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Urgent need, serene space

August 11, 2011

Most of us are familiar with “urgent care” as the place to go when a medical situation’s not dire enough for the emergency room—but too serious to ignore.

Now apply that concept to mental health issues and you’ll have a picture of what the county’s now offering in a newly-opened facility.

The Olive View Community Mental Health Urgent Care Center, located at 14659 Olive View Drive in Sylmar, is expected to serve 5,000 people a year and to relieve crowding in the psychiatric emergency room of the nearby Olive View-UCLA Medical Center by assessing and treating patients in psychological distress, as well as helping them to swiftly secure follow-up care.

The facility is not just state of the art, it’s full of art—funded under the county’s Civic Art policy and created by Amy Trachtenberg and Jeffrey Miller. Artful elements in the new center explore bright yet soothing motifs, imbued with natural elements. The message—architecturally, artistically and clinically—is one of healing and hope.

The $10.8 million, 10,800-square-foot project—which has earned LEED silver certification—will serve clients from the San Fernando, Santa Clarita and Antelope Valleys. The new facility will allow the county to serve an additional 2,000 people a year. Its opening comes as economic pressures and joblessness are adding stress to the lives of many.

“Opening this new mental health facility today could not have come at a better time. It’s not a moment too soon,” Supervisor Zev Yaroslavsky said. “Demand for our services is going up.”

Here’s a look at the new facility, inside and out:

Posted 8/11/11

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New health chief rolls into town

November 4, 2010

In the public imagination, San Francisco and Los Angeles have long been California’s odd couple. They’ve got cable cars, we’ve got freeways. They’ve got cioppino, we’ve got burgers. They’ve got the pennant-winning Giants, we’ve got…oh, never mind.

But soon San Francisco and L.A. will have someone very important in common:

Dr. Mitchell Katz.

Katz, San Francisco’s top health official since 1997, is set to leave the City by the Bay to become L.A. County’s director of health services in January.

His charge: to lead the vast county health care system into the future—fast. In the course of the next three years, Katz and his department will seek to reshape how care is delivered here. That means implementing national health care reforms that emphasize preventive care and increase access to outpatient services rather than continuing to pour resources into the large public hospitals that have long been the cornerstones of the L.A. system.

“Something I’d like to work on in Los Angeles is creation of a comprehensive ambulatory care system that includes both the private providers and the public providers,” Katz said, describing the county as the “glue” that would unite the systems. “Every clinic has to be clearly connected to a hospital that takes their referrals.”

He also wants to create a “system of record” in which each patient will have a “primary care home” and medical records in a centralized registry. That will make it easier for providers to know, for example, which patients have diabetes and to make sure they keep up with the eye exams their condition requires.

Katz, 50, said he is a “change agent, not a figurehead.” Even as San Francisco’s top health official, he still makes a point of working as a hands-on doctor for about one day a week—something that the Harvard Medical School grad intends to keep doing when he gets to L.A.

“You find out what’s working and what isn’t,” he said. Moreover, the frontline work creates credibility and a sense of shared understanding with the staff—which are important when it comes time to propose new ways of doing things.

“The natural response to an administrator is ‘You don’t know what it’s like to take care of our patients.’ Well, no one ever says that to me.

“When I’m in my room, I have my stethoscope, my prescription pad. I’m like anyone else.”

Katz, who will earn $355,000 a year in L.A., was recruited to come here two years ago but declined, citing unfinished work in San Francisco. That included seeing through the implementation of the award-winning Healthy San Francisco, a voluntary universal healthcare program that provides coverage to more than 54,000 people.

Making the move now, he said, just “feels right.” Many in the Los Angeles County Health Department, which is battling a large deficit and has not had a permanent leader for more than two years, have reached out to him by phone or email since his appointment, offering to do “everything they can to help me,” Katz said.

While Katz believes L.A. and San Francisco are far from polar opposites from a health care perspective—“I think they are more alike than different”—he knows that his management approach will have to change somewhat when he makes the move.

“I’m a very hands-on person,” Katz said. “I know every single health center in San Francisco that’s part of my department. Most of them I’ve actually worked in as a doctor. I can bicycle to any of them.”

In L.A., “I have to think of a completely different way to be. You can’t do a lot of walking around when it takes two hours to drive somewhere.”

The county’s vast sprawl can be even more daunting if you’re a self-described bad driver.

“I’m terrible!” Katz said. “It’s certainly going to be a challenge to me.”

Katz, a committed bicycle commuter in San Francisco, said he can often be seen pedaling around town in tie and jacket, his backpack stuffed with papers. “It’s not unusual,” he said, “for someone to yell out, ‘Hi, Dr. Katz!’ “

After he moves to L.A. in January (his partner, Igael Gurin-Malous, a teacher, and their kids Maxwell, 8, and Roxie, 6, will join him when the school year is over) Katz intends to continue his cycling ways.

He’s looking for a house in a neighborhood, perhaps Silver Lake or Los Feliz, that’s within biking distance of his new office and County-USC Medical Center. He knows he will need to get behind the wheel to get to more far-flung hospitals such as Olive View-UCLA Medical Center in Sylmar. “I’ll just have to do it,” he said.

But he doesn’t sound like he’s planning to become a Southern California car culture convert any time soon.

