Medicare assigns poor-to-middling scores to Washington area’s hospitals

Medicare assigns poor-to-middling scores to Washington area’s hospitals

By Jordan Rau, Kaiser Health News, April 19 at 7:47 PM

Few Washington-area hospitals won recognition as the federal government handed out its first star ratings based on patients’ appraisals.

Nationally, only 7 percent of the hospitals Medicare evaluated were awarded the maximum of five stars in the government’s attempt to make comparing hospitals more like shopping for refrigerators or picking movies. None of the top scorers were in the Washington area.

Throughout the country, many leading hospitals received three stars, while comparatively obscure local hospitals and others that specialized in lucrative surgeries frequently received the most stars.

Evaluating hospitals is becoming increasingly important as more insurance plans offer patients limited ­choices. Medicare already uses stars to rate nursing homes, dialysis centers and private Medicare Advantage insurance plans. While Medicare publishes more than 100 quality measures about hospitals on its Hospital Compare Web site, many are hard to decipher, and there is little evidence consumers use the site very much.

Many in the hospital industry fear Medicare’s five-star scale won’t accurately reflect quality and may place too much weight on patient reviews, which are just one measurement of hospital quality. Medicare also reports the results of hospital care, such as how many died or got infections during their stay, but those are not yet assigned star ratings.

“We want to expand this to other areas like clinical outcomes and safety over time, but we thought patient experience would be very understandable to consumers, so we started there,” Patrick Conway, chief medical officer for the Centers for Medicare and Medicaid Services, said in an interview.

Medicare’s new summary star rating, posted on Hospital Compare, is based on 11 facets of patient experience, including how well doctors and nurses communicated, how well patients believed their pain was addressed, and whether they would recommend the hospital to others.

In the District, Medicare gave a single star, its lowest rating, to United Medical Center in Southeast. Others did only marginally better: Medicare gave two stars to George Washington University Hospital, Howard University Hospital, MedStar Washington Hospital Center, Providence Hospital in Northeast and Sibley Memorial Hospital in Northwest. MedStar Georgetown University Hospital got three stars, the highest of any in the city.

In Montgomery County, two stars were awarded to Holy Cross Hospital in Silver Spring, Suburban Hospital in Bethesda, MedStar Montgomery Medical Center in Olney, and Adventist HealthCare’s Washington Adventist Hospital in Takoma Park and Shady Grove Medical Center in Rockville.

In Prince George’s County, Doctors Community Hospital in Lanham received two stars. Prince George’s Hospital Center in Cheverly, Fort Washington Medical Center, MedStar Southern Maryland Hospital Center in Clinton and Laurel Regional Hospital each got one star.

In Northern Virginia, Reston Hospital Center, Novant Health Prince William Medical Center in Manassas, Sentara Northern Virginia Medical Center in Woodbridge and the Inova Health System’s hospitals each received three stars, except for Inova Alexandria, which received two. Virginia Hospital Center in Arlington County was the only four-star hospital in the Washington area.

In assigning stars, Medicare compared hospital against each other, essentially grading on a curve. It noted that “a 1-star rating does not mean that you will receive poor care from a hospital” and that “we suggest that you use the star rating along with other quality information when making decisions about choosing a hospital.”

Some hospital officials doubt that the differences are that significant. “A one-point difference can change you from a two-star to a three-star hospital,” said Lisa Allen, chief patient experience officer for Johns Hopkins Medicine, which operates Sibley and Suburban among others (including Baltimore’s Johns Hopkins Hospital, which received four stars). “I’m not sure they’ve designed it to truly differentiate a hospital that provides a great experience from one that doesn’t.”

Deneen Richmond, an executive at Inova, said the star ratings should encompass more than one aspect of a hospital. “I’m a Consumer Reports junkie, and I look at TripAdvisor whenever I’m out of town, but the difference is those ratings are comprehensive and take in multiple dimensions, whether it’s for a restaurant or a hotel,” she said.

