This is going to be a wonderful addition to life as we know it for people who live in Ward 7 and 8.”

Follow progress on the new hospital at St. Elizabeth’s by visiting https://dhcf.dc.gov/page/new-hospital-st-elizabeths-east.

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