Update 12/4 8:34 p.m.

After adding on several amendments, the D.C. Council voted to postpone further discussion of this bill. The Council will take the bill up again on December 18, during its last legislative session of the year. If you’re curious about the discussion and the amendments, you can see here and here.

Original

The D.C. Council will cast its final vote Tuesday on a controversial bill to finalize a deal with George Washington University Hospital to build a new hospital east of the Anacostia river. The bill is the culmination of a years-long effort to build a medical center to serve Wards 7 and 8, which suffer the brunt of the District’s health disparities and yet have no functioning full-service hospital nearby.

It’s been a long road trying to figure out how (and whether) to make the city’s partnership with GW Hospital work, and now the D.C. Council is set to vote on a bill that would exempt GW from certain requirements in order to cement the deal and expedite the hospital’s construction. So far, the deal has faced opposition from an ANC, Howard University, and even George Washington University itself, despite the bill passing on a first vote at the D.C. Council with two “no” votes.

If the bill does not pass, it jeopardizes the construction of a hospital in an area of the city that badly needs one.

For those that haven’t kept up with the unfolding saga, here’s a rundown of what’s happened and where we are now:

Why the city needs this hospital 

Communities east of the Anacostia do not currently have access to a full-service hospital in their wards. United Medical Center, the only hospital in Southeast, has been constantly beset by management problems and medical mistakes, sometimes resulting in patient injury and death. UMC had to shut down its obstetrics unit last year after medical errors endangered patients there, meaning women in Wards 7 and 8 do not have a nearby hospital to deliver their babies.

Mayor Muriel Bowser announced plans for a new hospital in September 2017, but the need for one existed long before that. Bowser’s predecessor Vincent Gray (who is now the Ward 7 councilmember) had talked about building a new hospital as far back as 2014, but it never came to fruition.

How did GWU get the project?

Back in August, Mayor Bowser signed a letter of intent with George Washington University Hospital to partner in running the new 150-bed hospital, which is set to be built at St. Elizabeths, a sprawling old psychiatric campus slated for major redevelopment. The partnership was the result of a proposal process; both GWU Hospital and Howard University, in partnership with Sibley Memorial Hospital, submitted proposals for the project.

A District official told the Washington City Paper that “the differences in the quality of the proposal were striking.” GW’s proposal was more “extensive,” according to the source, while Howard and Sibley’s “demanded more of the city and offered little in return.” So GW appeared to be the path forward for the hospital.

So, what’s the problem now?

There are several. But most strikingly: GWU Hospital came to the Council asking for a waiver for its “certificate of need” on the project (basically, the certificate establishing that the hospital beds and medical services it’s building are actually needed in the community). But GW Hospital doesn’t just want a waiver on the project at St. Elizabeths; it also wants a waiver on 270 more beds at its Foggy Bottom campus, which it says it needs in order to finance the Ward 8 hospital. That means GW Hospital would get to build hundreds of new hospital beds in an affluent part of the city without establishing that the city needs those beds. (For more on this, here’s a detailed piece in the Washington City Paper).

The Council had already previously approved $325 million in city money to build the hospital. Gray (with backing from the Bowser administration) introduced a bill to grant GW its waivers, and the council cast its first vote to approve that bill on November 13. During its legislative session Tuesday, the Council will cast its final vote to approve or deny the waivers.

In another snag: George Washington University is not in agreement with its hospital (which is a separate entity) that it should build an additional 270 beds at Foggy Bottom.

Why is Howard University upset?

Search #HowardMedicineMatters on Twitter and it’ll become clear pretty quickly. Howard University Hospital says locking them out of the project (and expanding GWU at Foggy Bottom by so many beds) endangers its very existence–the medical school wants its students and staff to have a chance to train and work at the new facility.

https://twitter.com/ekoslof/status/1069551609439506432

WCP reports that Gray plans to introduce an amendment to his bill Tuesday that will ask the city to “study the feasibility” of involving Howard in the project. Ward 4 Councilmember Brandon Todd said in a statement that he’ll support that amendment. It’s unclear what that will mean for the bill or for Howard’s actual ability to participate in the project, especially if their inclusion scares off GWU Hospital.

What do councilmembers and the mayor have to say?

This is a deal the mayor’s office has been brokering for some time now, and Bowser is backing Gray’s legislation. Ward 8 Councilmember Trayon White has joined Gray in support of the bill, which he co-introduced, but he will reportedly offer an amendment to the bill Tuesday.

The Council approved Gray’s bill on a first vote on November 13, with only Ward 2 Councilmember Jack Evans and Chairman Phil Mendelson voting against it. (Evans co-introduced the measure, but told City Paper he didn’t fully read it first.)

If the new hospital deal gets approved by all parties, it’s slated to open by 2023.