The American Hospital Association also issued a caution to patients, saying: “There’s a risk of oversimplifying the complexity of quality care or misinterpreting what is important to a particular patient, especially since patients seek care for many different reasons.”

Nationally, Medicare awarded the top rating of five stars to 251 hospitals, about 7 percent of all the hospitals it judged, a Kaiser Health News analysis found. Many are small specialty hospitals that focus on lucrative elective operations such as spine, heart or knee surgeries. They have traditionally received more positive patient reviews than have general hospitals, where a diversity of sicknesses and chaotic emergency rooms make it more likely patients will have a bad experience.

A few five-star hospitals are part of well-respected systems, such as the Mayo Clinic’s hospitals in Phoenix, Jacksonville, Fla., and New Prague, Minn. Mayo’s flagship hospital in Rochester, Minn., received four stars.

Medicare awarded three stars to some of the nation’s most esteemed hospitals, including ­Cedars-Sinai Medical Center in Los Angeles, New York-Presbyterian Hospital in Manhattan, and Northwestern Memorial Hospital in Chicago.

The government gave its lowest rating of one star to 101 hospitals, or 3 percent.

On average, hospitals scored highest in Maine, Nebraska, South Dakota, Wisconsin and Minnesota. Thirty-four states had zero one-star hospitals.

Hospitals in Maryland, Nevada, New York, New Jersey, Florida, California and the District scored lowest on average. Thirteen states did not have a single five-star hospital.

In total, Medicare assigned star ratings to 3,553 hospitals based on the experiences of patients who were admitted between July 2013 and June 2014. Medicare gave out four stars to 1,205 hospitals, or 34 percent of those it evaluated. In addition, 1,414 hospitals, or 40 percent, received three stars, and 582 hospitals, or 16 percent, received two stars. Medicare did not assign stars to 1,102 hospitals, primarily because not enough patients completed surveys during that period.

Kaiser Health News is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation.

Nothing is certain in the fight for Marion Barry’s D.C. Council seat

D.C. Politics

Nothing is certain in the fight for Marion Barry’s D.C. Council seat

By Abigail Hauslohner, Washington Post, April 18

The ghosts of mayors past and present are haunting every step of the District’s Ward 8 council race.

Mayor Muriel E. Bowser (D) showed up at a barbecue for LaRuby May ahead of a straw poll earlier this month; former mayor Vincent C. Gray appears side by side with his endorsed candidate, Sheila Bunn, on fliers; and just about everyone invokes the name of the late D.C. legend Marion Barry as they place calls and go door-to-door.

As Bowser’s pick, May has attracted high-profile business endorsements and raised more money than anyone — four times as much as Gray’s pick — ahead of the April 28 vote.

But whether May, whom opponents have labeled a big-money “outsider,” can capture the vote of the District’s poorest ward and lure residents away from a long tradition of personality politics tied for years to one familiar face remains unclear.

“LaRuby is perceived as the front-runner because she has so much money,” said Bunn. “But as we know in politics, money does not always win you a race.”

In a rapidly gentrifying city where pricey restaurants and yoga studios have sprung up on what were once the District’s most destitute avenues, Ward 8 is still referred to as the “forgotten ward.”

It’s the city’s largest swath of land, across the Anacostia River in the District’s southeast quadrant. Yet it was the last to acquire a grocery store.

It is the “dumping ward” for the rest of the city, as one voter described it, the section of the nation’s capital with the highest proportion of families living in poverty and the place where city authorities once tried to put a private prison.

Barry, as the city’s longest-serving mayor and council member, was a symbol of the politics and priorities of Ward 8’s underclass. But the area was Barry’s turf for so long — up until his death in November — that no one seems sure about how residents will vote when the “mayor for life” is no longer on the ballot.

The evidence of that uncertainty may lie in the sheer number of candidates — 13, more than any Ward 8 race in nearly 20 years — but also in the variety of sales pitches they make as they talk to voters and huddle over campaign strategy meetings in their neighborhood headquarters.

