Supervisors Move to Close Some King/Drew Wards

A bitterly divided Los Angeles County Board of Supervisors took the first step Tuesday toward closing pediatric, obstetric and neonatology wards at Martin Luther King Jr./Drew Medical Center, saying it might be the last chance to save the troubled public hospital.

By a 3-2 vote, the board decided to hold a state-mandated public hearing Oct. 18 to formally consider the cuts recommended by the county health department. In addition to closing the wards, the plan would cut back staff and surgery services needed to reopen the hospital’s trauma unit, which was closed in March.

“When you’re flunking out of school, you’ve got to cut out baseball and you’ve got to cut out extracurricular activities and focus on reading, writing and arithmetic,” said Supervisor Zev Yaroslavsky, who sponsored the motion to proceed with the hearing.

Supervisors Don Knabe and Mike Antonovich joined him, saying the county is under pressure from federal regulators to fix the hospital after a series of troubling patient deaths and other medical mistakes. Without changes, the hospital could lose $200 million in federal funding -- half its budget.

Tuesday’s meeting was the latest emotional confrontation between officials seeking to reform the hospital and community members who want to preserve it. The vote pitted the board’s three white men against Yvonne Brathwaite Burke and Gloria Molina, its two minority women.

Dr. Marcelle Willock, former dean of the medical school affiliated with King/Drew, said she was troubled that the decision to downsize pediatrics and obstetrics at the hospital was being made by “all old white males.”

“When I look at this board -- and I don’t mean to be confrontational, but I think this has to be said -- we’re talking about women and children, and we need women to make important decisions with this regard,” said Willock, who until June worked for Charles R. Drew University of Medicine and Science. “I’m sorry, gentlemen. You are not as sensitive as you should be.”

The supervisors’ decision was greeted by jeers and chants of “Stop Zev” from a crowd that at one point reached about 200 people. It drew cries of “It is racist! It is racist!” from one man as he left the supervisors’ chambers in downtown Los Angeles.

During about five hours of public testimony, all of the more than 60 speakers opposed the plan, often saying they felt betrayed by the board. Many called for the ouster of Department of Health Services director Dr. Thomas Garthwaite, who drafted the recommendations. Some said they had been denied meaningful input into deciding the fate of King/Drew, which serves a largely impoverished minority community in the South Los Angeles area..

Many speakers noted that the hospital was created out of the anger of the 1965 Watts riots, whose 40th anniversary was last week. At the time of the riots, residents of the neighborhoods around where King/Drew now stands had to travel long distances to a hospital. Now, one of King/Drew’s most prized services is care for the community’s sickest babies.

“There’s a great disconnect,” said community activist Cathy Youngblood. “You have facts and figures, presentations ... but you have never taken a poll from the residents that live in this area. I challenge you to come to the area served by the King hospital complex. I challenge you to knock on our doors.”

Burke, whose district includes the hospital, and Molina had put forth a competing motion to delay the vote six weeks to give time for more consideration.

The prevailing motion also directed the health department to continue exploring the option of handing control of King/Drew to an outside company in case the proposed fixes don’t work. That would take at least six to 12 months of planning, based on a consultant’s review. Molina and Burke opposed that idea as well, saying it detracted from other efforts to fix the hospital and hire much-needed staff.

Molina said voting to move ahead with a hearing was “demonstrating to this community, once again, that the only urgency we have is an urgency to cut the services.”

She noted that less than a year ago the board voted to close King/Drew’s busy trauma center, telling hundreds of resentful community members that the step was needed to take pressure off the hospital so it could be fixed. “We haven’t delivered on that,” she said. “I think we’ve disappointed and let the community down because we didn’t honor our last commitment.”

Only Burke opposed closing the trauma center. But with Molina joining her in opposition to the latest plan, a deep rift in the board has been exposed.

On Tuesday, board members openly feuded, interrupting one another and refusing to craft a consensus motion.

“Madam chair, could I ... “ Yaroslavsky interrupted Molina at one point as she asked Garthwaite what the harm in delaying the vote would be.

“Excuse me. Excuse me,” she replied tartly.

“Since it’s my motion, I’d like to address it,” he said.

