The Washington, D.C., City Council on Tuesday unanimously approved a bill that will use $245 million from the city's share of the 1998 national tobacco settlement to build new medical facilities, improve emergency services, and develop programs to reduce cancer and chronic diseases, the Washington Post reports. The bill designates $40 million for disease prevention and management, including $20 million for cancer, $10 million for smoking cessation and $10 million for chronic conditions, such as asthma and hypertension. The cancer funds will be managed by the D.C. Cancer Consortium, which already is in place. The consortium will use part of the funds for public awareness campaigns and screenings, and it is considering establishing a "patient navigator system" that would help city residents locate services. The bill designates $116 million to construct new health care facilities and reserves "up to $80 million" for upgrades to hospital emergency departments. RAND is conducting an independent study of how the district can best use the construction funds. According to the Post, RAND is examining the council's recommendation for construction of a 24-hour "healthplex" that would be built on the grounds of the former D.C. General Hospital in the district's Southeast region. RAND also will consider the possible construction of ambulatory health centers in Wards 7 and 8 of the district, assess emergency services citywide, and analyze capital and operating costs for any proposed centers. Nicole Lurie, a physician who will lead the RAND study, said, "There are a lot of places where there are deep pockets of no information." She added, "There's almost no data in the city on children's health needs, where they go for care, and almost nothing on mental health." According to the Post, the bill "represents a sharp change in direction, targeting major capital dollars to communities more than institutions." The bill largely focuses on neighborhoods in the eastern side of the city "where health problems are most acute and health providers most scare," the Post reports (Levine, Washington Post, 12/20).

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