Supervisors order probe of problem workers at King

The Los Angeles County Board of Supervisors launched an investigation Tuesday into the failures that allowed problem employees from Martin Luther King Jr.-Harbor Medical Center to continue working in violation of county policies.

Acting Auditor-Controller Wendy L. Watanabe was ordered to complete within four weeks an investigation that will identify the people responsible for the flawed oversight of the problem employees -- those who had county discipline records or who had criminal convictions -- and to recommend reform.

But the supervisors acknowledged that any reforms that improve the tracking of employees would not necessarily be in place before the county moves forward on a long-delayed downsizing of hospital staff, by about 140 employees, next month. Many of them will transfer to other county facilities.

Supervisor Zev Yaroslavsky proposed the investigation of the oversight of employees after acknowledging that questions from his office and others have so far not resulted in a full accounting by the Department of Health Services.

The auditor-controller “has greater resources to answer the questions I have posed, and the board and public have found their work product to be credible and valuable,” Yaroslavsky said.

The Times reported in recent weeks that the county had not fully tracked employees who worked at the hospital in Willowbrook, just south of Watts, when it closed in-patient services a year ago after years of medical errors that led to patient deaths. As a result, the county has been unable to determine whether the disciplinary process had been completed in many cases, whether employees’ problems have reoccurred and where the problem employees are working in the county’s system of hospitals and clinics.

Additionally, as a result of a review prompted by articles in The Times, the county uncovered neglected records that showed that 17 King-Harbor employees had committed serious crimes or had lied about their criminal histories. Disciplinary action against those employees has begun, but the county has so far refused to identify them or their crimes.

Kathy Ochoa, a lobbyist for Service Employees International Union Local 721, which represents most King-Harbor employees, unsuccessfully argued that the investigation should be completed before the county moves additional employees from King-Harbor, now the site of an outpatient clinic that officials consider overstaffed.

“The worst thing that can happen is that we spend all of this time identifying what went wrong in September ‘07, only to come back and hurriedly repeat the same problems in August ‘08,” Ochoa said.

But the supervisors have grown impatient with the relative costliness of the facility.

The county is struggling to address the persistent financial inefficiencies at the outpatient clinic.

Patients have continued to come to the facility for outpatient services since emergency and other in-patient services ended a year ago. In that time, the county paid an average of $1,681 per patient visit at King while paying $1,121 per visit at a similar outpatient clinic in the Antelope Valley.

At the same time, the King clinic’s poor reputation has kept patients away: 180,000 visits were expected over the last year, but only 120,000 patient visits were reported.

The inefficiency has limited the effect of the $200 million spent on the King facility over the last year at the same time that the need to stretch every dollar has grown.

By many measures, South Los Angeles is one of the most medically underserved areas in L.A. County.

Additionally, in an area where the vast majority are uninsured, the facility and surrounding private hospitals expect to feel the brunt of proposed cuts by the state and federal governments to the Medi-Cal program -- estimated to cost L.A. County $240 million.

As the financial problems mount, some supervisors have chided the officials who run their hospital system for being slow to respond to the challenges.

County Chief Executive Officer William T Fujioka and Interim Health Services Director John Schunhoff said the cost of King visits is high because the patients it treats have more severe symptoms, the facility is large and the clinic provides a greater variety of services than the Antelope Valley clinic.

“In an organization this big, responses to these kinds of issues need to be highly professional and backed up with data, not anecdotes,” Yaroslavsky told Fujioka at a recent budget meeting. “If I told you every excuse ... about why things don’t work the way they should work, you wouldn’t keep me if I worked for you.”

The Health Services officials promised last month to provide a comprehensive plan to bring down costs, but it has so far not been delivered.

“It’s embarrassing,” Yaroslavsky said at the budget meeting. “We’re into the second fiscal year since the closure of Martin Luther King Hospital, and we’re still doing the same darn thing we were doing before, which is spending more money in that complex than we are spending at any other place in the county.”

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garrett.therolf@latimes.com