In a unanimous vote that sparked cheers of "thank you" from the audience, University of California regents on Thursday approved a partnership with Los Angeles County that clears the way to reopen the Martin Luther King Jr. medical facility in Willowbrook, possibly by 2013.
The regents, some expressing concern about potential pitfalls, said they acted out of a moral imperative to aid the South L.A. community for which the hospital was once a point of pride. But many hurdles remain.
"This is a proud day for the University of California," said UC President Mark G. Yudof. "The reopening of Martin Luther King Hospital will provide not just adequate care but the best care to the underserved."
The agreement, which creates a nonprofit entity to oversee the hospital and handle all hiring, is a crucial step in reviving the long-troubled facility, which shut down two years ago after repeated findings that inadequate care had led to patient injuries and deaths. Dire problems at the hospital were the subject of Times investigations in 1989 and in 2004, a series that won the Pulitzer Prize for Public Service.
Many view the death of Edith Rodriguez, 43, in May 2007 as the final straw. Rodriguez had writhed on the emergency room floor for 45 minutes as a janitor swept around her, an incident captured on security video. Within months, the ER and inpatient units were closed after federal officials threatened to pull funding.
L.A. County supervisors had initially promised to reopen the hospital by this year.
Under the plan, the King hospital will be considerably smaller than it had been, 120 beds instead of 233. It will include an emergency room and three operating rooms but no trauma center, a sore point with some supporters.
Even so, numerous improvements will be needed at the campus, which was built in 1972. Plans call for a new outpatient clinic and substantial interior construction at the existing tower, at a cost of more than $350 million.
Before they voted, Eddie Island urged his fellow regents to not delay.
"There is no greater public good than to engage and embrace the need a community has for healthcare," said Island, a retired Santa Monica attorney who called partnership "the right thing to do."
After the vote, several hundred supporters gathered outside the hospital, now the site of an outpatient clinic, as Supervisor Mark Ridley-Thomas shared hot dogs with constituents. Erma Hall-Wood, a retired county nurse, recalled that she wept when the hospital was shuttered.
"There's a lot more work to be done," she said, "but we can do it."
The regents voted yes after L.A. County officials promised to seek a $100-million letter of credit to underwrite the hospital for up to six years, should the facility fail. In addition, the county will contribute $73 million annually to cover expenses and operating costs. Further underwriting the effort, Los Angeles pharmaceuticals billionaire Patrick Soon-Shiong last month offered a $100-million guaranty, and on Thursday, Bob Ross, president and chief executive of the California Endowment, announced a $5-million gift.
Still, the plan to partner with L.A. County drew tough questions from some regents.
"Our reputation is going to be involved," said George Marcus of the Palo Alto-based Marcus & Millichap Co. investment firm.
Regent Norman Pattiz, founder and chairman of Westwood One radio network, called the partnership a "new national model" but warned "if we don't perform, it's going to have a disastrous effect. This is not something we can easily extricate ourselves from if this thing starts to go bad."
John Stobo, UC's senior vice president of health sciences and services, said the partnership protects the UC system legally but cautioned: "The court of public opinion is another thing."
After the vote, Supervisor Don Knabe said the county will be a reliable partner. The board is expected to formally approve the agreement Dec. 1.
"I was chair of the board when we voted to close MLK," Knabe said as he celebrated amid dozens of supporters. "I can't tell you what this means to me today."
Ridley-Thomas, who campaigned last year on promises to reopen the hospital, said the board is poised "to provide healthcare and top-quality services on an inpatient and outpatient basis for the people in the county who in many ways need it most."
Under the proposal approved by the regents, the university will provide 14 to 20 full-time physicians and medical oversight for the inpatient hospital, while the county will continue to staff and operate its ambulatory care center, Stobo said.
A new nonprofit governed by a seven-member board of directors -- two appointed by the UC president, two by L.A. County officials and three jointly -- will oversee the hospital. The directors, whom officials hope to name within a year, must have at least 10 years' experience in healthcare. They could decide to operate the hospital or to hire another company such as Catholic Health Care West, which has expressed interest in the past. The nonprofit entity will retain all hiring powers, a key concession that will make it possible to start fresh without the county requiring that past King employees be given back their jobs.
"I'm absolutely confident that what has happened in the past will not be repeated," said Assembly Speaker Karen Bass, who serves on the Board of Regents.
The reopening would be a significant victory for community advocates, who say South L.A. became increasingly underserved as emergency rooms and hospitals closed. The area -- whose population suffers disproportionately from chronic conditions such as diabetes and heart disease -- has one hospital bed per 1,000 residents, compared with a national average of three beds per 1,000 residents.
While the nonprofit is forming, the county plans to begin $237 million in renovations to the hospital inpatient tower and build a $139-million outpatient ambulatory care center nearby. County officials said they will apply for $56 million in federal stimulus funds to offset construction costs. Construction is scheduled for completion in December 2012, and the hospital could open by 2013. At the outpatient clinic Thursday, patients expressed gratitude.
"I was knocked off my feet when I heard," said Jackie Tobias, 59, of South Los Angeles, who was there with her sister. "I'm just happy that it's opening, because it's something that the community really needs."