A federal judge here yesterday ordered the District of Columbia government to immediately reopen the Upshur Street Clinic, one of the city's busiest public health facilities for indigent patients, which was shut down during the D.C. budget crisis last May.
Judge Aubrey E. Robinson Jr. ruled that the decision to close the clinic violated the city's legal responsibility to provide comprehensive medical care for the poor -- from checkups and X-rays to prescriptions -- at places within access of the patients' homes.
In a 27-page decision, Robinson said that city officials had failed to support their claim that shutting down the clinic, and funneling its resources to other public health facilities around the District, would relieve some of the city's budget problems.
The city had argued that the five-story brick building that housed the clinic at 1325 Upshur St. NW, needed up to $5 million worth of repairs. They also contended that the city could save $250,000 in health care funds by shutting down the Upshur Street operation, as well as two smaller facilities.
The evidence in the case showed instead, Robinson wrote, that the building could be repaired for between $500,000 and $1 million, that its current condition did not pose a danger to its occupants, and that the savings from closing the facility would only amount to about $45,000, which would be offset by costs that would be shifted to other clinics that would have to take on Upshur Street patients.
James A. Buford, the director of the city's Department of Human Services, said yesterday that his office would have to review staffing and services at the city's other health clinics before schedules could be set for reopening the Upshur Street clinic, which was closed on May 20 after being open for 30 years. Most of the staff and supplies from that clinic have been reassigned to other areas, Buford said. He added, however, that if necessary the reopening could be accomplished within a few days.
City Council Member Charlene Drew Jarvis (D-Ward 4), who had opposed the decision to close the clinic, said yesterday that Robinson's decision means the District government "has got to exercise greater diligence" before it decides to eliminate health care services, which are often a vulnerable target at budget time.
Robinson's decision came in a class action lawsuit brought on behalf of all District residents who are unable to pay for clinical health services. The suit was originally brought by a small group of citizens who use the Upshur Street clinic.
The citizens were represented by lawyers from the Neighborhood Legal Services program and from the Washington law firms of Steptoe & Johnson and Arnold & Porter, who helped represent the citizens for free.
In 1979, the clinic had more than 75,000 patient visits, involving about 14,000 people, and it dispensed more than 80,000 prescriptions from its pharmacy. Robinson noted in his opinion that before the clinic was closed, it was the only public health clinic in Northwest Washington that offered full-time services in general medicine, obstetrics, gynecology and pediatrics, in addition to other specialized services and treatment clinics for tuberculosis and venereal disease.
Although the city claimed that it had simply "relocated" the staff and services from Upshur Street to other locations, Robinson said that those clinics were not accessible to Upshur Street patients. Other clinics, already short on staff and services, could not absorb the high volume of patients shifted to them from the Upshur Street clinic, Robinson said. In addition to "fragmented service" at other clinics, Robinson said many patients are unable to travel by public transportation to other locations and face long waits for treatment -- up to four hours -- at the city's large and overcrowded clinic at D.C. General Hospital.
The D.C. Corporation Counsel's Office, which argued the case for the city government, declined comment on Robinson's decision. City lawyers could ask Robinson to delay enforcement of his order to reopen the clinic, if they decide to appeal his decision to the U.S. Court of Appeals.