Eugene Kinlow tells voters that he has big dreams of development, including expanding commercial real estate at the Anacostia Metro station, while May has echoed the campaign promises of her backer and D.C.’s rising star Bowser to fight for city resources so that “hardworking families have a pathway to the middle class.”

Bunn argues that she has the most experience, having served as the chief of staff to the District’s non-voting congressional representative, Eleanor Holmes Norton (D). She is banking partly on the ward’s loyalty to her own backer, Gray, who lost to Bowser in last year’s mayoral race but won Ward 8.

“If you talk to folks in the ward, they don’t really know who LaRuby May is,” said Bunn, whose father was a community business mainstay and whose campaign office is housed on the ground floor of the “Bunn building,” a family legacy.

And yet everywhere you go in the ward, where campaign signs adorn lawns, street corners and telephone poles, the May signs loom the largest. The funding is palpable. And at the end of the day, the guiding factor in who wins may still be one that Barry excelled at: busing the largest number of people to the polls.

On Friday evening, a team of campaign workers clad in May’s campaign color, purple, canvassed Woodland Terrace, a public housing project, urging people to get in a van they had ready to ferry them to the city’s central early-voting location downtown, where voting began April 13.

These workers have been helping Ward 8 residents register to vote for five months. They cheered when people accepted the offer of a ride, and they handed out fliers for a free barbecue and concert on Saturday, which coincided with the opening of early voting in the ward.

May, who hit the pavement with her team, greeted some residents by name and snapped selfies with residents. When purple-shirted workers ran into more of their own, they broke into a call-and-response chant: “Vote LaRuby May”—“So Eight may rise!”

Nearly all of the candidates have taken aim at May’s Florida upbringing, her ties to Bowser and her endorsements from key business and labor power brokers.

“It’s good not to have all your money coming from the mayor,” said Marion C. Barry, the late mayor’s son and another candidate who argued that Bowser’s support would make May “beholden to a political machine.”

May, who runs a local housing nonprofit group and two day-care centers and whose pledges of affordable housing and community policing sound much like her competitors’ campaigning, dismissed such labels as baseless.

“I’ve been working hard in the ward for the past 15 years to build infrastructure,” she said. “There definitely can be benefits of being a legacy child,” she said of Bunn and Barry. “But I know there are also benefits of hard work.”

Charlie Dunn, a Ward 8 resident who was standing with friends at Woodland Terrace Friday night, said that Bunn lives nearby but that only May has visited.

“I haven’t met any other candidates who’ve come through this neighborhood,” he said. “I have one who lives right next door to me, and she hasn’t knocked on my door.”

All of the candidates, including Barry, Trayon White and Natalie Williams, the president of the Ward 8 Democrats, say they will improve education and foster opportunities for youths and ex-offenders.

But for them, the funding has been thinner.

Kinlow set out to knock on doors last week with only one staffer in tow. Bunn set out with only a few more, targeting the doors of men and women who had proven voting records, many of them senior citizens.

One elderly widower told Bunn that he’d vote for her if he “can keep it in my mind to vote.”

“Well,” Bunn said, making a note of it, “I will remind you.”

Abigail Hauslohner covers City Hall for The Washington Post. Previously, she served as the Post’s Cairo bureau chief.

Driverless Cars: Unintended Consequences for Insurers to Watch

Driverless Cars: Unintended Consequences for Insurers to Watch

Robert McIsaac
Insurance Experts’ Forum, March 30, 2015

While I embrace many (most?) things with a technology flair, I have to admit to being a bit amused with all the recent breathless excitement exuded over the idea of self-driving cars. To be sure, technology is making them ever safer and more fuel efficient. It is also augmenting the driving experience so that paper maps are going the way of LP recordings and being “lost” is now something of a personal choice rather than a state of condition, but I suspect that the rush to sell ad space may have people overlooking a few practical realities that could lead to surprising, if not dire, unanticipated, consequences.

