As COVID-19 infection and death rates indicate that African American residents are most vulnerable, an expansion of healthcare access intended to provide care perpetually underserved communities in the District is now underway.
The District announced an expansion to testing for COVID-19 and that two new hospitals will be built, one on the St. Elizabeth’s Campus in Ward 8 and another on Georgia Avenue NW in Ward 1.
Mayor Muriel Bowser (D) presented the new hospital at St. Elizabeth’s as part of the effort towards a more equitable health system as part of the opportunity presented by the COVID-19 recovery process to rebuild and address issues that have long been a part of the District.
“We have a once in a generation opportunity to reopen our city in a way that builds a more equitable DC,” Bowser said, “and we should not let this opportunity pass us by.”
New Hospitals, Health Services in Wards 7 and 8
Bowser said these new agreements will help build a health care system to address the needs of all residents, attack disparities, and make the District more resilient for future challenges.
The hospital slated for the St. Elizabeth East campus in Ward 8 will be operated in partnership between George Washington University and District government and is expected to open in 2024. A new Howard University Hospital will be built on Georgia Avenue NW in Ward 1.
The packages also include a $69 million health services complex at St. Elizabeth’s, funded by the District and expected to open in Fall, 2023 as well as two urgent care centers in Ward 7 and Ward 8, slated to open in Fall 2021 and Spring 2022 respectively. Universal Health Services is footing the $22 million bill for the urgent care centers.
The deals come as the District faces a budget shortfall due to Coronavirus closures. DC Council must approve the contract, and a vote is expected in June.
Construction at St. Elizabeth’s hospital is expected to cost $306 million. The new facility will include 136 inpatient beds with possibility of expanding to 196, Intensive Care Unit (ICU), surgery and operating rooms, newborn delivery and emergency departments for adults and children. It will function as a teaching and research hospital in partnership with the George Washington School of Medicine and Medical Faculty Associates.
The Howard University Hospital will benefit from a $225 million tax abatement. Howard University and its new operating partner Adventist Healthcare will build the new, $450 million, 225-bed, Level I trauma and academic teaching hospital, with plans to complete by 2026. The current Howard Hospital will remain open until the new hospital is completed. In addition, the District is committing $25 million in public infrastructure support and $26.6 million over the next six years.
Negotiations on the agreements took more than a year, said City Administrator Rashid Young. ”The mayor’s mandate to us is that we ought to be out of the hospital business,” said Young, “and so it was a really difficult set of discussions to figure out how we could both finance a hospital and have a hospital operated by someone other than us that gets us out of the hospital business.”
Disparities in Health
The Howard University Hospital will house a Level I Trauma Center, with a Level III Trauma Center at St. Elizabeth’s. These categories refer to the kinds of resources available on-site and the number of patients admitted annually. A Level I trauma center should provide the highest level of care for trauma patients. A Level III center does not have the full availability of specialists on site but has resources for emergency treatment of most trauma patients, as well as transfer agreements with Level I and II trauma centers. Barbara L. Bass, CEO of the GW Medical Faculty Associates, said that GW anticipated that there would be surgical coverage at St. Elizabeth’s 24-7 once the facility opens.
Howard University President Dr. Wayne Frederick, who is also a surgeon at the school’s hospital, said that the new Howard University Hospital would help close health disparities in the District. “When you look at the number of black physicians in this county, Howard University has produced more than anyone else,” Frederick said, saying that the hospital would increase cultural competency in District health care.
The pandemic has laid bare the racial disparities in health and healthcare access for black residents of the District. As of May 2, out of the 251 District residents who lost their lives to COVID-19, 198 or 79 percent were black. People identifying as black also account for 47 percent of the 5,016 positive test results.
Asked at an April 30th press conference why the residents on the east end of the city ‘do not deserve’ a Level I Trauma center, City Administrator Rashid Young said that he did not think that being deserving was the issue. Young noted that the District was unusual as it has three Level I Trauma Centers in one jurisdiction.
“What we’re trying to do, and what I think is very important to emphasize here, is that we’re creating a system of care for the residents of the District of Columbia,” Young said. “You don’t need to have a Level I trauma center in every neighborhood of the District to provide that level of care to the residents.”
Rashid said that what plagues African American communities at a disproportionate level are chronic conditions that should be managed with education, intervention and continuity of care, like hypertension, diabetes and cancer. The District is focused on these issues, he said.
Young said that the new hospital would be able to support emergencies on-site with both an adult pediatric emergency center at the facility. If a complex procedure is necessary patients will be stabilized at this hospital and appropriate resources sought. “So, this really is about creating this system and access and equity, and this initiative does that.”
Learn more about the District response to COVID-19 by visiting coronavirus.dc.gov/testing. Read more about the deal on two new hospitals at https://dhcf.dc.gov/page/new-hospital-st-elizabeths-east