Update: After a contentious—and often confusing—discussion, the D.C. Council passed Ward 7 Councilmember Vincent Gray’s bill to keep the deal with GW Hospital alive.

The bill included one amendment from Councilmember Elissa Silverman that increased labor protections for hospital workers at United Medical Center, though it isn’t as strong as her original amendment. Silverman’s original proposal would have required GW to hire all unionized labor from UMC; the new one only requires that GW hire a majority of UMC’s workforce, and provide a written explanation to those it declines.

Another provision waives GW Hospital’s certificate of need for both the east end hospital and for the new beds at its Foggy Bottom. The bill also guarantees Howard University an academic affiliation with a hospital in D.C. (it would not have to be the GW hospital east of the river). If city, hospital, and university officials don’t find an academic affiliation for Howard by June 2019, the deal is likely off, according to Washington City Paper.

Original: Ward 7 Councilmember Vincent Gray is making a last-ditch effort to save a deal with George Washington University Hospital to build a long-awaited new hospital east of the river.

At Tuesday’s legislative meeting, Gray will introduce two measures he hopes will keep GW Hospital from pulling out of the deal, as it has threatened to do in the last few weeks. If the university hospital leaves the table, the city is back to the drawing board on building a new hospital on the east end of the city—an area in desperate need of a full-service hospital. Currently, that part of the city is only served by United Medical Center, a city-owned-and-operated hospital that’s faced a number of medical and management scandals in recent years, including patient deaths and the closure of the obstetrics unit.

One of Gray’s amendments assembles a committee of city and hospital officials that would help find a hospital to partner with Howard University Medical School (it would not have to be the new hospital run by GW Hospital). Howard has maintained that the city’s exclusive deal with GW Hospital would put the solvency of its hospital—and their medical school—at risk. Another of Gray’s amendments adds a tiered hiring preference to staff the new hospital when it’s built, giving current UMC hospital workers first dibs.

Both of these measures are meant as compromises that will nullify two amendments added on at the Council’s last meeting earlier this month, which Gray called “poison pills” to the deal. At that meeting, Gray pushed to postpone a vote on the legislation rather than allow it to pass with those amendments tacked on, fearing that it would cause GW Hospital to pull out. And the hospital was indeed unhappy with the amendments—it suspended negotiations with the city on the deal barring the removal of those measures.

This gets wonky, so here’s a refresher on the bill at issue and why there have been so many amendments introduced.

Mayor Muriel Bowser chose GW Hospital as the city’s partner in building the new 150-bed hospital east of the river (on the St. Elizabeths campus) back in August. The D.C. Council has already approved $325 million in city money to build it with GW Hospital.

Everything appeared to be going according to plan when GW Hospital asked the D.C. government to waive its “certificate of need” on the project—basically, the certificate that requires the hospital to prove the beds its building are needed in the surrounding community. Getting rid of this requirement seems simple enough, given that beds are obviously needed east of the Anacostia. But GW Hospital didn’t just want a waiver for the new hospital—it also wanted a waiver for 270 additional beds at its Foggy Bottom hospital, which it said it needed to finance the east end hospital.

The Foggy Bottom ANC and even George Washington University (which is a separate entity from the hospital) both opposed the plan. Howard University also had major problems with it, given that those 270 beds would be yet more competing with Howard University Hospital (and yet more where their medical students would not be able to train).

The Council passed both waivers on a first vote in November. But Council bills always need a second vote to pass, and the second vote saw several amendments introduced to try to appease Howard University and other parties upset about the deal. The Council passed two amendments that Gray said would scuttle the deal: one that would have required GW Hospital to work with Howard and allow its medical students to train at the new hospital, and another that would have required GW Hospital to hire unionized labor currently working at UMC to the new hospital (GW Hospital’s Foggy Bottom location does not employ unionized labor).

Gray’s new amendments are watered-down versions of both.

The Council will take its final vote on Tuesday. At the Council breakfast before Tuesday’s legislative session began, Ward 5 Councilmember Kenyan McDuffie said he could “convey that Howard University is in support” of Gray’s amendment that would require city, hospital, and university officials to find a hospital to partner with Howard, according to Washington City Paper. Howard’s support will likely play a large role in whether other councilmembers—especially Ward 8 Councilmember Trayon White—support Gray’s amendment, per City Paper.

The office of At-large Councilmember Elissa Silverman, who introduced the UMC labor amendment at the last meeting, declined to say where she stood on Gray’s amendments before the vote.