The impending loss of federal funds at Martin Luther King Jr./Drew Medical Center reverberated across the region Monday, as the Los Angeles County Board of Supervisors met in an emergency closed session to discuss the public hospital’s fate.
UCLA’s David Geffen School of Medicine said it plans to begin shifting some of its medical students out of clinical rotations at King/Drew in an “orderly transition.” About 50 third- and fourth-year students enrolled in a joint program with Charles R. Drew University of Medicine and Science will be transferred to UCLA-controlled hospitals to complete their instruction.
“The students receive their medical degree from UCLA, and our obligation is to those students to make sure they get the kind of education that they should be getting,” UCLA spokeswoman Dale Tate said. The move does not affect medical residents at King/Drew.
Also Monday, the state Department of Health Services began surveying other hospitals that serve South Los Angeles to assess their ability to absorb King/Drew patients if the hospital were to close.
“We have some capacity, but it is limited,” said Robert Fuller, chief operating officer of Downey Regional Medical Center. “If King/Drew were to really close, that would be the potential beginning of a disaster.”
Meanwhile, community activists rallied outside the Willowbrook hospital, near Watts, to call for keeping it open. “To close this facility means our kids are welcome to die in the street,” said Lita Herron, with the group Mothers on the March.
The U.S. Centers for Medicare and Medicaid Services notified King/Drew and county officials late Friday that the hospital did not pass an unannounced “make-or-break” inspection conducted this summer, failing to meet minimum standards in nine of 23 areas. As a result, it will lose $200 million a year in federal funding, nearly half of its budget.
The hospital has been out of compliance with federal rules since January 2004 for lapses in medical care that have repeatedly harmed and killed patients.
At Monday’s 2 1/2 -hour meeting, county supervisors discussed legal options and contingency plans but came to no conclusion about what to do with the hospital in light of the funding cut. The supervisors will continue the discussion today.
Sources familiar with Monday’s meeting said that several alternatives are being discussed. One option being seriously considered is to pare back services at King/Drew and operate it under the license of Harbor-UCLA Medical Center, a larger county hospital near Torrance.
Another possibility would be to convert the hospital into an outpatient clinic and pay nearby private hospitals to handle inpatient stays for indigent county residents.
King/Drew will lose its Medicare provider status Nov. 30, but some funding will continue for another 30 days. The hospital also stands to lose Medi-Cal funding, which comes from both the state and the federal government.
“The county cannot afford to operate that hospital in its current configuration,” said county Chief Administrative Officer David E. Janssen in a budget briefing Monday afternoon.
Supervisor Don Knabe described Monday’s meeting as “mostly just information gathering.” While there is a chance the county could appeal the federal decision, he said, supervisors must first determine “whether it’s even worth appealing.” An appeal would not stop the clock on the hospital’s termination from Medicare.
“The whole goal is to save the hospital,” Knabe said.
County health officials are expected to submit proposals on King/Drew’s fate to the board within two weeks, Janssen said.
Supervisor Zev Yaroslavsky said he and his colleagues are moving quickly to create a “path forward.”
“We have 65 days from today” until King/Drew loses its Medicare certification, he said. “We have virtually no time.”
The federal government might agree to reinstate funding, Yaroslavsky said, but only if the hospital were completely restructured. “They want real reform, and I agree with that,” he said. “They don’t want King doctors in Harbor smocks.”
Supervisor Yvonne Brathwaite Burke, whose district includes King/Drew, issued a statement saying she was committed to providing health services to the community served by the hospital. Supervisor Gloria Molina said Saturday that she would support turning over the hospital to a private company as long as the new operators agreed to continue treating indigent patients. Supervisor Mike Antonovich declined to comment, with a spokesman saying he wanted more information.
Meanwhile, other officials expressed alarm at the possibility that King/Drew could close.
Los Angeles City Councilwoman Jan Perry, whose constituents use the hospital, said she is particularly concerned about losing King/Drew in light of the announced closure of another emergency room -- at the Memorial Campus of Centinela Freeman Regional Medical Center in Inglewood.
“There would be a huge, gaping, meteoric-sized hole that can’t be filled,” Perry said.
