David Catania’s aggressive approach to D.C. health care hints at potential mayoral style
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Version 0 of 1. Gregg A. Pane spent much of his three years as director of the District’s Health Department in hearings under the rigorous scrutiny of D.C. Council member David A. Catania. “It was almost once a week — at least a hundred times I sat in front of the man,” recalled Pane, now a health insurance executive. “All the hearings were similar. You had to be ready.” These days, the big issue is education, but Catania (I-At Large) burnished his reputation over the past decade in a different realm: as chairman of the council’s Health Committee. During numerous battles in that post, he earned criticism as a micromanager and a hothead more interested in satisfying his own ego than moving the city forward. But he also spearheaded a number of initiatives that left a measurable impact on the District, including insurance coverage and HIV/AIDS care. Those eight years, from 2005 through 2012, offer voters a detailed public record of what kind of leader Catania, 46, has been — and, perhaps, the kind of mayor he would be. “David is brilliant without question, ridiculously hardworking and a little crazy,” said David Carmen, a lobbyist who counted Catania as a close friend before a falling-out. “He wants to make his mark, and he wants to make a big mark, and he fancies himself a samurai inside the bureaucracy.” Carmen compared Catania to titans of industry he’s worked with, including corporate turnaround maven Carl Icahn and oil tycoon T. Boone Pickens. “Yes, they do make things happen,” he said, “but they destroy a lot making things happen.” It is not a new line of criticism for Catania — and he has a ready answer for it. Amid other notable accomplishments, including the legalization of same-sex marriage, the openly gay 17-year council veteran believes that he left his most admirable mark on the city as head of the Health Committee. It is a record he has not been shy about promoting: He even printed a 35-page report on his accomplishments last year when he closed out his tenure. The moments when his judgment and priorities were questioned, when he turned to hard-nosed political combat to prevail, have led some to question his readiness to be mayor. To him, the results speak for themselves. “We’re not cutting the crusts off cucumber sandwiches here. This is not a garden party,” he said. “I am not afraid of anyone, and I am not afraid of any industry. If I think people are trying to lie, cheat and steal, I’m not bashful about pushing back.” The improvements of some key health-care statistics have been stark. Before there was Obamacare, for instance, the District had Cataniacare. He credits his drive to expand eligibility and enrollment in the D.C. Healthcare Alliance, the city’s health-care program for low-income residents not eligible for Medicaid, with pushing the city’s rate of uninsured residents from 12 percent to just over 6 percent during his eight-year tenure, according to Census Bureau surveys. Catania also had a hand in financing $70 million in new community health clinics with the District’s share of a nationwide tobacco settlement, and his legislation made significant investments in mental-health and school-based health care for youths. He is proudest of his efforts to combat HIV/AIDS. Many fewer new HIV cases are being reported, according to data collected by the city, and fewer HIV-positive Washingtonians are dying. That, Catania says, is the result of a focused “evidence-based” approach to public health that had been little in evidence before his tenure as Health Committee chairman. Part of that approach included weekly, or near-weekly, hearings that put Pane and his deputies under the klieg lights of the council chambers. When Pane was hired in 2004, the city was struggling to emerge from more than two decades of mismanagement in its human-service departments. Catania would demand that bills be paid, that contractors be dismissed, that employees be fired — demanding action, in some cases, within days. “Like it or not, these hearings have a way of motivating people into action in a way that meetings behind closed doors do not,” he said. Pane recalled Catania maintaining a gentle and respectful touch with constituents at community meetings, then demanding from the council dais that he fire people. “I would just ignore it, because he would cool off,” he said. “He never called me up or pulled me in his office. It was all in public for everyone to see.” Walter Smith, executive director of the D.C. Appleseed Center for Law and Justice, which has issued an annual report card on the city’s HIV/AIDS response since 2005, said other groups share credit for the city’s progress but that Catania’s persistence and publicity made a difference. “Some people’s hearings tend to be for show, but I think David’s hearings on this subject helped to get results,” he said. “He knew what to ask and where to press. . . . Part of his personality is that he’s relentless, and I think this was an area where I think this was a plus.” It wasn’t just HIV that got the Perry Mason treatment from Catania, who is a lawyer. Feseha Woldu, who ran the Health Department’s licensing arm for 13 years, said that Catania would show up at hearings with binders full of documents, marked up with yellow sticky notes. “If I went in there and he knew more about that department and what you’re doing and what it does than you do, then you’re in trouble,” said Woldu, who is now an executive at Howard University and has donated to Catania’s campaign. “I would never go in front of him with half-baked information.” A physical monument to Catania’s tenure stands on Southern Avenue SE: United Medical Center, the city’s only full-service hospital east of the Anacostia River. The survival of the 354-bed hospital was by no means a certainty when he became involved in 2005. The