Saint Elizabeths would become an independent hospital agency

A 13-member board would govern the hospital and appoint its chief executive, while a nine-member committee would provide patient-centered oversight. The board and committee would oversee hospital leadership, finances, care quality, safety, patient rights, staffing, and responses to identified problems. The Mayor would appoint 11 voting board members with the Council's consent; the chief executive and chief medical officer would serve without votes. Six committee members would come from outside the board, and privacy rules would limit their access to identifiable patient information. The act would take effect after mayoral approval or a veto override and a 30-day congressional review period.

The hospital would adopt an accessible patient bill of rights, support independent advocacy, provide appropriate care with the fewest necessary restrictions, and apply for accreditation. These requirements would cover Saint Elizabeths patients, including people receiving inpatient psychiatric, forensic, or competency-restoration services. Care with the fewest necessary restrictions would still have to meet clinical needs, public-safety requirements, court orders, and federal and District law. Patients and others could report concerns confidentially. The hospital, its workers, and its contractors could not retaliate against people for good-faith reports, grievances, investigations, oversight communications, or exercising legal rights. The independent advocate could see patient records only with lawful authorization. The hospital would have to apply for Joint Commission accreditation within 24 months after the transfer date.

The hospital and Department of Behavioral Health would sign a coordination agreement, publish shared results, and escalate long discharge delays and unresolved disputes. The agreement would divide responsibility and funding across admission, competency services, discharge planning, continuing care, shared data, emergency coordination, and dispute resolution. Delay rules would cover patients judged ready for discharge. Shared quarterly results would remove information that identifies patients. A dispute unresolved by hospital and department leaders within 10 business days would go to the City Administrator. A dispute affecting safety, rights, or discharge for more than 30 days would be reported to the Mayor and Council. Discharge delays longer than 14 days would trigger case escalation, those longer than 30 days would trigger a report, and those longer than 90 days would require a written plan to remove barriers.

A dedicated hospital fund would carry money forward, while audits, public reports, purchasing rules, and correction plans would track its use and hospital performance. The accountability rules would cover hospital finances, contracts, staffing, patient-safety measures, discharge delays, regulatory findings, and work to correct identified problems. The fund could receive District budget money, payments from other payers, grants, and gifts, but could be used only to operate or improve the hospital and carry out the bill. Money could remain available between budget years only when authorized in an approved budget and financial plan. Public reports would protect patient-identifying and legally confidential information. A Freedom of Information Act exemption would cover patient information; peer-review, credentialing, quality-assurance, patient-safety, personnel, and security records; and information created or exclusively provided to the Quality, Safety, and Patient Rights Committee. Purchasing rules would be due within 180 days after the board's first meeting. Financial audits would occur annually, broader independent reviews at least every three years, and public performance reports quarterly.

Hospital duties could transfer in phases, and identified employees would move from the department to the independent hospital without a break in service. The transition plan would identify the hospital duties, employees, money, property, records, contracts, and obligations that would move from the Department of Behavioral Health or another District agency. No clinical or operating function could move until the City Administrator certifies that patient care, payroll, purchasing, finances, information access, and regulatory compliance are reasonably protected. At least 60 days before the transfer date, the City Administrator and board chair would have to certify readiness to avoid a major interruption in care, employee pay, or regulatory compliance. Transferred employees would keep their base pay, accrued leave, retirement credit, health and other benefits, seniority, and applicable collective-bargaining protections. The transition plan would be due within 180 days after the act takes effect. The transfer date would be October 1, 2028, or a later date established by the Council.