State Assemblyman Mervyn M. Dymally (D-Compton) said he is exploring options for King/Drew, such as turning it over to Drew University, which runs training programs at the hospital. Drew had been experiencing troubles with its programs but has reconfigured its board and replaced its leadership.
A community forum held by Rep. Juanita Millender-McDonald (D-Carson) at the hospital Monday night drew a standing-room-only crowd of about 300. The congresswoman urged the attendees to move past pointing fingers. “We must come to grips with where we are, what we have before us, and where we will go from here,” she said.
Earlier in the day, community activists outside King/Drew called for more time and more money to fix the problems. In particular, they cited the thousands of lives the hospital has saved and the gun violence in the surrounding community.
Community organizer Earl Ofari Hutchinson said he had a message for the Board of Supervisors and King administrators: “Don’t even think about caving in, giving in. Appeal and ask for reinstatement.”
Both Hutchinson and civil rights activist Eddie Jones asked patients and staff milling around outside the hospital to offer testimonials. Patients doing so included a middle-age man with breathing difficulties and a boy who had broken his arms.
“Did they fix your arms, Douglas?” Jones asked the boy, Douglas Clark.
“Yes,” the child said.
“That’s from the mouths of babes,” Jones said.
Staff writer J. Michael Kennedy contributed to this report.
(BEGIN TEXT OF INFOBOX)
Martin Luther King Jr./Drew Medical Center has experienced numerous lapses in care that imperiled or killed patients.
Aug. 22, 2003: The Times reports that two women connected to cardiac monitors died after their deteriorating vital signs went undetected.
December 2003: The Los Angeles County health department closes the cardiac monitoring ward after a third patient dies under questionable circumstances. The Camden Group consulting firm is hired to help fix nursing problems. The county ultimately spends nearly $1 million for its services.
January 2004: The U.S. Centers for Medicare and Medicaid Services determines that King/Drew is out of compliance with minimum requirements for receiving federal funding. Government inspectors identify five patients -- including those on monitors -- who died at King/Drew after what were determined to have been grave errors by staff members.
March 2004: The Medicare agency says that King/Drew patients are in “immediate jeopardy” of harm or death because of medication errors at the hospital. The government again threatens to pull funding, citing such errors as giving a meningitis patient a potent anti-cancer drug for four days.
June 2004: The Medicare agency again says that King/Drew patients are in “immediate jeopardy,” this time citing the use of Taser stun guns to subdue psychiatric patients. The government again threatens to pull funding but later lifts its threat.
September 2004: The county health department recommends closing King/Drew’s busy trauma unit, saying the hospital needs to put its full energy into fixing problems in other areas. Despite intense community opposition, the unit is closed in early 2005.
September 2004: The county Board of Supervisors enters into an agreement with the Medicare agency to hire a new consulting firm to take over operations at the hospital. In November, Navigant Consulting takes over, and the county ultimately pays the firm more than $17 million for 18 months of work.
December 2004: The Times runs a five-part series on King/Drew, saying that problems are far deeper than the public knows. The report faults the Board of Supervisors for shying away from making needed changes, often because of racial politics.
December 2004: The Medicare agency for the third time says that King/Drew patients are in “immediate jeopardy” for relying too heavily on county police to shoot aggressive mental patients with incapacitating jolts of electricity. The threat is later lifted.
February 2005: A national accrediting group pulls its “seal of approval” from King/Drew.
July 2005: The Times reports on a seriously ill patient who died after nurses failed to respond “for an extended period” to audio alarms signaling his distress -- the seventh death in two years in which staffers virtually ignored vital-sign monitors.
August 2005: The county hires a new administrator for King/Drew, Antionette Smith-Epps.
November 2005: County health director Dr. Thomas Garthwaite quits after months of stinging criticism from the Board of Supervisors about his handling of King/Drew.
July 31, 2006: Federal inspection described by officials as the last chance for King/Drew begins to determine if the hospital has come into compliance with minimum patient-care standards. The review is completed Aug. 10.
Sept. 22, 2006: The Medicare agency informs King/Drew that it failed the “make-or-break” inspection and stands to lose $200 million a year in federal funding.
Times reporting by Charles Ornstein and Tracy Weber