End-of-life care and food justice dominate Committee on Health hearing
District residents, medical-service providers and advocates testified about a range of issues pertaining to the city’s wellbeing at a Feb. 12 hearing of the council’s Committee on Health.
Many witnesses were focused on food injustice, particularly the discrepancy in access to full-service grocery stores and fresh produce between D.C. neighborhoods. Councilmember Vincent Gray, the committee chair, said early in the hearing, “It’s shameful that we have situations in which on the western side of the city we have grocery stores that are renowned for their commitment to serving people, [whereas] with 150,000 people living collectively in Ward 7 and Ward 8, we have three grocery stores serving the people living in those two wards.”
Several initiatives to address these discrepancies were highlighted during the course of the testimony.
A representative from D.C. Central Kitchen said that in the past year, the Healthy Corners program has grown to include 67 participants. The D.C. Healthy Corners program is a collaboration between D.C. Central Kitchen and the Department of Health that seeks to improve the ability of D.C. corner stores to provide fresh, healthy produce in areas with few or no full-service grocery stores. Several D.C. residents testified in favor of programs such as Produce Plus and Produce Rx, while asking that funding for the programs be increased. Produce Plus and Produce Rx help individuals purchase fresh produce at farmers’ markets.
D.C. residents and experts spoke about two issues pertaining to elder and end-of-life care. In late 2017, the D.C. Council passed the D.C. Death with Dignity Act, which allows residents with terminal illnesses to seek medical aid in dying. The bill was widely supported by the public and the council, where it passed with an 11-2 majority. Despite some opposition from Congress, federal lawmakers have not yet blocked the law from going into effect, but its implementation has been slow. Advocates testified that since the passage of Death with Dignity, not a single service provider or patient has registered with the Department of Health portal, which is the first step in accessing the law. Several stated that this was due to patients’ lack of knowledge about the bill. Rev. Charles McNeill of Unity Baptist Church testified that he is “concerned that the patients that need the bill the most do not know about it, and if they do not about it, they do not know how to access it.” He added that many of those who might benefit from the bill are elderly and not adept at accessing the online information needed to register for medical aid in dying.
D.C. assisted-living facilities were thrust into the spotlight by advocates who cited rough handling of fragile patients and neglectful attitudes of staff at these facilities. Patients and families of patients testified to the poor quality of care at facilities such as Grand Oaks Assisted Living Facility at Sibley Hospital and the Methodist Home. A representative from the D.C. Long-Term Care Ombudsman said that their office had addressed more than 500 complaints relating to long-term elder care in the past year, and that 93 percent were resolved.
Dr. LaQuandra Nesbitt, Director of the D.C. Department of Health, gave her office’s take on some of the issues raised by those testifying. With regard to the Death with Dignity Act, Dr. Nesbitt cited financial constraints preventing a large-scale marketing campaign to inform patients about the benefits of the bill but noted that educational materials are available both online and by mail. Dr. Nesbitt noted that complaints related to long-term care facilities rarely reach her office unless they cannot be resolved by the office of the D.C. Long-Term Care Ombudsman.
Gray questioned Dr. Nesbitt about her involvement as a regulator in the 2017 suspension of obstetrics services at United Medical Center. In 2017, UMC was given 90 days to address issues raised by the Department of Health in response to dangerous medical mistakes made during the delivery of obstetric care. Shortly after, the Board of UMC voted in a closed-door session to shutter obstetrics services at UMC permanently. Chairman Gray stated that the closed-door vote “adds to the already very serious concerns I have about transparency at the hospital.” Nesbitt stated that “United Medical Center acted no differently than any of the other hospitals would have done” by remaining tight-lipped about their plans to shutter the department until the last minute.