I’m quick to point out, by the way, that driving my vintage BMW has a completely different set of experiences than driving a new one. No airbags, crash avoidance alarms, proximity radar or backup cameras. Driving it requires real and significant concentration and the consequences of an error can be real and immediate. While I’d never want to retrofit a blind spot warning system, I can appreciate the value. Heck, from the dark ages back in 1984, the vintage ride doesn’t even have a single cup holder.

I can appreciate ABS brakes and traction control too. These technology dependent devices can make drivers feel invincible … or at least support the idea that training and engagement are less important than they once were, since mistakes can much more easily be recovered from. Further, I can also appreciate that under “normal” conditions while cruising down the Interstate and experiencing the commuter equivalent of the “Talladega Draft”, where any open space on the road is an invitation for someone to dive in for advantage, advanced computer control can stay on top of following distances and emergency braking procedures better than the average distracted commuter trying to manage the car, the coffee cup, the kids and the cell phone concurrently.

No, my real concern will come about when we get to the point of auto-driver being a real possibility. At that point, under normal conditions, the onboard systems could handle all the easy stuff with a minimal amount of drama or trauma. Parking between 2 stationary objects? No sweat. Maintaining following distances at 70mph? Again, not much of an issue. The concern will emerge when bad or unexpected or unusual things happen and the computer control gives up and hands it back to the now, even more woefully unprepared occupant, under the tag line of “I don’t know what to do, you take it!”. A failed sensor, a set of road conditions that are unexpected, and a wide range of other factors could create scenarios where the on-board systems decide that they have reached max capacity. Or there’s just the Help Desk Rule #1 for electronic devices: when all else fails, reboot, and start clean.

In other forms of transport, such as high-speed trains and airliners, there is significant control automation even for such dicey maneuvers as station stops and landings. In the main, it works great. But when it goes wrong, it can go spectacularly wrong.

As a backup, these devices have alternative systems, called engineers or pilots, who are well trained and capable of taking over navigation in mid-transaction. They have a full training and testing regimen that they need to follow in order to maintain their certifications. When the training kicks in, the auto pilot comes off, and the results are generally good. Even at that, however, they aren’t perfect as some recent plane crashes have suggested. Training really does matter. A lot.

Which gets back to the driverless car concept. If the occupants are going to be expected to “take over” at any point in the journey, where is the training and experience going to come from? How will they practice dicey moments to build an experience base rather than becoming unwitting guidance systems for land-locked missiles that run amok?

Renting a car today can provide an interesting view if the future. Mastering such simple tasks as turning cruise control on and off varies so much between brands and model years that the first few miles out of the lot are like a training mission of their own.

So, one consequence of increasingly automated vehicles could be fewer, but sadly more spectacular, crashes that are hard to pinpoint “blame” for. The conversation around who is liable in such circumstances could be both long and full of rich legal entanglements. Breathlessly talking about self-driving cars and the end of accidents as we know them may be both significantly premature and a preview to different and more nuanced or complex dialogue.

Of course, on a weekend that required a surprisingly large number of re-boots to both my real world laptop and tablet devices at unfortunate moments, I find myself a little less concerned. If the technology crashes on an Excel problem, how can it possible handle a Jersey Jug-handle first time, every time? Or, maybe I should be more concerned. Time will tell. And that could be the actuarial nightmare scenario.

This blog entry has been reprinted with permission.

Results of Recent Ward 3 and Ward 8 Straw Polls/Bowser Candidates Prevail

Ward 8 — 584 residents attended the event to vote.

LaRuby May 177

Trayon White 79

Natalie Williams 77

Sheila Bunn 53

Eugene Kinlow 30

J Abraham 26

Marion C. Barry 21

Leonard Watson 12

Greta Fuller 3

Ward 4 390 votes cast in the straw poll.

