Hospitals & Clinics

Taking the temperature at MLK

No one will feel the impact more keenly of the deal between Los Angeles County and the University of California than the patients of Martin Luther King Jr. hospital.

Patients and family members interviewed there Thursday shared high hopes that the partnership to operate the 40-year-old hospital complex in Watts will dramatically improve and expand medical services to the South L.A. communities it was built to serve.

Most thought that UC physicians enjoyed a high reputation and expect staffing levels to improve. Patients also hope that the new operators will move quickly to reopen shuttered hospital services such as the emergency room and expand specialty medical care to cut wait times and improve service.

Today’s UC vote brought a holiday spirit to the beleaguered medical facility. Second District Supervisor Mark Ridley-Thomas hosted a raucous lunchtime celebration in the hospital’s auditorium with patients, community members, hospital staffers and union officials. Many were sporting stickers reading “Open a New MLK Hospital. We are ready to partner.”

Even patients who didn’t know about the new agreement were optimistic. “I think it’ll be great,” said Marco Godoy, 42, of Norwalk, visiting the Urgent Care clinic with his son Andrew, 21, who’d injured his foot. “This hospital has had a reputation for not being well run. With the leadership coming in from the UC, I think service can only go up.”

Many patients expect a more streamlined and effective administration. Timothy Bingham, 62, believes that the old regime’s major shortcoming wasn’t ineffective medical care. The real problems, he argues, were caused by administrators who “operated and manipulated” the hospital as a jobs program rather than as a health-care provider.

“This is a nice facility, and the community deserves that it be well run for everyone’s benefit,” said Bingham, a retired schoolteacher who was receiving dental care at the hospital on Thursday.

Security guard Markus Cook said he also looked forward to a new day of improved administration and medical care for Watts and all of South Los Angeles County. “I would expect the UC to do a better job running the hospital,” said Cook, who retired from the Los Angeles Housing Authority and was keeping an eye on a remote parking lot Wednesday. “They have a better reputation and they’ll want to protect it.”

Still, a few patients had reservations about the advent of the UC regime.

“I’d rather not see them come in,” complained Tony Allen, 77, who said was happy with MLK hospital services before the closure. He’s afraid UC medical personnel will be “elite…prima donnas” culturally unable to connect with the hospital’s working class patients. “They wouldn’t know how to act with the community,” said Allen, a musician who leads the Watts 103rd Street Band and sat ramrod straight as he waited to obtain heart medication. Calling his doctor “the best,” Allen said he doesn’t want to lose him in the changeover.

Despite such misgivings, hopes are high that the chaos of recent years is nearing an end. Said Jeanetta Shamburger, who was visiting the internal medicine clinic for a checkup: “I expect to see more doctors here, and I think there’ll be less pressure on them” as they strive to deliver good medicine in an area that needs and deserves it.

MLK hospital: “Like a Phoenix rising” *

The University of California regents voted today to join forces with Los Angeles County to create a new hospital at the site of Martin Luther King Jr.-Harbor Medical Center—a signal of hope, innovation and commitment rising from one of the nation’s most distressing health care failures.

The unanimous vote, which came moments after the regents’ health services committee approved the plan, creates a partnership widely hailed as a potential national model.

“This is like a Phoenix rising in the heart of South Los Angeles,” said Regent Monica Lozano.

UC President Mark Yudof called it “a proud day for the University of California….This is what we do—public service.” He pledged that the new facility would deliver “not just adequate care” but “the best medical care.”

Supervisor Zev Yaroslavsky first advanced the idea of a County-UC partnership in a Los Angeles Times Op-Ed piece last year. “What a difference 18 months makes,” the supervisor said. “This is going to be a great partnership.”

Supervisor Mark Ridley-Thomas, whose district includes the hospital, summed up the feelings of many when he stated simply that the union between L.A. County and the University of California “will have a lasting effect on the quality of health care in Los Angeles.”

After years of mismanagement and patient care lapses, the hospital was dropped from the Medicare program in 2006 and was closed to in-patient services the following year.

Under the new agreement, which now goes to the Board of Supervisors for approval, the county would create a $50 million start-up fund for the hospital and pay $50 million a year to run it, with an additional $13.3 million in county funds going to support indigent care services at the facility each year. It also would provide a $20 million revolving line of credit.

In addition, the county is spending $208.5 million to rebuild the hospital facility and bring it up to seismic safety standards, and $145.3 million to build a new multi-service ambulatory care center (MACC) nearby.

For its part, the UC would provide the “broad spectrum of physician services necessary to operate the hospital” and would direct any teaching activities at the site.

A nonprofit corporation would oversee the new 120-bed hospital, with a seven-member board of directors appointed by the UC President and Los Angeles County.

The relatively small crowd inside the regent’s meeting room in Covel Commons on the UCLA campus on Thursday was sedate compared to the loud crowd of students outside protesting fee hikes. But they erupted into vigorous applause after the vote, and county officials in attendance embraced their UC counterparts.

“Now the real work begins,” L.A. County Chief Executive Officer William Fujioka said, noting that changes to the building schedule should allow completion of the capital project by the end of 2012. “The hope is to get this done in a three-year period.”

