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GOVERNMENT OF THE ws DC|HEALTH BCMURIEL BOWSER, Mavor October 3, 2018 The Honorable David Grosso Councilmember, At Large ‘The John A. Wilson Building 1350 Pennsylvania Avenue, NW Washington, DC 20004 Dear Councilmember Grosso: Thank you for your letter of September 26, 2018 expressing concern around the planned closure of Providence Hospital's acute care and emergency room services and DC Health's role during this, transition. Within DC Health, the State Health Planning and Development Agency (SHPDA) promotes accessibility to quality health care services throughout the District of Columbia. Section 2002(c) of the Fiscal Year 2003 Budget Support Amendment Act of 2002 (D.C. Law 14-307) removed the Director of DC Health from SHPDA’s State Health Coordinating Council in an effort to further isolate health planning from political pressures. The SHPDA Director decides all certificate of need applications and exemptions. Before 1996, any person who wanted to permanently close or terminate operation of a health care facility or service was required to apply for a Certificate of Need (CON). In 1996, the statute changed. Under current law, a health care entity must provide notification of its intent to close at east 90 days before closure or termination, ‘The notification must include the reason for closure, identification of patients affected and the provisions in place to ensure an orderly transition. Upon receipt of notification of closure, SHPDA must provide assistance in ensuring the safe and orderly transition of patients into appropriate care. DC Health received official notification from Providence Hospital on September 14, 2018 of its intent to end acute care and emergency room services. A copy of the notification is attached. Since then, we have met with hospital leadership to review its transition plan in order to ensure that the hospital provides appropriate staffing and continued services to those patients under their care until the proposed closures occur. DC Health, through the Health Licensing and Regulatory Administration (HLA), will continue to monitor for patient safety and quality throughout the closure process. In 2017, the Health Systems Plan (HSP) was developed by the State Health Planning and Development Agency and the Statewide Health Coordinating Council, a group comprising public health and community stakeholders appointed by the Mayor with the advice and consent of the DC Council, Released in September 2017, the Health Systems Plan draws on the District's community health needs assessment conducted in 2014 and DC Healthy People published in 2016. The Health Systems Plan provides a roadmap for leveraging DC’s high-quality medical services and facilities in order to address chronic health inequities, including gaps in primary, specialty and mental health care. The Health Systems Plan recommends that the District: ee 299 North Capitol Street NE_1 Washington, DC 20002 1 P202-442 5955 | F 202.442.4795 | Councilmember Grosso Page 2 - promote engagement in appropriate, quality, and timely primary care services, including preventive, acute, and chronic disease management services; = reduce inappropriate utilization of care, especially in emergency rooms; = consider social determinants as part of reducing health disparities; and = review and strengthen uncompensated care and community benefit programs and = policies. ‘The Health Systems Plan was informed by a comprehensive needs assessment that clarifies community need, barriers to care, unmet service need, provider capacity, and service gaps across all health service categories. The SHPDA utilizes the HSP to recommend specific strategic action and to facilitate cooperation between DC Health and other public and private sector entities. Further, the Health Systems Plan is a source of information and guidance in determining if CON applications show public health value. The HSP is also an important resource in helping health care entities align community benefit investments with community health needs. The Health Systems Plan was widely shared with DC Health stakeholders, partners and within the community [appreciate your interest. Please contact me directly at 202-442-9366 should you have additional questions, Sincerely, udu andra S: Nuthor LaQuandra 8. Nesbitt, MD, MPH Director