Brandon Todd 310

Renee Bowser (no relation to the mayor) 58

Dwayne Toliver 22

(A number of Ward 4 council seat candidates boycotted that straw poll, including Ron Austin, Acqunetta Anderson, Leon T. Andrews, Gwenellen Corley-Bowman, Judi Jones, Doug Sloan, Edwin W. Powell, and Bobvala Tengen.)

Bowser Picks Win Special Election Straw Polls

Posted by Will Sommer, City Paper, on Apr. 2, 2015 at 3:31 pm

LaRuby May at the Ward 8 straw poll

The Green Team knows how to win straw polls. Muriel Bowser launched her mayoral bid last year with a surprise straw poll victory over Vince Gray, and last night, her picks in the Ward 4 and Ward 8 special elections demolished straw poll rivals of their own.

In Ward 4, Bowser favorite and almost-sorta-councilmember-elect Brandon Todd easily defeated the other candidates, taking in 310 out of the 390 votes cast at the Ward 4 Democrats poll. Rival Renée Bowser came in second with 58 votes. Most of Todd’s opponents boycotted the poll because Todd runs the Ward 4 Democrats, but the vote itself was organized by D.C. Democratic State Committee members from outside of the ward.

Ward 8 Bowser pick LaRuby May had a similar, if not quite as sweeping, success at a Ballou High School straw poll organized by civic groups. May won 177 votes, followed by former State Board of Education member Trayon White with 79 votes, and Ward 8 Democrats President Natalie Williams with 77 votes. Grayfavorite Sheila Bunn won 53 votes, while Eugene D. Kinlow received 30 votes. Everyone else, including Marion C. Barry, received less than 30 votes.

Here’s the part of every straw poll blog recap where LL has to write that straw polls, which rely on campaign muscle and the most die-hard voters, are usually wonky at predicting who’ll win the actual vote. That might not be true this time, though, since special elections also rely more than regular elections on campaign organization and driven voters. That goes double in low turnout Ward 8.

LL went to the Ward 8 straw poll, where May’s advantages showed before the poll even began. May put her substantial fundraising advantage to work, organizing a BBQ a few blocks away from the straw poll. Muriel Bowser showed up and waved a May sign on Martin Luther King Jr. Avenue SE.

For a forum pervaded with worry about residents being pushed by gentrification (every candidate opposed extending the streetcar to Anacostia), even the long shots played it safe with their answers. Only Ward 8 heavy Anthony Muhammad, who received only nine votes in the poll,has decided to go in for some plans so crazy that they just might work. Muhammad’s tactics include the declaration that only he has the "testicular fortitude" to represent the ward and an extended monologue accusing Seventh District Metropolitan Police Department officers of preying on the ward’s young girls (not without some accuracy).

Muhammad also threw the harshest jabs of the night, using his opening statement to say that he doesn’t owe the District $600,000 (a diss for candidate Jauhar Abraham) and that he’s voted in every election (a not-so-subtle nod to Barry’s spotty voting record).

Despite all the Green Team organization at work outside Ballou, the mood inside the straw poll forum was decidedly opposed to the mayor and her endorsed candidate. To cheers, longshot (and cranky!) candidate Leonard Watson Sr. declared that attending Bowser’s State of the District address Tuesday night would amount to a "waste of time."

May’s late arrival was met with a little applause and a lots of boos, while candidate Sandra Seegars urged the crowd to vote Bowser out in 2018 if she doesn’t deliver for the ward. Presumably, Seegars wouldn’t mind if voters applied the same scrutiny to her Bowser-backed rival.

Mayor’s Office Budget Summary — “Pathways to the Middle Class”

See attached.

Kevin Wrege, Esq.

