Candidates talk about healthcare issues

The Times is asking the two major candidates competing to succeed Los Angeles County Supervisor Yvonne B. Burke about some key issues in the 2nd District, which stretches from Mar Vista through South Los Angeles and into Compton and Carson.

Today, Los Angeles City Councilman Bernard C. Parks and state Sen. Mark Ridley-Thomas (D-Los Angeles) offer their solutions to healthcare issues facing the county and the district, including a growing budget deficit in the county's Health Services Department, large numbers of uninsured patients and the failure, so far, to reopen Martin Luther King Jr.-Harbor Medical Center, formerly known as Martin Luther King Jr./Drew Medical Center, near Watts, as promised.

Between now and the June 3 election, the candidates will address other questions in this series of occasional articles.

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What specific steps should be taken to get the hospital reopened, including ways to pay for and ensure quality patient care there? Is a county partnership with another entity, such as the University of California or a private healthcare provider, a desirable option?

Parks: King-Harbor must be reopened as a full-service hospital at the earliest possible date under the management of a competent and accountable partner.

I believe in reopening King-Harbor in stages . . . first as a quality inpatient care community hospital. As that is accomplished, we can then add specialty services like trauma care, specialized surgeries and specialized critical care functions. I think the collaboration of a teaching institution, preferably a UC system school, (as I proposed in my recent letter to Gov. Arnold Schwarzenegger) is important. While maintaining oversight and control of county funding, the Board of Supervisors cannot and should not be the primary interface. The county needs an independent, expert and accountable structure to do this.

The most attractive alternative would be a county Health Authority dominated by healthcare and health management professionals sufficiently insulated from political vagaries to provide firm and dispassionate oversight, completely transparent.

A new idea that needs to be explored is the creation of an independently elected county surgeon general position. The restoration of the hospital to a full-service, fully licensed facility would return federal funding lost by virtue of the loss of accreditation. The structural imbalance between costs of operation and revenue to pay those costs would remain, however, so long as the size of the uninsured population continues to grow.

Ridley-Thomas: We must end the unconscionable level of political inattention and bureaucratic disregard for patient care and safety that caused King-Harbor to be closed in the first place. The hospital is an integral part of a countywide system of publicly funded indigent care and emergency services.

Reopening King-Harbor hospital must be moved to the top of the agenda of the Board of Supervisors, and . . . it must be the top priority of the supervisor of the 2nd District. It is critical that key stakeholders be brought into the process of developing a plan to reopen King-Harbor.

Key steps that must be taken if King-Harbor is to be reopened successfully:

* The hospital must be structured as a public-private partnership. It must be managed and staffed with culturally competent and compassionate healthcare professionals who view patient care as their top priority. This is the only way to encourage public and private investment in this essential community health resource.

* The hospital must have an administration and governance structure that operates outside of L.A. County's political authority and its health services bureaucracy.

* The hospital must have a governing authority that is accountable to the people it serves. It must empower residents to play a much greater role in their own healthcare and the delivery of services provided to them. It must be sensitive to the healthcare disparities that exist in its service delivery area.

The creation of this hospital public-private partnership must be undertaken in view of the public, so community residents can understand the stakes involved.

A public-private partnership to reopen King-Harbor will require the investment of time, energy and funds from the federal government, state of California, private hospital systems and nonprofit organizations.

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Beyond reopening the hospital, what is your plan for improving healthcare throughout the 2nd District?

Parks: My appointee to the First 5 L.A. commission will support First 5 funding for continuous and comprehensive health insurance coverage for young children in families with incomes under 300% of the federal poverty level, support funding for programs in the district that expand and improve prenatal care, preventive care for young children, dental care, behavioral wellness screening and early mental health treatment.

Either through the First 5 program or as part of the county outpatient clinic program, I would want to see mobile units periodically stationed at locations such as malls and schools to provide diagnostic services along with immunization and low-level treatment.

A disproportionate number of below-acceptable health inspection grades are received by restaurants in the 2nd District, putting patrons at risk of food-borne illness. I would work to improve the educational aspect of the county's restaurant inspection program to bring restaurants in the district into more consistent compliance.

As I have done on the City Council, I would support limitations on the permitting of fast-food restaurants as well as the posting of nutrition data at all restaurants. . . . I would also support soda and junk food bans at all schools, as is currently the practice at Los Angeles Unified School District.

In addition to working to enhance the year-round emergency shelters program [for the homeless] countywide and in the district, I would work to include health and mental health clinicians among the shelters' staff.

Finally, the 2nd District includes or is impacted by major polluters or existing pollution. It is imperative that there be sensitivity to the full impact of these environmental concerns on the health of 2nd District residents, visitors and workers, with particular emphasis on children.

Ridley-Thomas: We must protect the 2nd District's network of community health clinics and comprehensive health centers to encourage residents to seek preventive care.

We must also increase efforts to encourage residents to enroll in community wellness programs to improve their overall health status...[and] also make use of high-tech methods to connect patients with nurses and physicians. I will continue my efforts to expand school health centers in the 2nd District.

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As a way to save money, county officials have proposed finding outside agencies to take over most of its outpatient clinics. What do you think of that proposal? Do you have an alternative?

Parks: As a philosophical matter, I am not opposed to third-party management and operation of the county's outpatient clinics. The county has successfully contracted with third parties to run everything from its airports to golf courses, and there is nothing inherently sacrosanct about county employees staffing outpatient clinics.

As with other privatization . . . proposals, however, the test must be whether the service can be provided at less cost with equal or superior performance results, and the county staff has not yet made that case with respect to outpatient clinics.

Ridley-Thomas: I am not in favor of having outside agencies take over most of the county's outpatient clinics. But I am a strong believer in forming public-private partnerships that can be used to strengthen our county's health clinic network or add resources to our network of community clinics.

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On latimes.com

More on candidates' views

Some of the answers have been edited for space reasons, but the full responses to these and other questions appear at latimes.com/california

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