Vince Gray may not be running for mayor—at least as a Democrat—but he is challenging incumbent Muriel Bowser on a significant issue for residents who live east of the Anacostia River: the lack of an easily accessible hospital that provides high-quality health care.

The current hospital that primarily serves Wards 7 and 8, United Medical Center, is in great turmoil. The consultancy that formerly managed it, Veritas, presided over its decline into functional bankruptcy and the lead-up to its obstetrics unit shuttering. District lawmakers have recently approved subpoenas to investigate Veritas’ top executives and subjected the UMC board to scrutiny.

But there are plans for a new hospital to open in Southeast within the next few years. Following a site-selection study performed by a third-party group, Bowser’s administration determined that one should be built on the St. Elizabeths East Campus, where other major development is also planned. Unlike UMC, which is a public hospital, the new facility would operate in partnership with a private firm.

Bowser says she intends to pick a partner sometime this spring. But precisely when the hospital would début has emerged as a point of contention between her and Gray, who chairs the D.C. Council’s health committee and has closely monitored UMC since rejoining the legislature as the Ward 7 councilmember in 2017. 

Gray served as mayor from 2010 to 2014, having booted Bowser’s mentor, Adrian Fenty from office. Then Bowser unseated Gray in the 2014 primary while a now-closed investigation into his 2010 campaign finances proceeded. Gray has not ruled out a bid in the November general election this year. In recent weeks, he has said he wants to continue focusing on health challenges in the District.

On Friday, Bowser and Gray squared off during testimony she gave to the Council about her proposed budget for the fiscal year that starts in October. Gray pressed Bowser on the timeline for opening the future hospital in Southeast. The proposal invests $300 million in the construction of the hospital, which Bowser says would be done by 2023. Gray, though, questioned why it can’t happen sooner.

“I don’t see the sense of urgency that I would hope to see around that,” he said about the mayor’s proposal, in his opening statement.

Bowser said her budget plan would allow the District to advance designs for the hospital later this year, and that needed infrastructure and building locations must be settled first. The administration does not know the exact cost of the hospital yet since it has not chosen a partner to operate it.

“It is possible that [the cost] will be less than what it is in this proposal, and if that is the case we know for sure that we would be ready to open probably a year in advance,” Bowser said. “We weren’t comfortable with adjusting the numbers down.”

She added that in the budget proposal the last year of funding is for hospital equipment costs that could be dispersed “in other ways.” The proposal also includes a separate $14 million as a “bridge” between phasing out UMC and opening the future hospital, she noted.

“We can’t walk away from the hospital until we have a new one up and running,” Bowser said. “Of course not, of course not,” said Gray.

But pointing to the current state of construction technology, the Ward 7 councilmember harped on the possibility of opening the project a year or two earlier than 2023. “What forecloses us having the ability?” Gray asked. “You look at what’s going on in our city right here, and you see that things are being built in two years that used to take four or five. There’s no way this hospital should take five years to be able to be built.”

Bowser said it would be “irresponsible” for her to say the facility could be built in that time without designs in hand. “I can assure you, however, if when we get to those stages and we can build it quicker, we’ll build it quicker,” the mayor continued.

As for choosing a company to operate the new hospital, City Administrator Rashad Young said officials still must finalize whether they will solicit bids through a competitive process or engage in direct negotiations with a preferred firm.

“There’s a limited number of health systems to even talk about this issue with,” Young said. He added that the administration would examine providers’ histories and whether they would be willing to invest in the construction of the facility or even put up money to hedge against operational loses after it opens.

Bowser said Young’s office is shepherding the process with help from the Department of Health Care Finance, led by Wayne Turnage.

This wasn’t the only matter of timing for a future project that councilmembers and Bowser officials discussed on Friday. Chairman Phil Mendelson raised concerns that D.C.’s paid leave law, enacted in 2017 but still not implemented, is at risk of delay because Bowser’s budget proposal does not increase the funding for establishing the IT system to collect taxes and provide the benefits for the program.

The proposal maintains $40 million in capital funds that were put in the budget last year. Young said the cost estimates for creating this system range from $40 million to $100 million. D.C. is set to begin collecting taxes from employers in July 2019 to finance the benefits.

“At this point, to invest additional resources in a project for which there’s wide variation as to its final cost doesn’t seem to be pretty practical to me,” Young told Mendelson. He said the Bowser administration would issue a solicitation for the project later this year.

“Mr. Chairman, this is purely hypothetical,” added Young. “We don’t yet know what the IT costs are to make the assertion that this would cause a delay.”

Mendelson didn’t seem to buy that response. “OK, so when the critics say to me this is getting delayed, I’ll just say, ‘Well, this is purely hypothetical,'” he said, snickering.

“Sounds like a great answer to me, Mr. Chairman,” Young said, drawing laughter from the audience. He reiterated that at the current stage, he does not “have a reason to believe that this issue is a cause for delay” implementing the law.

The Council will review and mark up Bowser’s budget proposal over the next two months, with a vote on the budget expected in May.