The District had to close its alcohol detoxification center for all but a few hours yesterday because it had failed to pay the center's doctors.
The hours of the 50-bed unit at D.C. General Hospital have been shaky for about two months because of a shortage of doctors. The hours became even more erratic three weeks ago, when two doctors walked off the job complaining that they hadn't been paid since late September.
Two other city-run facilities that treat alcoholics are facing similar staffing problems. The Mary Herring Home at 700 Monroe St. NE is operating under a provisional license due to understaffing, according to a Dec. 23 memo from Curtis Dance, chief of the Bureau of Alcoholism Treatment Services of the D.C. Department of Human Services.
Two of the five floors of Karrick Hall, a 30-day alcohol and drug treatment program on the grounds of D.C. General, also have been closed due to lack of staff, officials at the human services agency said.
D.C. police said last night they planned to take inebriated persons to the emergency room at D.C. General Hospital instead of the detoxification center, but a hospital official said the emergency room was ill-equipped to cope with them.
"Most of them don't need admission," said Dr. Renuka Gupta, the medical officer in charge of the emergency room. "They stay in the emergency room and it gets more crowded. Then they disappear when you call them or they are sleeping" and must be shaken awake to be examined.
After telephone calls from a reporter, Dr. Reed V. Tuckson, the city's public health commissioner, said he would personally admit patients at the detoxification center starting at 1 a.m. today "to make sure we don't have any critical problems falling through the cracks."
Tuckson said he expected the center to be operating normally by Monday because the doctors have received their late paychecks within the last few days.
Staffing problems have disrupted operations at the detoxification center since at least November, when the unit was forced to close about 25 percent of the time, according to department reports. Of the five doctors assigned to the unit, two refused to show up last month because they hadn't been paid, according to John Jackson, administrator of the Alcohol and Drug Abuse Services Administration.
One other doctor is on annual leave and another is on medical leave, department officials said. A fifth doctor said he was continuing to work despite the problems in getting paid. Another doctor is filling in temporarily on some shifts, according to Jackson.
Jackson said the agency didn't get the paychecks out on time primarily because of the agency's effort to reorganize and tighten its contracting process. The reorganization followed heavy criticism of lax contracting procedures while the department was under the leadership of David E. Rivers.
The agency hired the doctors under personal service contracts, rather than as regular city employes, in part to avoid the city's requirement that employes live in the District, Jackson said. When department officials learned the contracts were held up, they tried to pay the doctors using other procedures, but more delays ensued, he said.
The detoxification center is prohibited from admitting patients if a doctor is not present to examine them. Patients have been allowed to remain at the unit under the care of nurses during periods when no doctor is there, Jackson said.
Jackson said he would visit the center twice daily over the weekend "to make sure there's nobody there who is too ill to be managed at that facility."
Jackson said the facility was closed to new patients yesterday except for a four-hour period in the morning, though he arranged for one additional patient to be admitted in midafternoon. The center, which includes 35 beds for alcoholics and 15 beds for drug addicts, is about half full.
Staffing at the Mary Herring Home and Karrick Hall is short because of retirement, resignation and transfer, according to officials. Requests for replacement staff members have not yet been approved.