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CARE Lobbying For Help to Save Hospital

As if Inova Health Systems didn't have enough to worry about with constituents questioning their claims not to close Mt. Vernon Hospital, they now have the Federal government questioning their rationale.

In a letter addressed to hospital administrator Susan Herbert, Paul F. Cushing of the U.S.Department of Health and Human Services, warned, "the possible closure or realignment of services violates "the Community Assurance Provision of the Hill Burton Act under Title VI of the Public Health Service Act."

He clarified this by writing, "Recipients of Hill Burton funding are required ... to comply with the requirements ... that recipients make the facility ... available to all persons in the facility's service area "without discrimination on the grounds of race, color, national origin, creed, or any other grounds unrelated to an individual's need for the service or the availability of the needed service in the facility."

The letter was written as a result of a complaint against IMVH alleging the possible closure or realignment of services. Cushing acknowledged that "Mt. Vernon Hospital was not a recipient of Hill Burton funds and therefore, is not obligated to comply with the Community Services provisions. OCR will therefore, not pursue this complaint at this time."

Cushing said, "Although the Mt. Vernon facility is not subject to Hill Burton, we should remind you of Inova Health System's continuing obligation under Title VI of the Civil Rights Act of 1964 ... which prohibits discrimination on the basis of race, color or national origin by recipients of federal financial assistance...

"As a recipient of federal funds through the Medicare and Medicaid programs, Inova and its member hospitals, including Inova Mt. Vernon Hospital, are obligated to comply with Title VI... The regulations specifically address the closing and relocation of health care facilities."

Cushing cautioned, "OCR strongly recommends that any decision Inova might make to relocate health services from Mt. Vernon to an alternate site take into consideration the potential disproportionate adverse impact a relocation might have on persons based on race or national origin."

Cushing further warned if such a relocation was found to have such an impact and "Inova were unable to show that it had a "substantial legitimate justification" for its decision ..., Inova could ultimately be found in violation of Title VI."

COPIES OF THE letter went to Knox Singleton, president and CEO, Inova Health System, and Mack B. Rhoades, president of Huntington Community Association. He, in turn forwarded it to a wide array of persons involved with saving IMVH as a full-service hospital at its present location.

Armed with a copy of this letter, Mt. Vernon District Supervisor Gerald W. Hyland convened the initial meeting of the Advisory Committee of his newly constituted Citizens Advisory Rescue Effort (CARE) on September 17, at the Mt. Vernon Government Center. The organization's stated purpose is to "Save Mount Vernon Hospital."

At a recent meeting of the 23 member executive committee, it was decided the group's mission was to bring community pressure to bear on IHS to keep IMVH were it is and enhance its medical capabilities and to support and augment the work of Inova's Southeast Health Planning Task Force.

THE ADVISORY Committee consists of the president or a delegate from the 13 citizens' associations throughout the Mt. Vernon District. The 23 member Executive Committee is comprised of physicians, elected officials, heathcare experts, business leaders and community representatives.

Hyland explained to the Advisory Committee, "The purpose of this group is to engage as many of our civic associations as possible to save Mt. Vernon hospital. The main objective of CARE is to have Inova Mount Vernon Hospital remain where it is."

He acknowledged that IHS had responded to the letter from the County Board of Supervisors requesting answers to a host of questions posed by the supervisors. But, Hyland said, "I think we are a long way from getting answers."

He outlined how the crisis developed, making particular note that, "Until two years ago the bottom line at Mt. Vernon hospital was a plus. For the last two years it has been a minus. And, the first I learned of this was in May."

Hyland said, "Inova, as a system, is not losing money. It is making money. But to build a $200 million hospital eight miles away from this one doesn't make any sense."

In order to thwart any attempt by IHS to either relocate the medical facilities now clustered in IMVH, or to turn it into nothing more than a healthplex, Hyland insisted, "We need to put as much pressure as possible on the Inova Board."

He also urged the group to lobby the SE Task Force members, the Health Care Advisory Board and state officials.

"Inova's Board needs to hear from the people in the community," he said. He compared Inova wanting to put a hospital in Lorton to HCA, Inova's major competitor in providing hospital medical care, to wanting to put a hospital in Springfield.

Former U.S. Representative Herbert Harris, who also sits on the hospital task force, pointed out how the whole community worked together to pass the $57 million bond issue to build the hospital.

"It was everybody's goal," he emphasized.

WHEN IT CAME to discussing the lease arrangement between IHS and the county, which provides that IHS pay $10 a year to lease the land and hospital, former State Senator Joseph Gartlan pointed out, "It requires, that in addition to the $10, the hospital is required to serve all indigent people in the hospital's service area.

"I don't know how they can change their services without being in default. Inova cannot be permitted to step away from their obligation to provide indigent care."

Dr. Stephen Goldberger, a practicing physician at IMVH, said, "Mt. Vernon Hospital is dying a little bit more everyday. This is being accomplished by IHS making no decision on its future and Inova's mismanagement. The Inova Board doesn't want this hospital here. It's not a matter of saving Mt. Vernon hospital. We need to convince them [the IHS Board] they can't build in Lorton."

Goldberger argued, "The only group that can accomplish this is the County Board of Supervisors. We need to call for a vote now."

Dr. Khosrow Matini, immediate past president of the Medical Staff at the hospital, noted "Susan Herbert is a nice lady. But, she is the obedient servant of Knox Singleton."

Goldberger said, "What will help our cause more than anything else is to talk about the mismanagement, active and passive. And, not only as it applies to Inova Mt. Vernon, but of the whole system."

Hyland told the group of community leaders, "I need your help to reach out to those who are going to make the decision. We need to put as much pressure as possible on the Inova Board." He also noted, "The Task Force is going to play a large part in the final decision. And, we need to make contact with the Health Advisory Board and state officials."

In order to accomplish this, the group was given instructions on "Ways to Lobby." Charles Unger of Hyland's staff instructed, "Utilize personal contacts. If you know people who know those you are trying to reach, contact them to help."

The group was urged to attend the "Save Mt. Vernon Hospital" Rally scheduled for October 4, at the Mt. Vernon Government Center prior to Hyland's annual LobsterFest.

"I thought about having it on the hospital grounds, but, that might be too much," Hyland said.