Move to Protect Health Funds OKd

Hoping to prevent a potentially crippling loss of federal funds for Martin Luther King Jr./Drew Medical Center, the Los Angeles County Board of Supervisors voted Tuesday to spend $7.7 million to hire psychiatric workers to calm disruptive patients at county-run hospitals.

The county will hire 90 to 100 employees as replacements for unarmed county police officers who team with doctors and nurses on calls involving violent patients.

The use of officers at King/Drew has drawn criticism from the U.S. Centers for Medicare and Medicaid Services.

The federal agency last month threatened to cut $200 million in federal reimbursements to the hospital unless it improved its handling of disruptive patients.

Losing that money would eliminate about half of King/Drew’s budget and raise the prospect of closing the hospital, which serves the largely low-income African American and Latino populations in South Los Angeles.

Health services officials told county supervisors on Tuesday that such a loss would mean having to find roughly $170 million to keep the hospital open for nine months while King/Drew reapplied for the federal funds.

“It would be devastating,” said Fred Leaf, chief operations officer at the Department of Health Services.

“We’d have to start cutting in other facilities to fund that if it went on for a long period of time.”

Federal inspectors have repeatedly cited King/Drew for failing to properly handle aggressive patients, including the inappropriate use of restraints and Taser stun guns.

Teams of doctors, nurses and unarmed police officers now respond to disruptive patients and try to calm them through various tactics, such as talking to them or administering drugs.

Once patients begin to threaten themselves or others, members of the team can request that armed officers intervene.

Health officials said federal inspectors were alarmed that the teams could not prove they had done everything possible to calm patients before calling in police officers with stun guns and handcuffs.

County health officials acknowledged that hiring psychiatric workers will not address all the concerns.

But the step should lead hospital staff members to summon police only as a last resort, they said.

“It allows us to erase the blurred lines of involvement of the police officers,” Leaf said.

About 15 psychiatric workers trained to manage violent patients are expected to start at King/Drew in the next few weeks. The county’s other hospitals will add similarly trained workers.

Supervisors expressed dismay at the choice they would face if the federal funding were cut: close the hospital or keep it running and risk adding to a massive projected county health budget shortfall.

“It’s a horrible, horrible situation,” Supervisor Zev Yaroslavsky said. “Someone has to be prepared for the worst-case scenario.”

The timing of such a threat could not be much worse.

County health services officials released new budget predictions for the board that show the department will be short $1.3 billion by July 2008 if it continues to spend at its current rate.

A new contract with nurses has added to department costs while federal courts have blocked the county’s efforts to cut spending by closing Rancho Los Amigos National Rehabilitation Center in Downey.