Board Agrees on King/Drew Effort
Los Angeles County supervisors agreed Tuesday to launch a last-ditch effort to salvage Martin Luther King Jr./Drew Medical Center.
The plan, adopted in principle, would dramatically reduce services at the troubled public hospital and turn over its management and some of its services to another county hospital, Harbor-UCLA Medical Center. King/Drew’s staff would be transferred to other county hospitals.
“Among the very difficult and risky choices, this is the best option,” said Dr. Bruce A. Chernof, head of the county Department of Health Services. But Chernof said the county would have no choice but to close King/Drew entirely if the new plan didn’t lead to a restoration of federal Medicare funding.
Supervisors gave him two weeks to draw up specifics of the proposal and return for final approval.
Among the remaining uncertainties are whether the hospital would have to be closed during a transition period and what would happen to the private Charles R. Drew University of Medicine and Science, which uses King/Drew as its teaching hospital. Chernof’s plan would sever the relationship with Drew.
King/Drew, established in the aftermath of the 1965 Watts riots, serves some of the poorest patients in Los Angeles County and has long been a symbol of the frayed social contract between the county supervisors and their neediest constituents. As the governing board of the hospital, the supervisors have repeatedly failed to fix long-standing problems at King/Drew, opening themselves to sharp criticism for not turning around the medical center.
The situation got far worse last month, when the federal Centers for Medicare and Medicaid Services announced that, by year’s end, it would pull about $200 million in funding for King/Drew, nearly half the hospital’s budget. County officials say they can’t afford to make up the shortfall.
At the supervisors’ regular meeting Tuesday, Chernof said the plan to put King/Drew under the umbrella of Harbor-UCLA is far from risk-free. Federal regulators must agree to keep funding the hospital, and state regulators must sign off on the management transfer.
“The federal government has made it clear that if they see a credible plan, they’re prepared to be supportive,” he said at a later news conference. If not, he added, “there is not a way to keep the hospital open.”
He added that federal officials expect to see “a hospital that is simpler and more focused.”
“I wish this didn’t come about this way,” said Supervisor Yvonne Brathwaite Burke, whose district includes King/Drew, in Willowbrook, south of Watts. “I think we’re moving forward in a way to keep the safety net.”
As recently as two years ago, the county faced a firestorm of community and political opposition when it announced plans to close King/Drew’s trauma unit to shore up the rest of the hospital. Many in the community considered the trauma center a vital resource in an area plagued by violent crime. On Tuesday, the reaction to the latest down-scaling plan was far more muted, with community leaders recognizing that the only alternatives were bad and worse.
“This is not a time for division; this is not a time for finger-pointing. This is a time for us to work together, to follow the leadership of the board,” said Rep. Maxine Waters (D-Los Angeles), who has rallied opposition in the past when the supervisors have proposed cuts in services at King/Drew.
She added that the community “does have a vision” that the hospital eventually would be restored to full service as an acute-care hospital with a trauma unit. If the county agreed, she said, “I think that would give a lot of hope and inspiration to the community to stand firm with you.”
Los Angeles Councilwoman Janice Hahn, whose district includes Watts and whose father, Supervisor Kenneth Hahn, was the guiding force behind the creation of King/Drew, sounded resigned to, but far from content with, the county’s recovery plan.
“Maybe we’ve plugged the hole,” she said. “But it’s hard to be happy about a plan that requires the residents of Watts to have to travel to Torrance to go the hospital. That’s why this hospital was built: to overcome the obstacle in that community 40 years ago that had people traveling long distances to get access to healthcare. Now it looks like we’re going back to that time where some communities have that access and others don’t.”
Gov. Arnold Schwarzenegger said he applauded the supervisors’ action and pledged state support, a potentially significant portent for the plan’s ultimate success.
“Patient health and safety comes first,” the governor said in a statement issued by his office. “That’s why my administration will work shoulder to shoulder with the county to keep these essential services in the community where they belong.”
The plans for the new Harbor-Martin Luther King Jr. Community Hospital include a scaled-down facility with 114 beds and an emergency room, in addition to an expanded outpatient center on site. Specialties such as pediatrics, neurosurgery and neonatal intensive care would be transferred to Harbor-UCLA, 10 miles away.
The process would take longer than a year to complete, Chernof said.
He acknowledged resistance among Harbor-UCLA staff to taking on King/Drew. On Monday doctors at Harbor-UCLA issued a statement questioning whether their hospital had the resources to assume the new responsibility without compromising the quality of service it provides its own patients. And two doctors, speaking anonymously, told The Times that Harbor-UCLA’s well-regarded chief executive officer, Tecla A. Mickoseff, had threatened to resign over the plan.
Hospital spokeswoman Julia Rees said Tuesday, however, that Mickoseff had no such intentions. “She’s not available for comment, but she has told me that she is not intending to resign,” Rees said.
Other employees at Harbor-UCLA expressed concern about the plan Tuesday.
Harbor will strain under the new burden, said Norma Rene-Jones, a patient registrar who was taking a break outside the hospital. The medical center is already overwhelmed with patients, she said. “If you add more, it’s going to be ridiculous,” she added.
Chernof pledged county support for Harbor-UCLA during the transition. “If Harbor’s left to solve this problem on their own, that will not work,” he said.
The health chief also said King/Drew staffers in good standing would be reassigned elsewhere in the county but could request a transfer back to the hospital. He said no exception would be made for King/Drew’s chief executive officer, Antionette Smith Epps, who took over only last October. However, he added that he hoped she would stay with the county.
“We are incredibly lucky to have Antionette’s leadership in what is clearly the most challenging time in the hospital’s history,” Chernof said. “I would strongly hope and encourage Antionette to stay and be part of the team.”
Kathy Ochoa, a senior health policy analyst for Service Employees International Union Local 660, called for a hiring freeze in the county to accommodate King/Drew employees.
Through tears, she said that she supported the plan and that it was time for the hospital to try something new. “One chapter in the King/Drew legacy has closed,” she said.
Chernof confirmed that the plan would sever ties between King/Drew and Drew University and said the county hopes to help place the school’s 250 or so residents elsewhere.
“Medical education and resident education adds a level of complexity to a hospital,” he said. “It’s clear that additional complexity is part of the challenge here.”
Susan Kelly, the university’s president, told supervisors that the plan could threaten her institution’s future. “Our major fear is that we will be collateral or road kill” in such a plan, she said, adding that the school probably will have to cut back some of its training programs.
“Frankly, the implications of this are deeper than we imagined,” Kelly added.
David Janssen, the county’s chief administrative officer, said the county intends to let its contract with the university expire June 30. The county pays Drew University about $12 million a year to oversee the training of doctors and provide some care to patients at King/Drew.
Times staff writers Mitchell Landsberg and Sam Quinones contributed to this report.
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