DOCSLIB.ORG

St. Elizabeths East Campus Urban Hospital Site Feasibility Study Preliminary Findings, December 2014 TABLE of CONTENTS

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
St. Elizabeths East Campus Urban Hospital Site Feasibility Study Preliminary Findings, December 2014 TABLE of CONTENTS St. Elizabeths East Campus Urban Hospital Site Feasibility Study Preliminary Findings, December 2014 TABLE OF CONTENTS SECTION 01. EXECUTIVE SUMMARY 2 Historic Background Vision Of St. Elizabeths East Jobs In The Education And Health Care Industries Combined Review Team Evaluation Process Summary SECTION 02. PROJECT OVERVIEW 7 Project Initiatives Healthcare Needs Proposed Program Resiliency Design Criteria Program Benchmark Projects St. Elizabeths East Master Plan SECTION 03. INITIAL SITE SELECTION 22 Initial Site Selection SECTION 04. SITE RECOMMENDATION 24 Building Data Summary Conceptual Cost Estimate SECTION 05. NEXT STEPS 27 Development Timeline Private Development Opportunities APPENDIX A: EVALUATION PROCESS i APPENDIX B: DUE DILIGENCE REPORTS xxi Due Diligence Report For St. Elizabeths East A. Government Entitlements B. Environmental Reports And Filings C. Geology And Hydrology D. Surrounding Real Estate Development (If Applicable) E. Miscellaneous ST. ELIZABETHS EAST CAMPUS URBAN HOSPITAL SITE FEASIBILITY STUDY PRELIMINARY FINDINGS, DECEMBER 2014 SECTION 01. Executive Summary HISTORICAL BACKGROUND VISION OF An essential element of the Master Plan is ensuring that the redevelopment A National Historic Landmark and local ST. ELIZABETHS EAST efforts incorporate the following Historic District, St. Elizabeths East was stakeholder-driven development The St. Elizabeths East Master Plan established as the first hospital in the objectives: and Design Guidelines, dated June 4, nation for the humane treatment of 2012 (the “Master Plan”)1 function as individuals with mental illness. At one 1. Open up the campus, the outline for the ongoing time, the hospital employed over 7,000 2. Create connections with surrounding redevelopment of St. Elizabeths East. staff members and was the source of communities, The Master Plan contemplates that economic stability for neighborhoods 3. Attract new development, the redevelopment will include a range east of the Anacostia River. The 4. Preserve the historic character, and of end uses, including commercial District has committed to redeveloping 5. Treat existing residents fairly office, educational, retail, and residential St. Elizabeths East into a vibrant mixed- and equitably. uses, as well as the District’s first use campus featuring the District’s first Innovation Hub. Innovation Hub. The Innovation Hub is expected to spur the creation of new The St. Elizabeths East Innovation Hub technology-related businesses and JOBS IN THE EDUCATION is planned to be an integrated center of jobs for all skill levels, which will create research, education and private sector AND HEALTH economic opportunities for residents commercial activities. Success will of Ward 8 and the District as a whole. CARE INDUSTRIES be defined by the District’s ability to The generation of new businesses The education and medical industries co-locate community users, universities, and employment will accelerate the are amongst the largest and most vital technology businesses and technology- diversification of the District’s economy components of the District’s economy. focused amenities (such as business and reduce reliance on the federal accelerators, an innovation market government. The District’s ultimate goal • According to the 2O13 place, and other related components) is to revitalize this historic landmark to Comprehensive Annual Financial that are focused on cultivating once again become a destination place Report2, eleven (11) of the District’s commercial and globally significant for sustainable development that meets top fifteen (15) employers were economic opportunities. the needs of the community. either universities, hospitals or health-care companies. 1 St. Elizabeths East - Master Plan and Design Guidelines: http://stelizabethseast.com/our-opportunity/master-plan/ 2 DC.gov – Office of Chief Financial Officer: FY 2013 DC Comprehensive Annual Financial Report: http://cfo.dc.gov/node/772372 2 ST. ELIZABETHS EAST CAMPUS Section 01. Executive Summary • The educational and health services industries employ an estimated FIGURE 1: BUREAU OF LABOR STATISTICS - DISTRICT OF COLUMBIA UNEMPLOYMENT4 300,000 people in the District. • The Consortium of Universities of Data Series May June July Aug Sept Oct the Washington Metropolitan Area 2014 2014 2014 2014 2014 2014 member activity represents almost Number of Unemployed in, 27.8 27.3 27.5 28.4 28.8 28.7 3 percent of the regional economy, thousands, seasonally adjusted. an $11.3 billion impact. Unemployment Rate Seasonally 7.5 7.4 7.4 7.7 7.7 7.6 In October 2014, the D.C. Department of Employment Services3 reported that the unemployment rate for the