Health Chief Vows ‘Brutal’ Shake-Up if Managers Resist Change

Los Angeles County health services chief Mark Finucane on Wednesday promised a “quick and unfortunately brutal” shake-up of his top managers who fail to help turn the embattled department around.

“I’m taking a hard look at everybody who reports to me and I’m taking a hard look at the quality of work everybody does,” Finucane told state legislators and Los Angeles County supervisors at a briefing on the continuing county health care crisis.

Finucane, who took over the troubled $2.3-billion Department of Health Services last month with orders from the supervisors to “change it as fast as you possibly can,” said he has run into heavy resistance from some workers in the 25,000-member agency who “think I am a tourist.”

But Finucane, who held a similar post in Contra Costa County for many years, insisted that he is “committed to change.” He warned that any of the 50 or so top managers who did not join him and meet his high standards for performance could seek employment elsewhere.

“This is going to be a very, very quick and unfortunately brutal process,” Finucane said. “There are significant reorganizations that I plan to present to the board.”

Later, he told a reporter that “new rules” would be explained to the executives. He said he believes most will support the changes as the health care system shifts emphasis from traditional treatment at hospitals to less costly outpatient care at community clinics.

“You have to give them a chance to change,” he said of the executives, most of whom are protected by Civil Service. “A lot of them are going to do so. Some can’t.”

He said those found lacking would be encouraged to offer their services elsewhere. To cut costs last year, about 2,600 department employees were terminated.

Finucane spoke to a handful of legislators, staff members and four of the five Los Angeles County supervisors during a 90-minute review of the health care crisis that almost sank the county financially last year.

Burt Margolin, who served as county health care czar and is now a lobbyist for the county, said he expects that the federal government will soon accept a five-year plan advanced by the state and county that would shift certain federal funds from hospitals to community clinics.

He said it is uncertain whether the Legislature will be called on to help out.