Certificate of Need? Yes!

"VI. CONDITIONS PRECEDENT TO PROCEEDING TO CONSTRUCTION PHASE 6.1. Howard's obligation to proceed with this Project is contingent upon the Council's adoption of legislation approving . . . exemption of the Project from the Certification of Need requirements."

-- "Exclusive rights agreement" between the District and Howard University.

THE AGREEMENT to construct a $400 million hospital on the site formerly occupied by D.C. General Hospital comes with a potential deal-breaker, if we have correctly read the document signed by Mayor Anthony A. Williams and H. Patrick Swygert, president of Howard University, last week. Howard, the document states, will pursue the construction phase of the 250-bed National Capital Medical Center if the project does not have to be subjected to the same certificate-of-need review process that other health projects must undergo. We cannot imagine a D.C. Council charged with stewardship over the city's treasury approving such an enormously expensive major health facility that bypasses the certificate-of-need process.

There will be plenty of time to properly vet the rest of the "exclusive rights agreement" as well as the joint venture itself. The agreement, for example, frees Howard University and the city from any financial obligation for the new hospital after the first three years of operation. Certainly D.C. taxpayers -- whose commitment will reach at least $212 million -- will want to know how the new nonprofit entity that is proposed to operate the new hospital will manage financially without support from the university or the city.

But the attempt to make an end run around the certificate-of-need review is the main subject of today's editorial. The review process is the taxpayer's principal means of ensuring -- through the work of independent experts -- that the proposed hospital is needed, does not duplicate existing services, is cost-effective and well financed, and has well-thought-out management and operational plans. The city's review process, unlike the discussions between Howard and the mayor leading up the agreement, will solicit comments from the city's other health care providers, consumers and taxpayers -- the kind of public examination that a project of this scope and potential financial impact on the city's treasury should have.

The District, by any yardstick, is going out on a financial limb to help Howard undertake this high-stakes venture. Due diligence requires implementation of the certificate-of-need review process. We are pleased to learn that D.C. Council Chairman Linda W. Cropp has said she favors proceeding with that process, because the $400 million price tag is a top concern. Howard's predictions that the hospital will turn a profit by the third year make scrutiny by an independent outside review -- and not by a D.C. Health Department beholden to the mayor -- all the more important. The rest of the council should stand with Mrs. Cropp.