Los Angeles County Board of Supervisors Requests Report on Independent Health Authority To Run Hospitals
The Los Angeles County Board of Supervisors on Tuesday voted 4-1 to request a comprehensive "blueprint" proposal to establish an independent health authority to oversee the county's five public hospitals, the Los Angeles Times reports.
The vote follows a preliminary report issued last week by Navigant Consulting that cites lapses in patient care at Martin Luther King Jr./Drew Medical Center, which the board oversees (Leonard/Ornstein, Los Angeles Times, 1/12).
Navigant in November 2004 was awarded a one-year contract to assess the hospital and propose solutions to address its problems. The Navigant report includes about 1,000 recommendations to improve patient care, including appointing a separate, independent board to oversee the hospital. Navigant's report will be finalized Feb. 1, and following its issuance, county officials will have 30 days to decide how to proceed.
From December 2003 until Navigant assumed control, King/Drew's management was the direct responsibility of the Los Angeles County Department of Health Services. Regulators have repeatedly cited King/Drew for patient care problems. The Board of Supervisors in November voted to close King/Drew's trauma center and hire outside managers to operate the hospital. County officials have begun reducing services at the trauma center, and it is expected to close by Feb. 1.
King/Drew on Jan. 19 also is scheduled to lose $200 million in CMS funding after failing an inspection by federal regulators in December 2004. The hospital has a final opportunity to address the problems before it loses the funding. The Joint Commission on Accreditation of Healthcare Organizations also recently issued a preliminary denial of accreditation after JCAHO inspectors visited the hospital several times in response to reports of patient deaths, and JCAHO officials last month denied the hospital's appeal of the decision. JCAHO officials have said they are not likely to reconsider their decision (California Healthline, 1/4).
County supervisors have rejected the creation of a separate board several times in the last decade.
Supervisor Zev Yaroslavsky said, "It's something we need to do, and the time is now. This is not a short-term fix."
Supervisor Yvonne Brathwaite Burke said, "Myself, I have questions about it, but I realize that we have to look at some alternatives. We have a system here that has some problems."
County Health Department Director Thomas Garthwaite noted that a separate body would not be held accountable to civil service and county personnel rules, allowing it to offer higher salaries and more easily remove negligent staff. He expects officials will deliver a plan to supervisors within 90 days. Garthwaite said, "I don't think there's that much digging to do. The reports that have been done in the past are pretty decent."
Supervisor Mike Antonovich, who voted against the request, said, "It's like cotton candy -- a lot of fluff without substance. It makes everybody feel good, but it's not going to solve the problem."
The board on Tuesday also voted to reject a proposal Antonovich submitted that would have required the board to hold quarterly meetings on hospital issues (Los Angeles Times, 1/12).