Knabe Seeks Plan to Create a County Hospital Authority
Responding to a damning report on problems with patient care at Martin Luther King Jr./Drew Medical Center, Los Angeles County Supervisor Don Knabe called Tuesday for county officials to draft a plan to create an independent health authority to run the county’s hospitals.
The proposal marks a tentative first step toward removing oversight of the county’s five public hospitals from the Board of Supervisors -- one of many recommendations included in a report issued Monday by a consulting firm hired to overhaul King/Drew.
The board has rejected similar proposals at least twice in the last decade, but Knabe said medical failings at King/Drew and threats to its funding meant that supervisors must reexamine the issue.
He wants county administrators to draw up a “workable plan†for a health authority, examining issues as varied as who would sit on the board and how much control they would exercise over county health budgets.
The idea is likely to win approval next week. So far, Supervisor Mike Antonovich is alone among his colleagues in publicly opposing a health authority, which he says would just add an unnecessary layer of bureaucracy.
In recent weeks, Supervisors Zev Yaroslavsky, Gloria Molina and Yvonne Brathwaite Burke have expressed at least lukewarm support for a health authority to run King/Drew in Willowbrook, south of Watts.
Knabe said he was leaning toward supporting a health authority as long as it would control the county’s funding for hospitals, rather than having to go to the Board of Supervisors every year for money.
“It doesn’t do any good for them to do operational things and us to do money and, at the end of the day, we’re spitting at each other,†he said.
Knabe’s proposal came a day after Navigant Consulting, which is running King/Drew under a one-year, $13.2-million contract, released a lengthy assessment of the hospital’s ingrained troubles. And it came the day that Navigant briefed two dozen members of the community in a meeting at the hospital.
Consultants told the group that although King/Drew had many fine doctors and other staff members, patient safety was often lacking.
Some in the audience blamed the county Department of Health Services for the troubles, and told the consultants they should have focused more attention on the department.
“As surely as our reputation is on the line, so is your reputation,†said Lillian Mobley, a longtime King/Drew supporter.
Citing “politics†as the most disruptive force in running the hospital, Navigant recommended that supervisors immediately create an independent board of healthcare experts to oversee King/Drew and, in the future, consider an authority to run all county hospitals.
“The oversight body needs to be empowered to make changes,†Navigant’s report said, and “be independent of historical political interference.â€
Besides King/Drew, the county runs Olive View-UCLA Medical Center in Sylmar, Harbor-UCLA Medical Center near Torrance, County-USC Medical Center in Boyle Heights and Rancho Los Amigos National Rehabilitation Center in Downey.
Local medical experts welcomed Knabe’s proposal.
“It’s a great idea,†said Dr. Daniel Higgins, president of the Los Angeles County Medical Assn. “There’s so much politics -- unfortunately -- that [county supervisors] have to deal with, that it’s hard to get things done.â€
Currently, the supervisors delegate operation of the county’s public hospitals to the health department, but the board periodically intervenes.
Last month, The Times published a five-day series of articles chronicling errors and neglect at King/Drew that repeatedly injured or killed patients. When problems had become public, the board had often responded with half-measures, not lasting changes, The Times found.
Most of the two dozen healthcare experts The Times asked for solutions to King/Drew’s long-standing problems said a health authority or other independent board would put hospital oversight into the hands of people with the will and independence to fix problems.
The idea of a health authority is not new to the five supervisors, who all have served on the board at least eight years.
The county’s health crisis manager pitched the idea in December 1995, saying an oversight group would inject badly needed expertise into the health department. Only Yaroslavsky wholeheartedly supported the idea.
In 2002, a blue-ribbon commission, appointed by the supervisors to study alternative ways to oversee county hospitals, again proposed setting up a separate healthcare authority.
The idea was shelved because the health department was dealing with a financial crisis, said the county’s chief administrative officer, David Janssen. Little has changed since then.
“I think the same principal issue is going to face us again,†he said. “Can we afford a one- to two-year diversion of the organization
*
Times staff writer Steve Hymon contributed to this report.
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