Supervisors OK King/Drew Plan

Facing the loss of $200 million in federal funds and a possible shutdown of Martin Luther King Jr./Drew Medical Center, the Los Angeles County Board of Supervisors unanimously approved a rescue plan Tuesday that would keep the doors open but dramatically scale back the size of the hospital.

In their frankest public display yet, supervisors conceded that the plan is an all-or-nothing proposition that still must be approved by the U.S. Centers for Medicare and Medicaid Services.

“If CMS does not approve this plan, what happens?” Supervisor Gloria Molina asked Dr. Bruce Chernof, director of the county Department of Health Services.

When Chernof began describing the plan, Molina interrupted.

“Say it,” she demanded.

“The hospital will close,” he replied.

Punctuating the discussion, county Chief Administrative Officer David Janssen later added: “I think the bureaucracy is capable of miraculous things, and this will take a miracle. But, yeah, we can do it.”

King/Drew, in Willowbrook south of Watts, is one of four acute-care hospitals run by Los Angeles County, and for years it has struggled over issues of patient care. The medical center failed a federal inspection conducted this summer, and by Nov. 30 it could be stripped of $200 million in Medicare funding, about 45% of its annual budget.

The centerpiece of Chernof’s recovery plan would greatly downsize King/Drew and put it under the management of another county hospital, Harbor-UCLA Medical Center, 10 miles away near Torrance. The revamped facility would be called Harbor-Martin Luther King Jr. Community Hospital.

A public hearing to discuss the changes is scheduled for Nov. 6 at the county Hall of Administration.

County health officials outlined several points in the consolidation plan:

* The county would ask federal officials to provide the $200 million for one more year while the restructuring was implemented. It would also ask for $50 million more to help pay for the transition.

* In the immediate future, King/Drew’s capacity would fall to 42 beds by March 1, then rise to 114 by November 2007. Some patients would be shifted to Harbor-UCLA, Olive View-UCLA Medical Center in Sylmar and Rancho Los Amigos National Rehabilitation Center in Downey.

* No King/Drew staff member would be fired or laid off and workers given a “competent or better performance evaluation” would be reassigned to Harbor-MLK or elsewhere in the county health system.

Substandard employees would be dealt with individually in accordance with Civil Service guidelines, Chernof said. “The vast, vast, vast majority of problem employees are already gone,” he said of the hospital’s remaining 2,200 workers.

* The emergency room at the revamped Harbor-MLK would be kept open, and the hospital would continue to offer general medicine services, gynecology and routine surgeries. High-risk obstetrics, pediatrics, neurosurgery, oral maxillofacial surgery, neonatal intensive care, ophthalmology and cardiac surgery, among other services, would be moved to Harbor-UCLA.

* The county would set up a transportation service between Harbor-MLK and Harbor/UCLA seven days a week with “frequent and extended hours” to begin later this year.

The board also agreed Tuesday to expedite a long-planned $344-million expansion of Harbor-UCLA’s surgery, emergency and inpatient areas.

Chernof told supervisors that he has discussed the plan with federal officials but could not predict whether it would be acceptable and lead to a restoration of money.

Medicare spokesman Jack Cheevers said Tuesday from his San Francisco office that the agency has been in frequent contact with county health officials but has not yet seen a final plan and could not comment on its viability. In the last three years, he said, only three other California hospitals and nine nationwide have been similarly stripped of federal funding.

“This is the biggest hospital we’ve taken action against in recent memory,” Cheevers said.

Rep. Juanita Millender-McDonald (D-Carson) told supervisors that she had had frequent, encouraging communication about the plan with top administrators at the federal Medicare agency.

“This is our only hope,” she said.

Chernof said he intends to present the so-called MetroCare plan to federal regulators as early as today.

The prospect of a total shutdown of King/Drew has caused spasms of worry across the region, and Chernof did not rule out that possibility, even if only on a temporary basis.

Officials at private facilities point to the recent closure of other area emergency rooms and hospitals and say there could soon be a time when they could no longer handle the crush of patients, especially those with no health insurance.

Reaction to the county’s plan was mixed.

Lynn Kersey, executive director of the nonprofit Maternal and Child Health Access, told supervisors that shifting beds around the county would be a “shell game.”

Several protesters, including Earl Ofari Hutchinson, president of the Los Angeles Urban Policy Roundtable, held a news conference outside King/Drew on Tuesday morning to object to cuts in care at the hospital. He said the supervisors must “intensify their efforts to restore full funding to maintain King as a full-service hospital.”

Community members and healthcare advocates agreed that keeping the hospital’s doors open is paramount, but some objected to several points, including the proposed new name.

A letter from Rep. Maxine Waters (D-Los Angeles), signed by a host of local leaders including Democratic gubernatorial candidate and state Treasurer Phil Angelides, was read to supervisors by a Waters deputy. Waters insisted that certain core services be preserved at Harbor-MLK and that changing the hospital’s name to Harbor-Martin Luther King Jr. Hospital would mislead community members.

She instead recommended it be called Martin Luther King Jr./Harbor Hospital. “We would hope this does not become a divisive issue,” read the deputy.

Under the Chernof plan, Harbor-MLK would not be a teaching hospital. Susan Kelly, president of the adjacent Charles R. Drew University of Medicine and Science, said the school was preparing to reduce its King/Drew medical residents from 250 to 120.

Kelly also said that preliminary efforts to move some Drew medical residents to UCLA have stalled.

In a discussion with Chernof, Supervisor Zev Yaroslavsky underscored the day’s theme, that the MetroCare plan was perhaps the last, best hope for saving King/Drew.

“I think we’re all just frankly scared that we’ll be down the line,” Yaroslavsky said, “ ... and we’ll be left with nothing to show for it. And that’s not in anybody’s interests.”

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susannah.rosenblatt@latimes.com

steve.hymon@latimes.com