“I do not love cars,” he said. “I think that the world would be a better place if more people bicycled.”

Posted 10/25/10

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State wins billions in needed federal health aid

November 3, 2010

After more than a year of tortuous negotiations between state and federal health officials, it was announced this week that California will receive $10 billion in health aid during the next five years through the renewal of its ongoing Medicaid waiver.

The infusion of new federal funding will expand health coverage for uninsured low-income residents, improve access and quality of care for seniors and the disabled, and help implement federal health care reform when its new rules take effect in 2014.

The negotiations took place between the Centers for Medicaid and Medicare Services and California’s Department of Health and Human Services.

The County of Los Angeles—constituting roughly 30% of the state’s population but 34% of the state’s medically indigent and 36% of those living below the federal poverty level—will be a major beneficiary of the aid. Those funds have helped to underwrite the County’s continuing reform and restructuring efforts since 1995, when the Clinton Administration granted the initial five-year federal waiver under Section 1115(a) of the Social Security Act.

That waiver allowed Los Angeles County to reconfigure its health-care services, creating public-private partnerships with non-profit community-based clinics and expanding ambulatory and outpatient services with federal money. This was accomplished by “waiving” federal requirements that had restricted the funding to reimbursement for in-patient hospital services, the costliest type of medical care.

To learn more about the recently approved agreement, formally known as California’s “Bridge to Reform: A Section 1115 Waiver Proposal,” visit the California Department of Health Care Services site here.

Posted 11/03/10

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Cash infusion will let TB ward open

September 29, 2010

Supervisors on Tuesday approved $1.1 million to staff a new ward for patients with tuberculosis and other infectious diseases at Olive View-UCLA Medical Center, clearing the way for the facility to begin operating next year.

The supervisors’ decision to fund the unit came as a result of a motion by Supervisors Michael D. Antonovich and Zev Yaroslavsky. The money will be enough to staff the unit, set to open in March or April, for just half a year. Going forward, it will cost $2.2 million annually to staff the facility—less than was originally envisioned because of lower operating costs and more potential revenue from moving patients into the facility from other parts of the system. Even the reduced costs, down from $4.6 million originally estimated, will add to the department’s deficit but also will provide needed health care beds for infectious disease patients elsewhere in the overcrowded system.

“It does not make sense for this brand new building to sit empty [when] for a relatively small cost, it could be part of the solution to overcrowding in the hospitals and provide more appropriate care to these long-term patients,” the supervisors’ motion said.

Tuberculosis has been declining for years in Los Angeles County, but public health officials say it is important to remain vigilant. The new ward is seen as an important resource for treating some patients who require long-term hospitalization, including the homeless and those who live with small children and people with compromised immunized systems. The county lost its only dedicated tuberculosis ward when High Desert Hospital in Lancaster closed to inpatients in 2003.

The new Olive View facility also could be used to treat victims of a bioterrorism attack, and, on a more routine basis, for patients with infectious diseases other than tuberculosis. Such patients now often are confined to isolation rooms within intensive care units but could be relocated once the Olive View facility is up and running.

Carol Meyer, chief of operations for the Department of Health Services, said the decision to fund staffing for the new facility was a mixed bag: an added ongoing expense for an already financially-troubled system but, “from a patient perspective, it’s a positive.”

Posted 9/29/10

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Meet the new MLK Board

August 10, 2010

If it all begins at the top, the new Martin Luther King Jr. hospital is getting off to a powerhouse start.

A seven-member board of directors for the new facility, being created as a partnership between the county and the University of California, was approved Tuesday by the Los Angeles County Board of Supervisors.

The board’s members, who came jointly recommended by the county’s Chief Executive Office and the UC, are Southern California leaders in the fields of medicine, health care management, business and law. (See bios below.)

One of the appointees, Paul King, the president and chief executive officer of Children’s Hospital of Los Angeles Medical Group, said the array of talent and experience on display among his new colleagues would be enough to intimidate many hospital administrators.

However, he said, this will be a board “that understands the difference between governance and management.”

The directors, who are expected to come together soon for their first meeting, will work with the project’s management team as it moves toward opening the facility in 2013. Under the agreement, the county is funding and rebuilding the facility to modern seismic standards while the UC is taking charge of all physician services there. The private, non-profit hospital will have 120 beds.

It will replace the former Martin Luther King Jr./Drew Medical Center, which closed to inpatients in 2007 after years of mismanagement and patient care lapses. The idea of joining forces with the UC to create the new hospital was first proposed by Supervisor Zev Yaroslavsky.

Helping to restore a crucial health care provider to people in South Los Angeles is a strong motivator for the directors, who will serve without pay.

“I think it’s an exciting time,” said one of the new board members, Manuel A. Abascal, a partner at Latham & Watkins. “I think every community deserves great health care.”

Other new directors echoed that sentiment. “I really believe that the South Los Angeles community deserves better access to quality health care,” said Dr. Elaine Batchlor, chief medical officer of L.A. Care Health Plan.

But no one was underestimating the size of the challenge ahead.

“It’s going to be quite the task,” King said. “Most of us who’ve been approached look upon this as a community service, seeking to really return health care to that community…We’ve got a lot to do. 2013 will come faster than anybody thinks.”

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