District was 7.6 percent, compared to the national FIGURE 2: BUREAU OF LABOR STATISTICS - unemployment rate of 5.8 percent. DISTRICT OF COLUMBIA EDUCATION AND HEALTH SERVICES JOBS However, some Wards in the District Data Series May June July Aug Sept Oct have reached unemployment levels that 2014 2014 2014 2014 2014 2014 are more than twice the regional and national averages. Unemployment levels Education & Health Services 126.9 128.9 128.4 128.4 128.6 129.9 in Wards 7 and 8 stand at 14.3 percent Jobs, in thousands, and 17.0 percent, respectively. seasonally adjusted The health care and educational industries are major job generators. The development of these types These companies have a particular The general scope of services of industries east of the Anacostia concentration in the District itself. In consisted of the team conducting a River would significantly benefit local many neighborhoods of the District, high-level review of United Medical residents and provide jobs where they particularly those along Metro’s Center (UMC) supplied programming are needed the most. Developing a Green Line (which serves as a direct criteria and previous studies, and a new urban hospital would not only link to St. Elizabeths East), hundreds review of site requirements for benefit the goals of the Innovation Hub, of entrepreneurs have formed a similar facilities elsewhere to determine but also bring much needed jobs East technology-based creative class and what constitutes a successful urban of the River. startup culture. hospital site. In addition, the development of a new A combined review group consisting of hospital to anchor the Innovation Hub COMBINED REVIEW TEAM DMPED, Huron Healthcare on behalf of would help drive private commercial The Office of the Deputy Mayor for the UMC for specialized program input, development. The District’s private Planning and Economic Development and the team of CH2M HILL and Perkins sector economy, which now accounts (DMPED) retained the services of CH2M + Will (collectively, the review team) for 88 percent of the region’s jobs, HILL to prepare a planning analysis to studied the site layouts (See Appendix has long been dominated by federal determine the feasibility of locating an A) for the potential of locating an contractors, telecommunications urban hospital and medical ancillary urban hospital on St. Elizabeths East. providers and professional services. uses on St. Elizabeths East as part of a After feedback from the review group In the past five years, however, this mixed-use development. The vision for at multiple workshop sessions and has begun to change dramatically St. Elizabeths East is to create a shared producing variations of the potential as small and growing companies campus for academic institutions, site layouts, the group concluded that focused on education, healthcare, technology and community-based an urban hospital, such as UMC, could e-commerce, cybersecurity and energy services, and an Innovation Hub. be hosted at St. Elizabeths East. have taken root in the District’s region. 3 D.C. Department of Employment Services: http://does.dc.gov/node/184512 4 Bureau of Labor Statistics for the District of Columbia: http://www.bls.gov/eag/eag.dc.htm URBAN HOSPITAL SITE FEASIBILITY STUDY, PRELIMINARY FINDINGS 3 Section 01. Executive Summary FIGURE 3: COMBINED REVIEW PROCESS Review Preliminary Kick-off Draft Study Final Study Round 1, 2, 3 Presentation tend to be much larger, allowing for funding and those that could be EVALUATION PROCESS relatively inexpensive surface parking, delivered entirely by the private sector. optimization of both emergency and This distinction informed building The team of CH2M HILL and Perkins patient or visitor vehicular circulation, placement and massing, distribution + Will was directed by DMPED to and primarily horizontal adjacencies of program, parking strategy, and study all potential locations at the St. among program elements. Urban other design aspects in all of the Site Elizabeths East with no preconceived sites, on the other hand, tend to be Options considered. or predetermined preferences, except smaller and more constrained, requiring for the mandate to keep the main structured parking, vertical stacking The site layouts were presented to the hospital building and tower outside of program elements, and sometimes Review Team and after feedback via the Phase 1 Real Estate Development unconventional vehicular circulation several workshops, Site Option 3e, with RFP5 areas. This study resulted in the strategies. While suburban hospital sites variations anchored by Parcels 13 and analysis of thirteen (13) conceptual often allow optimal functionality and 16, was suggested as the most viable site layouts on four (4) alternative adjacencies, their inherent remoteness site for an urban hospital. It is described parcels of St. Elizabeths East. The site can compromise
Load more

Recommended publications
  • Utilization Indicators Calendar Year 2018
