Dr. Mitchell Katz, tapped by Los Angeles County seven years ago to lead the nation's second-largest public healthcare system out of a period of instability and mismanagement, has announced he will leave his post at the end of the year.
Katz oversees the county's Health Agency, the umbrella health organization with a budget of approximately $8 billion and 32,000 employees. He will return to his native New York to take care of his two elderly parents and to become chief executive of the New York City Health and Hospitals Corp., which operates the city's public hospitals, clinics and nursing homes.
Katz, who has two developmentally disabled siblings, said he had struggled during the last year knowing his parents needed his help but not wanting to leave a job he loves.
"This is an opportunity for me to do the work I love and take care of my parents," he said.
Katz formally notified the Board of Supervisors by email late Friday and spent Saturday making calls to his staff.
"I'm incredibly sad," he said. "I love Los Angeles County. It's been extremely good to me, I've had only positive experiences and I'm incredibly proud of how different the Department of Health Services is today than it was seven years ago."
Katz was hired away from San Francisco's public health department in 2010 to lead L.A.'s Department of Health Services, which operates the county's four hospitals and network of outpatient clinics. At the time, he inherited a department with a $270-million budget deficit, management instability and a history of poor oversight.
During his tenure, Katz, a primary doctor who continued to see patients himself, helped shift the department away from its reliance on emergency and hospital care. "We've transformed that into a system where most of the care is being delivered in the outpatient system, as it should be," he said.
He oversaw the county's implementation of the Affordable Care Act, which added millions of new patients to Medi-Cal rolls, and established a "Housing for Health" division to find permanent supportive housing for people with intense mental and physical health needs who make disproportionate use of county health services.
He also presided over the reopening of Martin Luther King Jr. Community Hospital and oversaw the successful transition to an electronic health record system. He built up the department's financial reserves so that today is it has a $660-million reserve, he said, and worked to improve morale among front-line employees.
"The atmosphere that he created was night and day different from what [front-line workers] had ever had," said Bob Schoonover, president of the union that represents healthcare workers. "There is genuine respect for him."
In 2015 the Board of Supervisors moved to consolidate the departments of Health Services, Mental Health and Public Health under one agency and nominated Katz to lead it. Detractors at the time worried that the agency would be unwieldy, give short shrift to public health and take money away from mental health for hospitals.
"I think everyone would agree the formation of the Health Agency has been successful and has not caused any of those problems," Katz said. "It hasn't done everything as quickly as people would like it to, but that's because it takes time."
Representatives for the county, who in public meetings frequently praise Katz, described him as an innovator whose leadership would be missed.
"It's an incredible loss to the county," Supervisor Sheila Kuehl said. "[He has] so increased the professionalism, outreach and treatment modalities in every aspect of public health … and strengthened all three departments while allowing them to remain unique in their missions."
"He has been pretty exceptional. … I would even say transformative in many respects," Supervisor Mark Ridley-Thomas said, calling the Housing for Health program a "forerunner" of what the county seeks to do with Measure H.
A search has already begun for a new director of health services, as Katz had continued to fill both roles but recently urged the board to separate the two positions. Ridley-Thomas said the county will conduct an additional search for the Health Agency position.
Katz said he hopes that person will continue the effort to integrate mental, physical and public health services; empower staff to identify and solve problems; and keep up pressure on the federal government to maintain its commitment to Medicaid.
Katz will begin his new job at the Health and Hospitals Corp., the nation's largest public healthcare system, in January. Known in L.A. for riding his bike to work and continuing to see patients of his own, he said he plans to continue doing both in New York.