“Excuse me, I’m not asking about your motion. I’m asking about my motion,” Molina shot back. She then told Garthwaite not to let Yaroslavsky “intimidate” him.

The meeting was closely monitored by Rep. Maxine Waters (D-Los Angeles), who sat in the front row for most of the hearing and led off the speakers.

“We have no choice but to engage in this process,” she said. “However, let the record reflect our adamant and constant opposition to further attempts to downsize or close any more units and/or services of Martin Luther King hospital or to contract out any physician or any other services.”

Waters, who has held weekly community meetings to discuss King/Drew, also demanded that Garthwaite resign or be fired, saying he had “disrespect and contempt for our community.”

She also criticized The Times for its coverage of King/Drew, saying it had “undermined, denigrated and basically dishonored the King/Drew Medical Center in every possible way.”

Following Waters, Rep. Diane Watson (D-Los Angeles) implored supervisors to solve the hospital’s problems instead of cutting its services.

“Don’t close it. Don’t shrink it. Don’t hack it up,” Watson said. “Don’t starve it of resources. Don’t drain it of its professional talent. Don’t hand it over to strangers. Don’t pass the buck. Don’t ignore it, and don’t abandon the people it serves day in and day out.”

The proposal to downsize is the latest in a long line of attempts to fix King/Drew over two years. The health department has sent in its own managers, hired a consulting firm to oversee nursing services, and, under pressure from the federal government, hired a second consulting firm to take over all operations at King/Drew. Navigant Consulting Inc. is being paid $15 million for its one-year contract.

“I know the frustration you must feel,” Watson told the board. “I feel it too.... I’m here to ask you not to yield, because there are still families that need a hospital in South Los Angeles, who deserve one, and who do, in fact, have one, battered as it may be.”

In the last two years, the hospital has been cited repeatedly by accreditors and regulators for major lapses in patient care. The hospital, located in Willowbrook south of Watts, also lost its national accreditation earlier this year.

Several King/Drew physicians told the board that their patients, who often lack cars and other resources, would have difficulty reaching other hospitals.

“My patients want to continue to come to us,” pediatrician Patricia Del Angel said. “They have faith in us despite all the negative publicity and the relentless media attack.”

Tuesday’s vote was also opposed by the members of the hospital’s advisory board, formed earlier this year by the supervisors to aid them in overseeing King/Drew.

“If we commit to the downsizing, I don’t think we’ll ever be able to regain the services we cut today,” said Dr. Hector Flores, the advisory board chairman.

Yaroslavsky said his plan allowed time for input but did not stop the process. It encourages community members and the hospital advisory board to submit alternative proposals by Sept. 30 and requires the health department to respond by Oct. 7.

In defending his plan, Garthwaite said his aims were to do -- extremely well -- fewer things at the hospital and to focus on the health needs of nearby residents. His plan also calls for expanding outpatient services for pediatrics, high blood pressure, high cholesterol, diabetes and cancer screening and treatment.

Garthwaite maintained that the number of pregnant women and children who sought care at King/Drew had decreased because most of those patients had private insurance or Medi-Cal coverage and sought care at private hospitals because they could. In 2004, the hospital delivered only 622 babies, down from 4,000 a decade ago.

But Burke said the proposed cuts were ironic, coming just weeks after the opening of King/Drew’s massive women’s center.

“I worked five years to get the women’s center,” she said. “Now, if a woman walks in there and takes a test and finds out she’s pregnant, what do you then say to her? ‘Well, you’re going to have to go to another hospital because we don’t give prenatal because all of our outpatient OB is going to be somewhere else?’ ”

Knabe said that he was bothered by the angry tone of the meeting and that he had not decided whether he would ultimately vote for the cuts. “We’ve all made the commitment that we want to save the hospital, and it takes a number of different ways to do that,” he said.

Antonovich and Yaroslavsky also did not commit to approving the cuts in October. But Antonovich said community members should be focusing their energy on gaining a safe hospital, not on preserving the status quo.

“The people should be outraged that that type of quality care has been in the community that has resulted in death in some cases and impaired the health of others who are receiving treatment there,” he said. “That should be the outrage. That is the outrage and that’s the action that this board is attempting to correct right now.”