    District of Columbia Hospital Association Utilization Indicators Calendar Year 2018 About This Report The charts and tables in this publication are intended to provide aggregate and comparative data on health care facility utilization in the District of Columbia. The source of the data is the District of Columbia Hospital Association’s Monthly Utilization Survey (self-reported by individual facilities). ISSUED | March | 2019 | www.dcha.org District of Columbia Hospital Association 1152 15th Street NW | Suite 900 Washington, D.C. | 20005 dcha.org AMBULATORY SURGERIES 2017 2018 % Change ACUTE TOTAL Children’s National Health System 12,482 12,614 1.1% The George Washington University Hospital 16,377 16,280 -0.6% Howard University Hospital 6,335 7,386 16.6% MedStar Georgetown University Hospital 7,913 8,071 2.0% MedStar Washington Hospital Center 10,872 10,583 -2.7% Providence Hospital – Ascension 6,488 5,586 -13.9% Sibley Memorial Hospital – Johns Hopkins Medicine 8,150 8,657 6.2% United Medical Center 1,175 1,204 2.5% GRAND TOTAL 69,792 70,381 0.8% AMBULATORY SURGERIES 72,000 71,353 70,381 70,000 69,941 69,126 69,792 68,823 68,380 68,000 67,034 66,000 65,103 64,000 63,195 62,000 60,000 58,000 56,000 ► YEAR 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Note: Calculations are based on reported utilization figures for the District of Columbia acute non-federal hospitals. UTILIZATION INDICATORS / PAGE 2 EMERGENCY DEPARTMENT VISITS 2017 2018 % Change The number of ACUTE TOTAL annual Emergency Department visits has Children’s National Health System @ UMC 33,046 35,016 6.0% remained fairly steady Children’s National Health System 85,016 91,016 7.1% in the last several years.
    [Show full text]
  • Monthly Utilization Report October 2019
    District of Columbia Hospital Association Monthly Utilization Report October 2019 Overview & Observations DCHA routinely reports occupancy rates for several specialized patient care unit types (pages 15–23 of this report). Occupancy rates are expressed as the monthly average census as a percentage of designated beds. These rates only show occupancy volume as “within hospital.” In the graphs below, we illustrate the “within-hospital” and the “between hospital” occupancy volume. For example, MedStar Georgetown University Hospital has the highest Med-Surg Occupancy rate, yet averages 270 (54%) fewer Med-Surg patients than MedStar Washington Hospital Center (Fig 1). Similarly, Howard University Hospital has a slightly lower ICU occupancy rate than does The George Washington University Hospital (GWUH); yet averages 24 (53%) fewer ICU patients than GWUH (Fig 2). Differences in volume by unit are important to understand as you look at the overall occupancy of a hospital to explore questions such as, why some patients may experience longer wait times before being moved to an inpatient unit. Comparison of Bed Capacity and Occupancy Rate for Acute Care Hospitals, January - September 2019 Figure 1: Med-Surg Beds by Hospital Figure 2: ICU Beds by Hospital Table of Contents Total Admissions ............................................................2 Emergency Department Visits........................................13 Total Discharges.............................................................4 Ambulatory Surgeries.....................................................14
    [Show full text]
  • Utilization Indicators Calendar Year 2019
    District of Columbia Hospital Association Utilization Indicators Calendar Year 2019 About This Report The charts and tables in this publication are intended to provide aggregate and comparative data on health care facility utilization in the District of Columbia. The source of the data is the District of Columbia Hospital Association’s Monthly Utilization Survey (self-reported by individual facilities). ISSUED | May | 2020 | www.dcha.org District of Columbia Hospital Association 1152 15th Street NW | Suite 900 Washington, D.C. | 20005 dcha.org AMBULATORY SURGERIES 2018 2019 % Change ACUTE TOTAL Children’s National Health System 12,614 13,151 4.3% The George Washington University Hospital 16,280 17,030 4.6% Howard University Hospital 7,386 9,324 26.2% MedStar Georgetown University Hospital 8,071 8,273 2.5% MedStar Washington Hospital Center 10,583 10,631 0.5% Providence Hospital – Ascension 5,586 - -100.0% Sibley Memorial Hospital – Johns Hopkins Medicine 8,657 9,010 4.1% United Medical Center 1,231 1,311 6.5% GRAND TOTAL 70,408 68,730 -2.4% AMBULATORY SURGERIES 72,000 71,353 70,408 70,000 69,941 69,126 69,792 68,823 68,380 68,730 68,000 67,034 66,000 65,103 64,000 62,000 60,000 58,000 56,000 ► YEAR 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 Note: Calculations are based on reported utilization figures for the District of Columbia acute non-federal hospitals. UTILIZATION INDICATORS / PAGE 2 EMERGENCY DEPARTMENT VISITS 2018 2019 % Change There was a statistically ACUTE TOTAL significant decrease in ED visits in 2019.
