Supervisor Calls On Health Chief to Quit

Los Angeles County Supervisor Mike Antonovich called Tuesday for the resignation of the county’s health director, saying Dr. Thomas Garthwaite didn’t know what was going on in his own department.

Antonovich’s call came during the second rancorous Board of Supervisors meeting in three weeks about troubles at Martin Luther King Jr./Drew Medical Center -- and the same day as new revelations came to light about the public hospital.

The Times reported Tuesday that King/Drew had paid more than $1.3 million from March 2004 to February 2005 for the services of a radiologist who said that, during one recent six-month stretch, he worked an average of 20 hours a day, seven days a week.

County Department of Health Services officials said they were unaware of such a marathon schedule for Dr. Harold A. Tate, who worked under contract to an outside firm, until The Times inquired about his pay and hours.

“Dr. Garthwaite, perhaps now is the time for you to step aside,” Antonovich said as the health director sat stone-faced before him at the weekly meeting. Scattered gasps and applause rippled through the chambers.

“There has to be full accounting,” Antonovich said. “We don’t know what we’re going to read next week.”

Garthwaite, whose voice in earlier testimony had been barely audible because of illness, did not respond during the meeting. Later, in an interview, he said, “I’m not considering resigning at this time.

“I think the director of health services has always been under fire, and I believe it’s the nature of the job,” he added. “I think most people in healthcare in L.A. understand that.”

None of the other supervisors joined Antonovich’s call for the resignation. Supervisor Yvonne Brathwaite Burke, whose district includes King/Drew, has said the current crisis at the hospital requires stable leadership in the health department.

But the supervisors expressed frustration Tuesday that they continued to learn of the medical center’s problems from the media and not from the department or from Navigant Consulting Inc., the turnaround firm the county is paying $13.2 million to overhaul King/Drew.

“We didn’t terminate [Tate] until we were called by the L.A. Times,” Supervisor Gloria Molina said during a lengthy grilling of health officials.

The supervisors asked why four King/Drew employees, including the radiology department’s interim chairman, regularly signed off on all Tate’s hours, even when they reached 22 to 24 hours a day for weeks at a time.

The board, with Supervisor Don Knabe absent, passed two motions calling on the health department and county auditor to investigate the matter and report back. They also asked county lawyers to review the findings and take legal action, if appropriate, to recoup county funds “that may have been inappropriately disbursed.”

Under questioning, county officials said King/Drew had eight full-time radiologists -- one of whom was on leave -- and six others under contract. They said they were unsure what the other radiologists were doing while Tate allegedly worked around the clock.

“What was going on in the radiology department where there were 15 physicians, permanent full-time radiologists, and you had one person working 23 hours a day?” Molina demanded as the officials scrambled for answers.

The people who approved Tate’s hours, she said, were “either real, real dense when they were signing all of these authorizations over and over again, or they were taking money for being so stupid.”

Reliable Health Care Services, the temporary agency that provided Tate’s services to the hospital and collected up to $225 an hour for his work, categorically denied any wrongdoing.

Vice President Shane Nagore said in a telephone interview Tuesday that Reliable repeatedly asked the county about Tate’s hours. He said the hospital responded that it did not have anyone else to cover the shifts.

“Of course we brought it up to them: Are these hours correct?” Nagore said. “They said, ‘We’ve signed off on them. Yes.’ They said [that] because of lack of coverage, he was forced to stay hours beyond what we would normally have a radiologist stay. As long as all the work was being done, they never objected. Never.”

Nagore also said hospital finance employees specifically directed Tate and Reliable to submit the hours in smaller increments so they wouldn’t attract attention.

“We were even told on occasion, not all the time, to list them all as eight-hour shifts so it wouldn’t show as one whole shift,” Nagore said. “Maybe it wouldn’t raise as many red flags.”

Tate said that he was at the hospital for all of the hours listed on his time sheets and that if he had left, there would have been nobody there to interpret X-rays.

Both the supervisors and health officials said his schedule was troubling in any light.

“Either he was working the 23 hours, which was very inappropriate, or he wasn’t and he was paid completely inappropriately,” said Fred Leaf, the health department’s chief operating officer.

“So it potentially could be a fraud case?” Molina asked.

“Could be. Yes,” he answered.

Supervisors also said they were bothered that the former acting administrator at King/Drew ordered staff members last summer not to pay invoices seeking round-the-clock compensation for Tate -- but that his orders were ignored.

The hospital’s current medical director, Dr. Roger Peeks, said Monday that he did not know the extent of Tate’s hours.

But a memo to him in July from the former interim radiology chairman said an increase in pay allowed King/Drew to “continue coverage with an in-house radiologist 24 hours per day, seven days per week.”

“The bulk of coverage was provided by a single physician (Harold Tate),” wrote Dr. Theodore Q. Miller.

Peeks said Tuesday that he believed Tate’s hours had been cut back.

“I was under the impression that it stopped,” the medical director said, adding that he did not review Tate’s time sheets to be certain.

Molina said she wanted the current interim chairman of radiology, Dr. Vaughn C. Payne Jr., to testify before the Board of Supervisors about why he approved Tate’s invoices.

And she asked to meet privately with the other finance employees who signed off on those forms. That meeting is scheduled for today.

Supervisors said they were flummoxed by so many contradictory statements about who approved Tate’s payments.

“Who are we supposed to trust on this?” Molina said.

A short time later, Leaf responded, “Based on this one, I would say you’re correct. You can’t trust anyone.”