$90 Million Urged to Expand Health Care

Rand Report Calls for Focus on Residents East of the Anacostia

The District should spend $90 million in tobacco settlement money to expand primary and urgent health care through community health centers in the city's underserved areas, mostly east of the Anacostia River, the independent Rand Corp. advised in a report released yesterday.

The long-awaited report provides guidance on the District's critical health needs and how the settlement money could be used to address them. The city has a total of about $245 million, its piece of the 1998 national settlement between tobacco companies and states.

City officials asked Rand to make recommendations on how to spend $135 million of the settlement fund. Rand also suggested spending $24 million on improving electronic medical records systems and reserving $7.5 million for mental and oral health issues, as well as a variety of smaller projects.

"We will be reviewing these findings with internal experts as well as stakeholders in the community to develop a plan for investing these funds through grants and other partnerships," Mayor Adrian M. Fenty (D) said at a news conference.

Fenty, D.C. Council member David A. Catania (I-At Large), representatives of Rand and medical staff spoke outside Unity Health Care's East of the River Center, a clinic just off Benning Road NE that could benefit from the funds.

"This will be the largest investment of capital in health care in the history of this city," said Catania, chairman of the council's Committee on Health.

The council had already weighed in on how to spend much of the money, including $79 million for the revitalization of United Medical Center, previously known as Greater Southeast Community Hospital.

Rand was charged with studying the city's ills, talking to residents and recommending $135 million in expenditures.

"It's been a labor of love from the get-go," said Nicole Lurie, a senior scientist at Rand. "We all know building bricks and mortar isn't alone going to solve this problem. What we really need here is leadership and community will to get this done."

In January, Rand released a 134-page assessment of the city's health needs, finding that 1 in 5 District residents did not a have a regular doctor or clinic despite being insured.

Access and quality of care were the main issues, according to the reports released yesterday and in January.

According to the report released yesterday, residents surveyed complained of long waits, both to get an appointment and then during the actual doctor visit.

"The issue of wait times is particularly troubling for parents seeking care for children as these prolonged times in non child friendly waiting rooms are difficult to manage," the report reads.

The report also enumerated complaints of poor people skills among the medical staff, including doctors. It described the experience of a Ward 8 resident, who said: "The doctor referred to me as 'mama.' I would have felt much better to be addressed by my name. His office was not neat. You expect basic cleanliness."

Such frustrations often lead residents to go to emergency rooms as a substitute for primary care, the report said.

Catania said Rand's recommendations include improving overall care, which includes "licensure of physicians, cultural sensitivity and bedside manner."