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Moran's Hospital Plan on Life Support?

Time ticking on joint Inova/DeWitt patient-sharing idea.

U.S. Rep. James P. Moran (D-8th) has proposed a plan that could provide a major infusion of revenue for financially endangered Inova Mount Vernon Hospital. It would also be of significant benefit to retired military veterans and their families throughout the region.

The question is will it be available in time to make a strategic difference in the decision-making process of the Southeast Health Planning Task Force? And, even if it is, will it have enough of an impact to enable the hospital to remain a full-service medical facility for the citizenry at large?

In a letter dated June 4 to Department of Defense undersecretary for personnel and readiness, Dr. David S. Chu, Moran requested "that military veterans, retirees, and their spouses who often find themselves waiting for care at Fort Belvoir's DeWitt Army Community Hospital be allowed to access services at Inova Mount Vernon Hospital just as they would on post."

Moran emphasized in his letter that his Congressional District "is home to 58,500 veterans and thousands of military retirees...Yet, one of the challenges ... is the ability to access their military health-care provider. More often than not, the waiting rooms are filled, and patients must sometimes wait for hours to see a health-care provider.

"Therefore, I propose ... that veterans, military retirees, and their spouses be allowed to access services at Inova Mount Vernon just as they would at DeWitt. This would benefit all parties since ... Mount Vernon ... has the available resources and capacity to handle more patients."

In announcing his proposal, Moran pointed out, "Residents of the Mount Vernon area have come to rely upon Inova Mount Vernon ... particularly for specialties such as knee and other joint replacements. ... Closing the hospital would be a devastating loss for the Mount Vernon community."

He also stated, "There would be a domino effect if the hospital closes or reduces services, with other health-care providers leaving, because the hospital serves as an anchor for health-care services that cannot be found anywhere else in the southern portion of Fairfax County."

BY PLACING AN emphasis on Inova Mount Vernon's orthopedics and joint-replacement expertise, Moran sees a benefit not only to potential patients but also to military physicians at facilities such as Bethesda Naval Hospital and Walter Reed.

"We could have an exchange program to have joint-replacement services provided at Inova Mount Vernon and training for military doctors," he said. "This proposal would not only save Mount Vernon hospital, it would make it into a hospital of national distinction."

Moran verified that he had spoken with both Navy and Army decision-makers at Bethesda and Walter Reed and "they are very much in favor of the idea."

So what is the problem? Before Moran can place a proposal to fund the program in the Defense Appropriation bill, he explained he has to have a concept paper from both the military hospitals as to their utilization of Inova Mount Vernon's expertise in joint replacement and rehabilitation and a corresponding document from Inova Mount Vernon on the services it could provide.

"We have asked them to come up with these documents on how the funds would be used, but my staff hasn't gotten anything from either," Moran said. "Time is getting short. The mark-up on the bill will probably be in the next week or so."

His proposal could provide up to $1 million in the coming fiscal year to get the program going. It could then increase annually, depending on the elements provided.

"I want to get this up to about $10 million a year," Moran said. However, the exact amount would vary from year to year by going through the same proposal-type process each year, according to Moran's staff. Getting to the $10 million figure would take several years, they verified.

Moran said that swift action by both parties is essential to get this into the bill. "I need some help here. I just can't go to the Congress with a blind proposal," he insisted.

HE STRESSED THAT he was very frustrated by the delay. "Back in January I mentioned this proposal to Knox Singleton. But I have received nothing back," he said. Singleton is president and CEO of Inova Health System.

As for Inova, it maintains that it is waiting for the concept paper from Bethesda before it can react. "We were to get a proposal from Bethesda on what they envisioned so we could respond," said Nancy Pugh, executive director, Orthopedics and Joint Replacement, Inova Mount Vernon Hospital.

"They have not even come to look at our facilities," she said. "Our intent is to respond immediately when we get it. We think it is a very exciting proposal."

In May there was a meeting in Moran's Capitol Hill office attended by all parties. The purpose of that meeting was to explore whether the concept was viable, if it could be done, and whether there was interest, according to his staff.

"I think that both parties may be somewhat unsure on how to move forward," he said. "This could be a benefit to both DOD and the hospital. But, we need to get collaboration going."

Moran views "the long-term fix for Inova Mount Vernon" being substantial federal funds for joint replacement combined with the medical education potential in that specialty plus shifting patient care from DeWitt to Inova Mount Vernon Hospital. "The whole goal behind this is how to create something that is mutually beneficial to both parties," Moran stressed.

As he stated in his letter to Dr. Chu, "It is particularly fitting for the U.S. military to play a contributing role in Inova Mount Vernon's economic recovery, since the Army's closure of Woodlawn Road has contributed to its recent financial difficulty."

However, none of this has been discussed by the Inova/citizen task force now analyzing the hospital's ultimate fate, according to Inova Health System's public information office. A representative of the System attends each meeting.

Plus, the proposal, in order to benefit the hospital's entire constituency, would have to include both the joint-replacement specialty element and the DeWitt Hospital aspect. The former alone would not necessarily alleviate the other service problems now being experienced at the hospital.

"There is a workable solution here," Moran said. "While there are many individual details to be hammered out, keeping Mount Vernon open for the community is a must, and this is one possible way to ensure its financial viability."