Fortunately, D.C. General employees who need new jobs will find that demand for good health care workers is high, especially for nurses. Beyond that, the council must seek assurances of continued service for D.C. General's clients and much more community care than previously provided. First, the council should set goals and establish a system of vigorous monitoring. Clear standards will help administrators enforce the contract's provisions. Tracking performance and sharing data with the public also will give voice to the many patients who lack the means to take their business elsewhere.
Good monitoring is rare in health care, especially for services to low-income public clients.
But it can be done if the District consistently applies pressure to measure up. Second, the council should do what it can to lock in future funding. Experience shows that safety net support can wane after privatization. A private contractor may not fight for enough funding to cover the needs of indigent patients, so the council must extract concrete promises from the mayor to continue funding. Of course, political promises aren't binding, but they do resurface during hearings and elections.