For many in the community who’ve followed the MLK hospital saga over the years, the UC’s involvement was critical—a “brilliant stroke,” in the words of Barbara Siegel of Neighborhood Legal Services. “It instills the confidence back into the hospital.”

“It will carry the imprimatur of quality that the UC is known for,” added Dr. Hector Flores, chair of family medicine at White Memorial Medical Center, who has been a close observer of MLK since he was appointed chair of the county’s Hospital Advisory Board in 2004.

Flores also noted that the county’s commitment to funding the new hospital is just as important—symbolically and practically—as the UC’s commitment to providing medical expertise.

“Knowing that there’s going to be a facility with safety net support from the county is important,” Flores said. “When you have a new facility in an underserved community, you worry that it’s going to end up closing.”

*Updated (12/1):

The Board of Supervisors today directed the county’s chief executive officer to hammer out specifics of a coordination agreement with the University of California for the new MLK hospital.

The supervisors also authorized CEO William Fujioka to create a project management team to oversee key next steps, including forming the non-profit and helping with its start-up; overseeing and coordinating the building process; and working out agreements on matters including indigent care.

“This is the beginning of a substantial effort,” Fujioka told the board.

The motion, by Supervisor Mark Ridley-Thomas, requires the CEO to provide progress reports to the board at least every three months on project milestones and anticipated costs. An amendment by Supervisor Michael D. Antonovich directed Fujioka to provide “actual expenditures, both anticipated and unanticipated” on the project, as well as projected budgets for construction and for the cost of putting into place the organization that will run the new hospital.

At the meeting, Fujioka introduced members of the “King Team”—a cross-departmental group of 14 that has helped push the project to this point. Among those saluting their work was Supervisor Zev Yaroslavsky, who hailed the recent regents’ vote as an “important milestone” and said, “I just want to congratulate everyone who’s been a part of this.”

Regents’ landmark MLK hospital vote expected Thursday

After months of negotiations, the plan to create a thoroughly transformed hospital on the site of the former Martin Luther King Jr./Drew Medical Center comes down to nine people: the members of the University of California Board of Regents’ committee on health services.

The deal that UC Senior Vice President John Stobo will present to the committee Thursday morning at UCLA’s Covel Commons calls for the creation of a new community hospital—staffed by UC doctors, funded by L.A. County and governed by a newly-formed private nonprofit corporation.

Hundreds are expected to attend the meeting, a milestone in the difficult journey to chart a new course for MLK, which closed as an inpatient facility in 2007, following years of mismanagement, neglect and poor patient care.

The UC partnership idea was first put forward by Supervisor Zev Yaroslavsky last year in an L.A. Times Op-Ed piece and has gathered momentum ever since. The regents’ vote would be the first to formally link the county and the UC on this project.

UC President Mark G. Yudof supports the proposed deal and is urging the health services committee to recommend its passage to the full board. If approved by the committee—which is headed by Sherry Lansing, the Regents’ vice-chair—the proposed agreement would move quickly to the full Board of Regents, which could take action immediately. The Los Angeles County Board of Supervisors also would need to approve it.

“For myself, I can say that I am very, very supportive of it,” Lansing said Wednesday. She said that she had not discussed it with other regents but she believes that they, too, are committed, in general, to a mission of providing healthcare in under-served communities.
“I myself feel it’s a moral imperative,” Lansing said. “The holdback is that we’ve had these enormous cuts in the legislature…We needed to be assured from a financial standpoint.” She applauded the work of the county and of Stobo and said that she believes those assurances are now in place.

Under the agreement, the county would create a $50 million start-up fund for the hospital and pay $50 million a year to run it, with an additional $13.3 million in county funds going to support indigent care services at the facility each year. It also would provide a $20 million revolving line of credit. In addition, the county is spending $208.5 million to rebuild the hospital facility and bring it up to seismic safety standards, and $145.3 million to build a new multi-service ambulatory care center (MACC) nearby.

For its part, the UC would provide the “broad spectrum of physician services necessary to operate the hospital” and would direct any teaching activities at the site.

The nonprofit corporation in charge of the new 120-bed hospital—which could open as early as late 2012—would be overseen by a seven-member board of directors appointed by the UC President and Los Angeles County.

Although the UC’s analysis shows the new hospital would be expected to have a positive cash flow, the university system asked for and received a commitment from L.A. County to secure a $100 million letter of credit to “backstop” its commitment to funding the new institution over the first six years.

Olive View/UCLA Medical Center

Northeast Valley residents can look forward to greatly expanded emergency room services at Olive View/UCLA Medical Center under the hospital’s new ER project. On April 16, Yaroslavsky and other officials broke ground for new facility, which will offer 51 treatment areas in 32,000 sq. ft of space, virtually doubling the size of the existing ER, which currently handles 42,000 emergency and 19,000 urgent care visits annually. Among the numerous state of the art amenities will be 16 adult critical care rooms, six pediatric treatment rooms, five OB/GYN exam rooms, and a new 11,000 sq. ft. acute care/isolation unit with 15 two-person inpatient isolation rooms for patients with infectious diseases.