    [Show full text]
  • Monthly Utilization Report February 2019
    District of Columbia Hospital Association Monthly Utilization Report February 2019 Overview & Observations Emergency Department (ED) visits in January increased along with the CDC noted influenza outbreak. However, ED visits decreased in February despite CDC reported increased incidence in Region 3 (Delaware, DC, Maryland, Pennsylvania, Virginia, and West Virginia ). Underlying reasons for this pattern are unclear based upon the utilization data available. Hospitals may wish to further analyze reasons for admission or diagnostic data to identify additional details. Although overall ED visits decreased slightly in February, the impact of the Providence closure remained evident, particularly for MWHC and HUH. [A similar impact is also evident when comparing changes in Providence admissions to overall admissions for other District hospitals.] Note: Most of the utilization data are significantly skewed when the 28-day February counts data is contrasted with other months. We have modified the graph formats to reflect a “per-day” basis to facilitate comparisons over time. Table of Contents Total Admissions ............................................................2 Emergency Department Visits........................................13 Total Discharges.............................................................4 Ambulatory Surgeries.....................................................15 Total Patient Days...........................................................5 Observation Patients and Observation Patient Days......16 Psychiatric Admissions,
    [Show full text]
  • Health Care Services on the District's East End: a Vision for Access And
    Health Care Services on the District’s East End: A Vision for Access and Sustainability Introduction The District of Columbia Hospital Association (DCHA) supports the current effort by the Mayor and the Council of the District of Columbia to address the delivery of health services to all District residents, and the immediate need to deliver health services to residents of Wards 7 and 8 – an East End Health Care Strategy. Individuals living in these Wards are over-represented among the District’s most vulnerable populations. In fact, multiple reports commissioned by the District government and conducted over the past decade chronicle the turbulent history of health care delivery to residents east of the Anacostia River - from the bankruptcy of Greater Southeast Community Hospital and numerous acquisitions and restructurings, to present efforts to stabilize United Medical Center. While this may have offered residents a consistent source of medical care, it did not establish a community-wide infrastructure that integrated multiple levels of health care delivery – including preventive, appropriate specialty and post-acute care - with community and social services. The District of Columbia now has an opportunity to transform the delivery of health care on its East End and improve the standard of care for its most vulnerable and underserved residents. As such, it is DCHA’s position that any East End Health Care Strategy must include elements that will stabilize and improve the delivery of and access to health services in a long-term and sustainable way. A persistence to push forward change efforts, regardless of challenges and opposition, will be critical to this strategy’s success.
    [Show full text]
  • Utilization Indicators Calendar Year 2010
    Utilization Indicators Calendar Year 2010 Issued March 2011 ABOUT THIS REPORT ON UTILIZATION INDICATORS The charts in this publication are intended to provide aggregate and comparative data on the utilization trends of the District of Columbia hospital community for calendar year 2010. The source of the data is the District of Columbia Hospital Association’s (DCHA) Monthly Utilization Survey and Quarterly Bed Capacity and Census Survey (self-reported by individual hospitals). The graphs in this report describe utilization trends in the aggregate for the following District acute care non-federal hospitals: • Children’s National Medical Center • Georgetown University Hospital • Sibley Memorial Hospital • George Washington University • Howard University Hospital • United Medical Center Hospital • Providence Hospital • Washington Hospital Center Operating Bed Capacity 4th 4th Quarter Quarter Five Year Trend: 2006-2010 2006 2010 % Change Acute Care 2,780 2,714 2,766 2,724 Children’s National Medical Center 230 255 10.9% 2,734 George Washington University Hospital 339 341 0.6% Georgetown University Hospital 402 402 0.0% Howard University Hospital 218 291 33.5% Beds Operating Providence Hospital 291 272 -6.5% Sibley Memorial Hospital 264 205 -22.3% United Medical Center 228 184 -19.3% 0 1,000 2,000 3,000 4,000 Washington Hospital Center 808 774 -4.2% 4th Qtr 06 4th Qtr 07 4th Qtr 08 4th Qtr 09 4th Qtr 10 ACUTE TOTAL 2,780 2,724 -2.0% Period Covered Other Specialty National Rehabilitation Hospital 137 187 36.5% Compared to last year, there has been a slight decrease of 42 operating beds, approximately 1.5 Psychiatric Institute of Washington 104 104 0.0% percent, in the District’s acute care non-federal SHW - Capitol Hill 60 60 0.0% hospitals.
