A deal to build a new hospital east of the Anacostia River appeared to survive — at least temporarily — on Tuesday, as the D.C. Council approved a last-minute measure that proponents say will allow negotiations for the project to move forward.

The legislation, most of it drafted by council member Vincent C. Gray (D-Ward 7), stipulated that Howard University’s medical school must have an academic affiliation with either the new hospital or some other medical facility.

A stricter version of that requirement, debated by the council two weeks ago, looked as though it would torpedo the project. But in the last hour of the last day of the legislative session, after lawmakers had been debating and passing bills for nearly eight hours, there were enough votes to approve the plan.

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The council’s vote marked a victory for Gray and for the Bowser administration, both of which have invested substantial time and energy in planning the new hospital serving the largely poor, mostly African American communities east of the Anacostia.

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Gray said he hoped new provisions in the law would allow for continued negotiations with George Washington University Hospital, the city’s partner in the project.

But opponents said the hastily assembled bill put the District on a fast track to what could ultimately be a bad deal. Even in the final hours of deliberation, it was clear lawmakers were struggling to understand what they were voting for.

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“This is the way you make bad law,” said Jack Evans (D-Ward 2), who represents residents of the area surrounding the current GW Hospital site.

Evans and council Chairman Phil Mendelson (D) cast the only no votes among the council’s 13 members. The council will still have to vote on the final deal between the city and GW Hospital, which is expected to be finalized early next year.

The council’s 11th-hour action caps weeks of debate over the hospital project, as critics ranging from Foggy Bottom neighborhood activists to union members emerged to protest the deal that was taking shape between the District and GW Hospital.

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When Mayor Muriel E. Bowser (D) announced in August that she had struck a tentative agreement with the hospital — which is primarily controlled by a subsidiary of Universal Health Services, a Pennsylvania-based corporation that owns health facilities across the country — it seemed the city was at last on a path to replacing United Medical Center (UMC).

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After decades of financial struggles, UMC, the District’s only public hospital, was at the center of renewed controversy last year. Under a management company run by one of Bowser’s political donors, the hospital needed millions in taxpayer subsidies and was scrutinized over questionable deaths of patients.

Elected leaders agree on the need for a new public hospital on the east end of the city — a priority that has become more urgent since UMC’s obstetrics ward was shuttered and Providence Hospital in Northeast Washington announced it would be closing.

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But Gray’s legislation waiving the review process typically required for new medical facilities built in the District prompted a swift backlash.

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“We are flying blind, folks — that’s what this is,” council member Elissa Silverman (I-At Large) said. She said decisions about creating a new hospital should not be done without an independent analysis of the number of hospital beds in the city and surrounding area and which medical services are available and which are in short supply.

Gray said the bill was needed to ensure the hospital would open by the end of 2021. But the measure would have exempted from review both the new hospital on the campus of St. Elizabeths Hospital and a new tower filled with beds for speciality services at the current site of GW Hospital in Foggy Bottom.

The Foggy Bottom proposal drew protests from neighborhood activists. And Howard officials said the dual projects east and west of the river posed a threat to their hospital, which has a storied tradition of training ­African American physicians. Unions expressed concern that UMC workers could be cut out of jobs at the new Southeast hospital.

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Two weeks ago, Gray withdrew his original legislation after the council approved an amendment guaranteeing that union workers would be hired at the new hospital. The next day, GW Hospital officials said they were suspending negotiations until the council rolled back that requirement.

The new bill aims to soften restrictions on the deal while ­allaying critics’ concerns. It would require that Howard University College of Medicine be guaranteed an academic affiliation with one or more regional hospitals — including the new Southeast facility — before the new hospital at St. Elizabeths could be built.

The bill also reduces the expansion at the Foggy Bottom site from 270 beds to 200. And it softens the requirements for the hiring of current UMC workers at the replacement hospital, while still requiring that the city and GW Hospital take steps to employ at least some unionized employees.

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Silverman, who pushed to include the labor protections, said she worried that the legislation’s goal had become a “moving target” as it was rushed through the council’s final session before the holidays.

“We are making a last-minute decision at the last meeting of the year on an extremely important issue,” said Silverman, who voted for the final version of the bill.

Gray, assessing the legislation’s effects before the vote, was circumspect.

“What we have, ladies and gentlemen,” he said, “at the end of the day, is legislation that allows us to proceed.”

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