- The Washington Times - Friday, September 22, 2000

D.C. Council members put in an award-winning performance during two days of hearings into the future of the D.C. Health and Hospitals Public Benefits Corporation (PBC), which operates D.C. General Hospital and a network of neighborhood clinics. The proceedings were filled with bravado, chicanery and heavy doses of Marion Barry-esque obfuscation politics, fueling the volatile mix of race and class that increasingly has come to singe every debate over reform of government agencies and institutions.

Fresh from the campaign trail, some legislators were intent on assaulting an executive who frequently sets up himself for attack by failing to vet his plans with affected communities and leaders. Council members also suggested that those who want to create a smaller, more cost-efficient, and better managed D.C. General Hospital are helping to foster a two-tier health care system in the city, where the poor are denied essential services. They argued that patients currently seen at D.C. General, which is located east of the Anacostia River, would not be welcomed in hospitals in predominantly white upper Northwest communities including Georgetown, Sibley and George Washington. Mostly, however, they attempted to deflect blame, shifting the discussion away from what their responsibilities may have been as the PBC deteriorated into wholesale mismanagement and financial chaos.

While Mayor Anthony Williams, who as chief financial officer (CFO) sat on the board of the PBC from 1997 through 1998, shares some responsibility for this latest brouhaha over D.C. General, the Council may be even more culpable. Since 1990, the PBC and its predecessor, D.C. General's board of directors, have racked up $197 million in deficits, including $67 million in this fiscal year, according to the new CFO, Natwar Gandhi. Earlier this year, the firm of Mitchell and Titus announced it could not provide an annual audit of the PBC because the agency's records were in disarray. But neither the council's finance committee nor its Committee on Human Services, which has direct oversight of the PBC, asked for an investigation into the agency's management of the $45 million subsidy it received from the city.

The Council only stepped into action after a series of events: The U.S. General Accounting Office (GAO) reported that the PBC had consistently received from the District cash advances, or loans, against money it expected to collect; it never collected those funds and never repaid the District government. The PBC was circumventing the budget process and masking its violations of the federal Anti-Deficiency Act. Consequently, congressional representatives prohibited the CFO from making any future loans to the PBC, forcing the agency to live within its budget. That mandate meant the PBC would have to reduce its expenditures; the board immediately announced it would lay off more than 500 workers and create a smaller D.C. General, eliminating some services and possibly closing one or two neighborhood clinics. Mayor Williams and his health director, Ivan C.A. Walks, presented their own proposal, albeit an incomplete one, for restructuring the PBC and D.C. General, which called for the creation of the Community Access Hospital. The moves by the PBC and the Williams administration generated an uproar from and lobbying by employees, union representatives and some residents pushing council members to convene their hearings.

One thing became clear during those hearings: The District has a long way to go before it can declare itself disabused of its old ways. In the past, the Council passed laws, knowing it had neither the funds nor the personnel to enforce those laws effectively. It instituted programs without a long view to whether it could sustain such programs. And, it frequently ignored the political reality of its Siamese relationship with Congress, deciding to play an adversarial role with the federal government instead of negotiating amicable solutions. Little has changed.

At the hearings, Council members pledged to find money to keep open D.C. General, knowing that in the upcoming fiscal 2001 budget, officials had to raid the city's reserve account to find funds for essential programs. On Capitol Hill, there is a move to force the city to create both a "rainy day" account and a reserve fund. Any grab for additional money for the PBC also could jeopardize the very sizable tax cut the council passed last year and expanded in fiscal year 2001. Further, allocation of any new funds for the PBC would have to meet the approval of both the control board and Congress. While Council member Kevin Chavous, who obviously has launched his 2002 mayoral bid, may pontificate on the issue, he is in no better position to effect the kind of open-ended rescue of D.C. General he pledges than he was in the fight to reform the city's school governance.

The Council's performance doesn't help to resolve the difficult question that confronts the government: How best to provide quality health care to the maximum number of poor and indigent residents? Nor do its shenanigans and nuanced game of racial and class politics help to prepare residents and workers for the inevitable: Given the city's fiscal condition and the political climate, the PBC and D.C. General won't continue in its present form. One hopes, the Council will learn eventually that real leaders speak truth to the people; they don't play games with their emotions, their livelihood, and their futures.



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