    [Show full text]
  • Huron Consulting Group Inc
    A NEW HOSPITAL AT ST. ELIZABETHS EAST ANALYSIS OF A FINANCIALLY STABLE, HIGH QUALITY INTEGRATED MEDICAL CAMPUS AND AMBULATORY PAVILION PROJECT #: DHCT-2017-R-0028 FULL REPORT SUMMARY © 2018 HURON CONSULTING GROUP INC. AND AFFILIATES. ALL RIGHTS RESERVED. 1 © 2018 HURONMarch CONSULTING 2018 GROUP INC. AND AFFILIATES. ALL RIGHTS RESERVED. © 2018 HURON CONSULTING GROUP INC. AND AFFILIATES. ALL RIGHTS RESERVED. AGENDA 1 Objectives and Engagement Overview 2 Summary of Findings and Next Steps 3 Appendices: CLIN Summaries (1-6) 2 © 2018 HURON CONSULTING GROUP INC. AND AFFILIATES. ALL RIGHTS RESERVED. 1 OBJECTIVES AND ENGAGEMENT OVERVIEW OBJECTIVES AND ENGAGEMENT OVERVIEW SYNTHESIS OF RECOMMENDATIONS AND OUTPUT Contract line item number (“CLIN”) 7 provides a comprehensive review of Huron's findings, recommendations, considerations, and other output, in response to the questions solicited through each of CLINs 1-6 CLIN 1 CLIN 2 CLIN 3 CLIN 4 CLIN 5 CLIN 6 • Who are the ▪ What are the ▪ What are the ▪ What are the • What range of • What criteria utilizers of potential key services specific financing and health care impacts of utilized by services and options exist opportunity resources in changes in Wards 7 and 8 product line and are should be Wards 7 and health care residents, and offerings; and feasible for evaluated in 8, and what policy reforms, where do they expected bed D.C. to pursue identifying and factors care delivery go to receive size at the for new negotiating influence how and these replacement hospital with an they utilize reimbursement services? facility? construction? operating health care? that can • What is the • What specific partner? • What is the potentially framework for ancillary • What is the ten-year affect hospital a replacement services optimal market outlook operations? facility, given should be operational for health care • What are our findings offered at the and utilization in practical from historical replacement management Wards 7 and pursuits for utilization and facility? archetype 8? D.C.
    [Show full text]
  • Health Innovation Resources in DC
    Health Innovation Resources in DC With 16 medical centers and hospitals, numerous research universities and federal health agencies, major funders of biomedical research, and a thriving health tech sector, the DC region is a growing hub for health innovation. This document outlines the organizations and support organizations helping drive forward health innovation in DC. The Business Development Unit at the Office of the Deputy Mayor for Planning and Economic Development (DMPED) helps businesses navigate resources to help them grow and thrive in DC. We consistently hear from our stakeholders a need for a central location to view resources available to support businesses and individuals interested in different industry areas. This document strives to list the key organizations and resources in DC’s health innovation ecosystem. We included all organizations and resources we are aware of. This document will be updated periodically. The date on the bottom of this page denotes the date of the last update. Please email [email protected] with any organizations or resources we may have missed. Table of Contents Hospitals with Health Innovation Centers .............................................................................. 1 Health Innovation Accelerators & Incubators ........................................................................ 2 Medical Schools in DC ............................................................................................................. 2 Major Government Agencies Based in the DMV ...................................................................
