Los Angeles County Supervisors to Consider Creating a Public Authority for Troubled Health Department
Los Angeles County's Board of Supervisors today will hold its "first formal discussion" about creating a public health authority to control the county's health department, as supervisors' long-time "opposition" to such a move has been "softened" by the department's projected $884 million deficit and reports of substandard care in county hospitals, the Los Angeles Times reports. Currently, the health department, which provides care for Los Angeles County's roughly three million uninsured residents through its numerous clinics and six public hospitals, reports to the five-member Board of Supervisors and as a result is a "highly politicized institution." The county hospitals "operate as virtually independent institutions, not even sharing patient records with one another," and supervisors traditionally have "looked after the interests" of the hospitals in their districts "rather than the system as a whole." And despite "repeat[ed]" attempts to reform itself, the county health care system is "wracked by crises, from medical mishaps to chronic budget woes," which placed the county on the verge of bankruptcy in 1995, necessitating a bailout from the federal government.
Two months ago, following reports by the Times and a county grand jury detailing "dangerous overcrowding" in County-USC Medical Center's psychiatric emergency room, supervisors asked their staff to develop several models for creating a public authority of medical professionals to run the health department. The supervisors will hear this report on Sept. 4 and "could order an additional study." If the supervisors decide to move forward with the authority, state legislation would likely be required, as would "years of uncoupling the health system from other elements of the county bureaucracy." According to the county's administrative office, the transition could take between three and five years. The health authority itself could take such forms as a "county commission composed of experts who deal with daily medical matters and report to political leaders," or a not-for-profit organization that "contracts with" the county but "otherwise runs like a business" (Riccardi, Los Angeles Times, 9/4).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.