Founder & President

Pulse Issues & Advocacy LLC

Office: 202-625-1787

Mobile: 202-253-4929

4410 Massachusetts Ave., NW, #150

Washington, DC 20016

2016 Introductory Budget Rollout_v12.pdf

D.C. mayor proposes tax increases to confront homeless crisis, Metro woes

D.C. mayor proposes tax increases to confront homeless crisis, Metro woes

WASHINGTON, DC – MARCH 31: By Aaron C. Davis, Washington Post, April 2 at 6:59 PM

D.C. Mayor Muriel E. Bowser on Thursday proposed raising the city’s sales tax, saying that despite growing revenue, the District needs more money to end the epidemic of homelessness that she says voters elected her to fix.

Bowser (D) called the increase — from 5.75 percent to 6 percent and equal to the sales taxes in Maryland and Northern Virginia — necessary to make a “down payment” on transforming the District’s approach to homelessness. That would include hundreds of new permanent units for the city’s most chronically homeless individuals. She also proposed borrowing $40 million over the next two years to construct a network of new neighborhood shelters to replace the city’s troubled warehouse for homeless families on the former D.C. General Hospital campus.

“While I wish we didn’t have to consider it [a tax increase], residents all across the city — and I mean, literally, in each of our eight wards — say to me, fix the homelessness problem,” Bowser said. “We have to close D.C. General and we have to end homelessness, and the additional revenue will allow us to do that.”

[Bowser
pledges new era of government accountability
]

But advocates for the poor cautioned that the $22 million expected annually from the sales-tax bump would cover only a fraction of the price tag of ending homelessness in the District. Bowser’s proposal also drew sharp criticism from members of the D.C. Council, which last year rejected the same increase, calling it likely to hurt the poor.

“It’s the most regressive kind of tax . . . and besides, you save raising the tax for the rainy day,” said D.C. Council Chairman Phil Mendelson (D), noting that local revenue is projected to grow to more than $7 billion next year, an increase of $185 million, or nearly 3 percent. “When revenues are growing by 3 percent, you don’t need to be raising taxes.”

Bowser also proposed increasing taxes on e-cigarettes to the same rate as traditional cigarettes and raising the levy that residents and commuters pay at downtown parking garages, from 18 percent to 22 percent. That boost, Bowser said, would raise almost $10 million and cover a third of the city’s increasing cost next year to subsidize a $323 million share of operations at Metro, the region’s troubled transit agency.

Combined with federal funds, total District spending for fiscal 2016 would grow to $12.9 billion, a 2.5 percent increase. That would be the smallest percentage increase in five years, but the latest in a wave of new revenue over that time that has driven up District spending by a combined $2.4 billion — or 23 percent — since the end of the recession.

Bowser’s first budget plan now goes to the D.C. Council for consideration.

In a briefing before the council and then at a midday news conference, Bowser sought to temper talk of the tax increase, saying that at the same time, she would tighten the city’s belt elsewhere, cutting agency operating expenses­ by a net of more than $15 million, including “tough decisions” to cut funding for the University of the District of Columbia by $3.5 million, or 5 percent. Bowser also said she would defer almost $5 million in preventive maintenance at city facilities.

The mayor’s budget also cuts $27 million in expenses by eliminating vacant positions and $58 million by reducing budgets to what agencies spent this fiscal year. She also drew the ire of hospitals by reducing Medicaid reimbursement rates to what officials in her administration said was more in line with the national average and would save $9 million annually.

Those cuts made room for Bowser to fulfill a central campaign pledge to direct $100 million to affordable housing projects next year. About half of that is paid for annually by a tax on home sales, but Bowser pulled together another $50 million and promised to continue hitting the $100 million figure each year she is in office.

She also earmarked $20 million over three years for a new education initiative dubbed “Empowering Males of Color,” a support program for black and Latino boys that includes opening a controversial all-boys college preparatory high school east of the Anacostia River.

Bowser also directed $15 million to raise and standardize educational and extracurricular activities at middle schools — another of her top campaign promises.

After three months in office, Bowser said she also had found new goals.

Under a six-year vision, the city would spend $50 million for tree planting, green space, and bicycle and pedestrian improvements; even more on road and sidewalk enhancements; and $115 million for recreation centers, pools and parks.