hospital, then called Greater Southeast Community Hospital, was under the control of an Arizona businessman. Doctors and nurses went unpaid; supplies had to be borrowed; and the hospital’s licensing and accreditation were in question. Catania, who in a recent interview recalled a hospital “spiraling out of control,” openly demanded a sale. The businessman, Paul Tuft, said at the time that Catania “blackmailed and extorted” him by threatening regulatory action against his other hospitals. Catania denied making the threats. Within months, a sale went through. The buyer was Specialty Hospitals of America, a New England firm that ran two smaller hospitals in the District. The deal, negotiated by Catania and then-mayor Adrian M. Fenty (D), included using $79 million of public money to shore up the hospital’s finances. The D.C. Council gave the deal unanimous support despite warnings from the District’s chief financial officer at the time, Natwar M. Gandhi, that Specialty was “not in strong financial condition.” Less than three years later, the renamed hospital was back in fiscal distress. The city declared Specialty in default and seized the hospital. Since then, the city has pumped in additional cash and hired consultants to revamp its operations, putting the total public investment at well over $100 million. Catania, who credits a public hospital with saving his life during a bout with meningitis as an infant, said decisive action was needed to prevent the hospital’s closure, which would have created a health-care vacuum in the neediest part of the city. Much of the public funding went to physical improvements at the nearly 50-year-old hospital — new elevators, updated equipment, a glass exterior — and he argues that the subsequent cash infusions have been money well spent. “You don’t run core government services for profit,” he said, calling Specialty’s default partly a consequence of the global financial meltdown. “I knew there was a challenge, a legacy of disinterest and disinvestment. But I didn’t close my eyes and walk away.” Yet questions persist about the wisdom of Catania’s crusade, which has left a trail of broken relationships. Carmen, who represented a hospital contractor who later explored taking over the facility, said Catania was “at his worst” then, making demands and refusing to consider other options. “David doesn’t believe in anything except David,” he said. “That’s the flaw.” Peter Nickles, the former D.C. attorney general who was deeply involved with hospital matters under Fenty, said Catania would “tear the city apart” as mayor. “David is a very bright guy,” Nickles said. “But he has a problem with temper and getting along with people, and I think that’s troublesome — particularly for a mayor.” Although the hospital’s bottom line has greatly improved, a financially sound private owner has yet to be found. But the hospital remains open. Robert A. Malson, president of the D.C. Hospital Association, said Catania “went far beyond the requirements” of a lawmaker to keep the hospital alive. “It’s fair to say, had he not taken the steps he took, it would have closed.”Another safety-net hospital once owned by Tuft’s firm, Chicago’s Michael Reese, closed in 2009 and has been demolished. One thing Catania doesn’t mention in his exhaustive list of health accomplishments was a months-long campaign targeting Whitman-Walker Health, the clinic that came to prominence in the 1980s as the center of the city’s fight against AIDS. By the mid-2000s, the clinic — privately run but dependent on public funds — was in deep fiscal distress, running multimillion-dollar deficits because of slipping private fundraising and poor fiscal management. To make ends meet, the board and new chief executive Donald Blanchon embarked on a round of layoffs, terminating several dozen employees shortly before Christmas 2008 — including some close to Catania. The lawmaker responded, according to interviews and public testimony, by browbeating clinic staffers and board members in public and in private. “I feel like I’ve been duped, and I don’t trust you,” Catania told Blanchon amid an extended dressing-down at a council hearing that included his describing the firings as “Stalinesque.” A board member would testify that Catania verbally abused him after refusing to support firing Blanchon, an accusation Catania denied. June Crenshaw, the board’s chairwoman, referred to the probe at a later hearing as a “personal vendetta” and said, “Mr. Catania: Enough is enough.” More than four years later, few involved want to revisit the dispute. Blanchon declined to comment. Several board members at the time — including Crenshaw and James Sandman, another ex-chairman — also declined to comment. Council member Jim Graham (D-Ward 1), who ran Whitman-Walker from 1981 through 1998, joined Catania at the hearings. He said he had shared some of Catania’s concerns but felt that his colleague’s criticism became too harsh. “I don’t know where his animus came from, but it was very much in evidence,” Graham said, noting that Catania was particularly hard on Blanchon, whose brother had died of AIDS. His “investment was very personal. David cut him no slack.” Since the last hearing, in April 2009, Whitman-Walker has reported three straight years of operating surpluses and a growing patient base. Blanchon remains as the clinic’s chief executive. Catania said he has no regrets about his approach and said the clinic’s reliance on public money justified his intervention. He said he was particularly dismayed to have seen the clinic turn away from its gay-and-lesbian focus and treat longtime employees shabbily by firing them with little notice or severance. “To see your history erased before your very eyes — with no concern, no remorse and no explanation — deserved some attention,” he said, crediting the hearings with helping to maintain the clinic’s LGBT focus. “Whitman-Walker would not be here today but for my intervention.” |