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The county supervisors respond

The Troubles at King/Drew: The Search for Answers

December 23, 2004|Mitchell Landsberg | Times staff writer

As the governing body of King/Drew hospital, the Board of Supervisors is ultimately responsible for reforms there. The following are excerpts from interviews conducted by Times staff writer Mitchell Landsberg:

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The question: Has the board taken adequate steps to fix the hospital's problems? If not, what more should be done?

Michael Antonovich: Well, the board has given full authority to the director of health and the CEO to remove incompetent or negligent staff and to report Civil Service obstacles that hinder this effort. The Navigant [consulting] contract and the closure of the trauma center will allow us to focus on the core medical services and place King/Drew on the right track.

Yvonne Brathwaite Burke: I'm very optimistic about Navigant and their responsibilities, where they're going and the assessment that they're doing. I'm confident that they know what they're doing, that they've experienced these things before and that they will come up with the necessary steps to correct those problems that the hospital has experienced

Don Knabe: I guess my feeling is that at this point we've taken the adequate steps necessary to at least get a handle on the problem. As far as what more needs to be done, I guess we'll have to wait and see what Navigant recommends. We've done the adequate steps to try to get our arms around the problem, instead of continuously fixing it with Band-Aids.

Gloria Molina: You know, we keep assuming we are taking the appropriate and adequate steps necessary to do the final fixes, and yet at the same time, it doesn't seem to fix itself. Other than myself going in there with a whip, I don't know how else you can bring any order. We're hoping that Navigant is going to be our answer. We don't know that Navigant is going to be successful.

Zev Yaroslavsky: Well, I think the board has taken important and unprecedented steps to fix the hospital, and there's a lot more to be done. We've made a long-overdue decision to take ownership of the problems at MLK, and to treat the hospital as a countywide asset rather than a district facility. This is just a beginning. Hopefully, it's the end of a shameful and painful history at this hospital.

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The question: Is it time to consider an independent hospital authority to run the county hospitals?

Michael Antonovich: No, funding another layer of bureaucracy does not improve efficiency and quality. Historically, the effectiveness of authorities of this nature has been dismal.

Yvonne Brathwaite Burke: I'm still open to consider an authority. I recognize that it's a long process. I am more than willing to continue to listen to exactly how it would be implemented.

Don Knabe: I think it's always time to look at that issue. I've not necessarily been a strong advocate for it. The only thing I've ever had a concern about is how is it structured.

Gloria Molina: I don't know. We looked at this and it's not such a terribly bad idea ... but I don' t know that that's going to dismiss me from accountability. I don't know that that's going to create the fix.

Zev Yaroslavsky: I have long advocated a health authority for the county health system. But it's not a silver bullet. It does not in and of itself create excellence, and it does not in and of itself rid an organization of incompetence or failure.

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The question: Should Civil Service rules be changed to make it easier to fire incompetent workers?

Michael Antonovich: Yes, yes, yes. Where public safety is concerned, we cannot tolerate a Civil Service system that protects incompetence and life-threatening negligence.

Yvonne Brathwaite Burke: Civil Service rules, if carried out properly, make it possible to fire incompetents. Now, in order for Civil Service rules to work, you have to have the evaluations and you have to be willing to make decisions that those employees will be terminated.

Don Knabe: Absolutely. And you know, nobody's trying to weaken the Civil Service system, or at least that's not my perspective. But certainly when there's wrongdoing, there has to be an immediate process of some sort to remove them from the system.

Gloria Molina: The problem is management isn't handling Civil Service well. Our own lawyers aren't even prepared on some of the cases when they go before the Civil Service Commission. So I'm not willing to say, at this point in time, the only way to do it is to get rid of Civil Service.

Zev Yaroslavsky: Look, Civil Service rules can be a barrier to swift and decisive action in any governmental organization, and they're often used as an excuse. But the problems at MLK cannot be laid at the doorstep of the Civil Service system.

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The question: There's a risk that the hospital could lose both its accreditation and its federal funding within a year. Under what circumstances would the county close it?

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