    [Show full text]
  • Sibley Memorial Hospital Community Health Needs Assessment Fiscal Year 2013
    Sibley Memorial Hospital Community Health Needs Assessment Fiscal Year 2013 June 26, 2013 Sibley Memorial Hospital SIBLEY MEMORIAL HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT FY 2013 CONTENTS PAGE I. Executive Summary ............................................................................................................................... 2 II. Introduction a. Overview ................................................................................................................................... 3 b. The Community We Serve…………………………………………………………………….3 III. Approach and Methodology a. Community Health Needs Assessment ..................................................................................... 4 IV. Selecting Priorities a. DC Healthy Communities Collaborative Identified Priorities .................................................. 6 b. Additional Hospital Priorities 1. Table One ..................................................................................................................... 7 c. Hospital Programs that Support other Hospital Needs 1. Table Two .................................................................................................................... 8 V. Conclusion ............................................................................................................................................. 9 Appendices Appendix A ................................................................................................................................................ 10 1 Sibley Memorial Hospital
    [Show full text]
  • Utilization Indicators Calendar Year 2013
    Issued March 2014 UTILIZATION INDICATORS CALENDAR YEAR 2013 Ambulatory Surgeries ABOUT THIS REPORT The charts in this publication are intended to provide aggregate and comparative data on the utilization trends of the District of Columbia hospital community for calendar year 2013. The Note: Calculations are based on reported utilization figures for the District of Columbia acute care non-federal source of the data is the hospitals. District of Columbia Hospital Association’s Ambulatory Surgeries (DCHA) Monthly 2012 2013 % Change Utilization Survey and Acute Care Quarterly Bed Capacity Children’s National Medical Center 12,438 12,652 1.7% and Census Survey (self- George Washington University Hospital 9,105 10,884 19.5% reported by individual Howard University Hospital 8,771 7,996 -8.8% hospitals). The graphs in MedStar Georgetown University Hospital 8,644 8,676 0.4% this report describe MedStar Washington Hospital Center 11,896 11,509 -3.3% utilization trends in the Providence Hospital 8,741 8,303 -5.0% aggregate for the Sibley Memorial Hospital 7,009 7,155 2.1% United Medical Center 2,219 1,951 -12.1% following acute care non- ACUTE TOTAL 68,823 69,126 0.4% federal hospitals: • Children’s National Federal Medical Center Veterans Affairs Medical Center 2,532 2,690 6.2% • George Washington Walter Reed National Military Medical Center 11,367 11,616 2.2% University Hospital • Howard University SUBTOTAL – DC ONLY 71,355 71,816 0.6% Hospital GRAND TOTAL 82,722 83,432 0.9% • MedStar Georgetown University Hospital • MedStar Washington The number of ambulatory surgeries continues to increase steadily.
    [Show full text]
  • Reading Medicaid Approaches to Addressing Maternal Mortality in The
    MEDICAID APPROACHES TO ADDRESSING MATERNAL MORTALITY IN THE DISTRICT OF COLUMBIA TARA WILSON* ª...government still has an obligation to act. Just as we can't be just a little pregnant. You either are or you are not. You cannot be a little misogynistic and racist. This is not about intentions. Lack of action is `unintentionally' killing us.º1 Representative, Black Mamas Matter Alliance ABSTRACT Maternal mortality in Washington, DC, has reached crisis levels. In a coun- try that boasts the highest maternal mortality rate (MMR) in the developed world, DC's MMR is double the national MMR. The closure of obstetrics units in areas of concentrated poverty has made the problem particularly acute in low-income DC communities, and most low-income residents in DC are black. This paper aims to present changes in Medicaid policy that DC City Council may take to prevent further reductions to access to obstetric care and to pro- mote healthy pregnancies. In Part II, this paper will address contributing fac- tors to DC's maternal health crisis, and in Part III, the paper will argue for: (1) increased base payment reimbursement for obstetric services, (2) expanded public transportation to improve access to those hospitals with obstetrics units, and (3) the extension of Medicaid coverage to doula services to improve ®nan- cial feasibility for hospitals and ensure healthy pregnancies for patients. Finally, Part IV addresses the advocacy required to implement these changes. I. INTRODUCTION ................................................ 216 II. PROBLEM STATEMENT .......................................... 218 A. MATERNAL MORTALITY IN THE UNITED STATES . 218 B. MATERNAL MORTALITY IN THE DISTRICT OF COLUMBIA .
    [Show full text]