Hearing of the House Committee on Oversight and Government Reform - Lack of Hospital Emergency Capacity: Will the Administration's Medicaid Regulation Make it Worse --Day Two

Statement

Hearing of the House Committee on Oversight and Government Reform - Lack of Hospital Emergency Capacity: Will the Administration's Medicaid Regulation Make it Worse --Day Two

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DEL. ELEANOR HOLMES NORTON (D-DC): Thank you, Mr. Chairman. I want to thank both of these witnesses for being here, and I particularly am grateful for this hearing, because I'm afraid I'm more deeply implicated than some because of my representation of the District of Columbia.

I've worked closely, of course -- and I work on the Homeland Security Committee -- with Secretary Chertoff.

Secretary Leavitt, I worked with your predecessor on something called ER-1.

I am particularly concerned about this place, not only because I represent 600,000 people there, but because all of official Washington is here -- (inaudible) -- federal workers and because this is a prime target for terrorism.

This discussion about trying to separate out Medicaid from other money is important because we want money used for what it is intended, but you certainly can't see a hospital as if it were not an organism with core functions that treat private and the poor patients alike and as if you could collapse the part that treats Medicaid patients. And I think that's what some of us have been trying to get at.

I want to ask you about the hospitals here. We've got three trauma centers here. Two of them were surveyed in this survey; they were extensively above capacity. No available treatment spaces in the hospital, only six had intensive care units there. One could not participate in the survey because it was so overcrowded that it had to stop taking, accepting, new patients at all.

My good friends on the other side of this dais cite Washington Hospital emergency room as a model for the country. It is a very good emergency room, and that's what I've worked with on so-called ER-1, and I'll get to that in a minute. But since they cite the Washington Hospital Center, I went to the head of the emergency room, Dr. Mark Smith, and Dr. Smith confirmed the findings of the survey and in addition said -- when he said twice as many patients as he did treatment spaces. They're putting some in the corridors of the administration offices. They are putting them in waiting rooms, and he said he had a major problem with preparedness.

Now, I understand triage; I also hope we're not ever in the position where what I would believe would be chaotic triage, if everybody surged to one place. For this reason, here in the nation's capital I've been working with the administration -- actually we've almost gotten it through several times -- on at least one hospital that would surge capacity so that everybody would know in advance that. Don't put all these federal workers close to the nearest hospital. This is the one that is repaired; it has huge capacity. It would have a huge capacity; a lot of private money would go into this, some federal money.

Now, my question is this: If you cut billions of dollars of what amounts to safety net funding from hospitals, you're also including these trauma centers here in the nation's capital.

Can you assure this committee that even with such very severe Medicaid cuts, the hospitals in the nation's capital are prepared for a mass event here and to accept patients in the event of a mass event here.

And I would further ask Secretary Leavitt if he supports ER-1. First, I want to know, are you saying to this committee in the face of the survey that your are aware of, that in the event of a major or a mass event here that the hospitals, even with the cuts that are on the table, could in fact manage that event?

SEC. LEAVITT: Ms. Norton, I will tell you that the Washington, D.C. area engages in regular planning exercises, I think as well as any place in the country. I want to restate, am I saying that surge capacity is acceptable everywhere in the country? No.

DEL. NORTON: I'm not asking -- I'm asking about the place where members of Congress, the president of the United States, where members of the Cabinet, where 600,000 residents here, where 200,000 workers here, three trauma centers -- I'm being very specific. I'm not focusing on elsewhere. I'm focusing on target number one. Can you say you're prepared?

SEC. LEAVITT: I am not the person to answer that. The person in my department would be Rear Admiral Vanderwagen, who was not invited to the hearing today, and I'm sure he'd be happy to meet with you and give you his reaction to the preparedness of --

DEL. NORTON: I have to indicate that as a secretary I would think you would know whether or not the nation's capital is prepared for --

SEC. LEAVITT: I live here just like you do, and I'm anxious for that to be the case.

DEL. NORTON: And that troubles me both as a member of the Homeland Security Committee and as member of this committee that you cannot answer that question. Do you support ER-1 surge capacity?

SEC. LEAVITT: Is this the project at George Washington?

DEL. NORTON: This is a project at Washington Metropolitan -- Metropolitan Washington.

SEC. LEAVITT: I am aware of the project by title; I do not know enough about it to respond at this hearing. If you'd like, I'd be pleased to respond to you in writing.

DEL. NORTON: I very much appreciate it.

Thank you, Mr. Chairman.

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