Pact to Fix King/Drew Is Extended

A divided Los Angeles County Board of Supervisors voted Tuesday to extend the contract of the turnaround firm running Martin Luther King Jr./Drew Medical Center, despite concerns voiced in recent weeks by the county’s own auditors about the company’s performance.

On a 3-2 vote, the board extended its one-year contract with Navigant Consulting Inc. for six months at a cost of up to $5.7 million. That would bring the total value of the contract to $20.7 million.

Board members who favored sticking with Navigant indicated that it would not be good for the hospital to switch turnaround teams midstream.

“We’re at this critical juncture where we do not want to lose focus of what is before us, and that is to save that hospital,” Supervisor Don Knabe said. “That is what our ultimate responsibility is here today.”

A Navigant official said his company had made progress.

“We think the hospital is in better shape than it was a year ago,” said Larry Scanlan, a managing director of the Chicago-based firm. “Clearly there’s work to do, no question about it.”

Also Tuesday, the supervisors suspended the hospital advisory board they had created earlier this year to help them make decisions about King/Drew.

The panel was one of Navigant’s key recommendations earlier this year for fixing the hospital. But the supervisors were unable to resolve disputes about its composition despite hours of discussions over many weeks.

The supervisors endorsed the contract extension even though county auditors have faulted Navigant in two recent reports.

In one released late last month, auditors accused the consultants of deleting from its to-do list some goals the firm had not reached. The report also said Navigant had refused to turn over results of a practice inspection showing how unprepared King/Drew was for an upcoming visit by accreditors.

Although the county reviewers noted some accomplishments, they said the publicly traded firm had made far fewer reforms than it had pledged in its contract.

Two weeks later, auditors rejected more than $206,000 in invoices submitted by Navigant because they were for unauthorized trips and first-class travel.

In renewing the contract, the supervisors rejected a competing bid from another consulting firm that said it could do a better job at King/Drew. FTI Cambio Health Solutions proposed being paid $4.1 million -- with a bonus of $2 million if the hospital kept its federal funding.

Cambio, which was a finalist a year ago to turn around King/Drew, said it was better suited than Navigant to help the hospital retain its federal funding.

County Chief Administrative Officer David Janssen said he met with Cambio representatives but believed that switching consultants now would set the hospital back.

“I personally don’t think its worth the risk,” he said.

Similarly, Antionette Smith Epps, who started last week as King/Drew’s chief executive officer, said she did not think it would be wise to let go of Navigant, which has promised to provide up to 31 senior and mid-level managers at King/Drew as part of the contract extension.

“The task at hand was severely underestimated by everyone: by the board, by the Department of Health Services, by Navigant,” she said. “I don’t believe that they haven’t given it their best effort. They came in and underestimated the task, it appears to me, from looking at what has gone on.”

At the same time, Epps said, she is working feverishly to hire her own staff, which would reduce the need for Navigant’s consultants. On Tuesday, she announced that she had hired a chief nursing officer and a chief operating officer.

Supervisors gave Epps responsibility for managing the Navigant contract, a task previously reserved for the county health department.

Supervisors Gloria Molina and Mike Antonovich opposed the Navigant contract extension.

“This kind of reminds me of an abused child who is physically abused and yet when there’s an ability to put that child in a safe environment, [he] clings to the abusive parent,” Antonovich said.

The weekly wrangling over King/Drew points to how precarious the hospital’s future is. The county health department warned last week that the public hospital south of Watts might well fail an upcoming federal inspection crucial to its survival.

If the U.S. Centers for Medicare and Medicaid Services determines that King/Drew still does not meet basic requirements, it could pull $200 million in funding. And if that happens, county health director Dr. Thomas Garthwaite has said, he will urge closing the medical center or handing over control to a private hospital company.

In voting 4 to 1 to suspend the advisory board, the supervisors said the panel had become too much of a distraction. Instead of remaining focused on fixing the hospital, the health department and supervisors have been spending too much time discussing the group’s bylaws and membership, they said.

Several supervisors criticized the advisory panel after it voted to oppose recommendations by Garthwaite to close several patient-care wards at the hospital. (Garthwaite ultimately withdrew the plan because it would have cost the county $29 million in government aid).

Dr. Hector Flores, the advisory board chairman, said his members worked hard to make important and needed changes at King/Drew, yet their efforts were “misunderstood and mischaracterized.”

“I’m concerned that members of our board, perhaps even me, have been perceived as recalcitrant or activists for the status quo or apologists. And that’s not true,” he said.

Molina voted against suspending the group’s meetings.

Janssen said the hospital would continue to consult patient safety experts on the advisory board and could revisit the issue later if the hospital passes its regulatory and accreditation reviews.