The city would also in the fall begin spending $5 million over the next 18 months to purchase 2,800 body cameras — enough for every on-duty D.C. patrol officer. The city would also begin purchasing $80 million in new fire trucks and other new public-safety apparatuses for the city’s fire department.

Bowser’s spending plan sets aside $185 million for a complete remodeling of the city’s main Martin Luther King Jr. Memorial Library. That is down from the more than $200 million that Bowser’s predecessor, Vincent C. Gray (D), and the council expected for the cost last year. The mayor’s aides said the city could lower and lock in costs by beginning construction earlier, in the budget year beginning in October.

The mayor also pinched spending for a promise this week to build a new hospital east of the Anacostia River, setting aside $123 million over six years, down from the $135 million that the council approved last year. That’s about a third of what Gray had said last year was feasible to build a new hospital to attract a reputable operator for the facility.

The budget found controversy with some vocal city constituencies, including parents.

[Budget
boosts funding for Duke Ellington, but delays other school projects
]

Bowser proposed delaying a $67 million renovation of Benjamin Banneker Academic High School, one of the city’s oldest, near Howard University, until 2019.

At the same time, she committed to launching more than $100 million in renovations next year for Northwest elementary schools, including Garrison, which is at the epicenter of a baby boom along the District’s rapidly growing 14th Street and U Street corridors.

And just two days after the mayor took ownership of the city’s troubled streetcar system, promising an end to delays and to complete an east-west line, her budget made clear that she would largely pause all spending on the project next year. Council members said she did not set aside enough money to complete the project before the end of the decade — if ever.

But pleasing advocates for the poor, Bowser proposed a one-year delay in the city’s plan to end welfare payments for those who have received temporary assistance payments for five years or more. The District has been scaling back welfare payments to 6,000 families in that situation for years, and all were scheduled to lose remaining benefits in October.

Bowser’s aides said that the delay was necessary to make sure the city had done all it could to connect those residents with jobs and with other help before welfare is cut off.

But the highlight of the day for many was the mayor’s commitment and new challenge with homeless funding.

By linking a tax increase to solving the city’s homeless problem, Bowser appeared willing to risk raising the stakes for her fledgling administration by training even more attention on one of the District’s most in­trac­table social problems. Tying a general tax increase to the issue, most agreed, would only add pressure on her team to deliver tangible results before the end of her term.

Ed Lazere, head of the liberal DC Fiscal Policy Institute, said he was encouraged but also worried that with an increase of 0.25 percentage points in the sales tax, the mayor had not sought a big enough hike.

“We would have liked more on the revenue side,” Lazere said. “I think $25 on a $1,000 purchase . . . lots of D.C. residents would be willing to pay more to solve the big problem of homelessness.”

Aaron Davis covers D.C. government and politics for The Post and wants to hear your story about how D.C. works — or how it doesn’t.

Kevin Wrege, Esq.

Founder & President

Pulse Issues & Advocacy LLC

Office: 202-625-1787

Mobile: 202-253-4929

4410 Massachusetts Ave., NW, #150

Washington, DC 20016

DISB’s Biennial Report Now Available

DISB’s Biennial Report Now Available

DISB Biennial Report CoverWe are pleased to share our "DISB Biennial Report" highlighting our agency functions, programs and outreach efforts for fiscal years 2013 and 2014.

The report highlights a number of our priorities over the last two fiscal years including DISB’s work on the District’s health care reform efforts, our captive insurance company domicile and crowdfunding and innovative finance programs for D.C. small business. We also discuss the District’s commercial and international banking industry, foreclosure prevention and providing residents with access to mainstream financial services and financial education. In addition, the report includes discussion of our financial fraud enforcement efforts and government transparency initiatives.

We hope you find the “DISB Biennial Report" informative. To download a copy, disb.communications.

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DISB Office of Communications

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