The House District Committee staff has developed a draft compromise in the long-running dispute over the transfer of St. Elizabeths Hospital from federal management to the District government by 1991.
The plan, parts of which are opposed by District officials and hospital union officials, also would help to move more of the mental health hospital's patients to the care of community agencies.
Under the draft, obtained by The Washington Post but not to be formally proposed until later this week, the federal government would continue to have primary responsibility for the hospital for fiscal years 1986 and 1987. Over the following four years, federal financial support would decline, while the city's would rise.
After October 1991, the federal government would pay only for the care of patients that federal agencies or courts send to the facility in Southeast Washington.
The compromise is an attempt to reconcile plans put forward by the city, the federal government and the main employe union at St. Elizabeths. These groups, which have been at odds for years over when and how to effect the transfer, were brought together at negotiating sessions as part of the compromise effort.
Congress hopes to resolve the thorny issue of the hospital's future use and funding in legislation this year, but chances of final congressional passage appear slim with the session set to end in October.
But if the House could pass a plan this year, it would take Congress further along than it has ever been in resolving the hospital's fate and could act as a starting point for action next year.
Mayor Marion Barry has said that the city cannot afford to have St. Elizabeths on its hands, and earlier this year he said that the District would not increase its financial support for the hospital for at least six years.
The federal government has been trying to turn the 127-year-old facility over to the District government for decades. As part of plans to transfer the management of the facility over 10 years, the Office of Management and Budget has in each of the past three years reduced the amount of federal funding budgeted for the hospital.
As a result, for several years there has been a gap in the amount of money that the hospital needs to operate -- now about $127 million a year -- and what the federal and city governments combined have been willing to pay.
Only last-minute congressional appropriations have forestalled serious financial problems at the hospital, but the last such bailout was contingent upon the adoption of a plan in fiscal 1985 for funding the institution and being responsible for its operation.
City officials and the American Federation of State, County, Municipal Employees (AFSCME), which represents most of the hospital's employes, object to some parts of the staff compromise.
"I can't say categorically we would support this bill. We have some reservations about it," said Pauline Schneider, director of intergovernmental relations for the District.
The city's main objection is the cutoff of federal funding after October 1991, Schneider said. After that, the federal government would pay only for federal patients and for continuing some research programs at the hospital.
In addition, the bill would make the District responsible for the mentally ill who are homeless. City officials strongly oppose this, arguing that the District should not have to care for those who are drawn here because this is the nation's capital.
Bill Welsh, director of legislation for AFSCME, said that the draft legislation does not do enough to protect hospital workers. These workers now are federal employes, but the intent of the proposal is to have them brought into a newly formulated District mental health system as soon as jobs become available.
"The bill provides no guarantee that anybody working at the hospital today would be employed in the new system," Welsh said.
Employes would be put on "retention registers" and offered jobs in the new D.C. system according to their standing on the registers. Employes not retained in the new system would be put on a reemployment priority list, to be given preference in future hiring.
The draft legislation "asks us to sign off on that kind of operation without knowing what kind of a system D.C. will have," Welsh said.
Dr. Larry Silver, acting director of the U.S. Alcohol, Drug Abuse and Mental Health Administration, the federal government's main spokesman on St. Elizabeths, said he could not make any official comment on the legislation until it has been formally submitted.
The compromise would require the city to design a comprehensive mental health system by October 1986 for mentally ill people in the city, with an emphasis on community facilities.
That proposed system could then be amended by a specially created nine-member commission consisting of three senators, three congressmen, two mayoral appointees and one appointee of the City Council chairman.
The city's final plan, to be implemented by 1991, would specify how much of the federally owned St. Elizabeths property and buildings the city would need to run its own mental health system. Ownership of the property would be transferred to the city at no cost in October 1987. The institution covers 336 acres and now treats about 1,700 inpatients.
The amount of federal funding for fiscal years 1986 and 1987 would not be set under the bill, but would be determined in the budget process, as before. Last year's federal contribution was $69 million.
The draft bill would authorize a total of $76 million in federal funds in fiscal 1988 for the District to use for its mental health care system. The federal contribution would decline to $48 million in fiscal 1991, and to nothing after that.
City officials wanted the federal government to continue to pick up a significant portion of the cost of St. Elizabeths indefinitely, but Welsh, the labor union official, said that the money in the bill is "pretty good, pretty generous as a matter of fact."