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Success of new Martin Luther King Jr. hospital could hinge on board's makeup

Seven yet-to-be-named appointees would decide how to run the hospital and whom to hire.

November 23, 2009|By Molly Hennessy-Fiske
  • Outpatients wait in the lobby of the clinic that operates at the Martin Luther King Jr. medical facility in Willowbrook. By 2013, the reborn hospital is expected to have 120 beds and an emergency room.
Outpatients wait in the lobby of the clinic that operates at the Martin Luther… (Don Bartletti / Los Angeles…)

With Los Angeles County supervisors expected to sign off next week on plans to partner with the University of California to reopen the Martin Luther King Jr. medical facility, the hard work -- creating a new hospital from the ashes of the old by 2013 -- begins.

In many respects, the partnership with UC would wipe the slate clean, creating a nonprofit company overseen by a seven-member board of directors who would decide how to run the facility and whom to hire -- a key issue to critics who cite the county's poor history of dealing with problematic employees at the Willowbrook hospital.

Speculation already has begun about who would be named to the board and how they would avoid the kind of mistakes that resulted in the shutdown of inpatient and emergency services two years ago.

"There's going to be a lot of lobbying and fighting over who's going to be on that board. I just hope the authorities can step back and do what's right for the hospital and not the various constituencies," said Jim Lott, executive vice president of the Hospital Assn. of Southern California.

County supervisors closed King to all but outpatient care after the facility failed a make-or-break inspection that meant the loss of $200 million in federal funds. The final failure came after repeated findings that inadequate care had led to patient injuries and deaths.

Lott said county leaders need to establish a new standard of care and transparency at the hospital by choosing experts in the field over allies or community activists.

"Let's not fall back into the trap we've been in for the past 40 years of King's history," he said.

The www.latimes.com/news/local/la-me-king-hospital20-2009nov20%2C0%2C3225184.story "> www.latimes.com/news/local/la-me-king-hospital20-2009nov20%2C0%2C3225184.story last week calls for UC and L.A. County officials each to name two board members and to mutually agree on three others. All board members must have at least 10 years of experience in healthcare or a related field.

William T Fujioka, the county's chief executive, said he will propose to supervisors that a group of full-time county staffers be devoted to the King project, which includes more than $350 million in construction scheduled to be completed by December 2012.

The hospital is to have 120 beds -- it once had 233 -- and an emergency room but no trauma center.

Fujioka said that although it remains unclear how the appointees to the nonprofit board would be selected, vetted or approved, both hospital management experience and knowledge of the community would be considered.

"They need to understand the cultural dynamics of operating in a low-income area -- that's a factor. But most important is knowing how to operate a hospital," Fujioka said.

Supervisor Zev Yaroslavksy, who began pushing for a partnership with UC 18 months ago, said he is looking for board members with practical experience, not connections.

"There's no reason MLK Hospital can't provide the same quality of care the best hospitals in town provide, and it starts with the management," he said

Supervisor Mark Ridley-Thomas, whose district includes King, said he had some potential board candidates in mind but declined to name them, saying it was too early. "There's a diverse talent pool in this region," he said.

Once the board is formed, J. Eugene Grigsby, president and chief executive of the Los Angeles-based National Health Foundation, said the community will be watching to see whether its members act independently or take their cues from county leaders.

"The biggest potential pitfall will be political interference from the Board of Supervisors," he said. "If that happens, the likelihood that the hospital can achieve its goals is called into question."

Grigsby said hiring could become a tug of war between the board and the county. Officials from Local 721 of the Service Employees International Union said about 600 employees at the King outpatient clinic belong to their union, which represents most of the staff. Whether those hired for the new hospital would belong to that or any other union is unclear, county and union officials said.

Grigsby said the new nonprofit structure would allow King officials "to be more flexible in creating relationships with community-based clinics and other providers" than county bureaucracy allowed.

The hospital board could decide to operate the hospital itself, but is more likely to contract with an existing hospital company such as Catholic Healthcare West, which had expressed interest in the past.

One of those interested in serving on the hospital's board, Lark Galloway-Gilliam, executive director of the nonprofit Community Health Councils Inc., said patients will be watching the board's makeup closely.

"We want to make sure not only do we have the level of expertise but also that you have a level of cultural competency," she said. "There's a tendency to believe you can't have both. You can. There are people out there with the skills who look like the people in this community."

Galloway-Gilliam, whose group advocates for healthcare access in Los Angeles, said board members will need to understand King's troubled past and have ambitious plans to connect the hospital to nearby clinics and healthcare providers.

"The county and partners need to invest in the surrounding community," she said, "because at the end of the day, we need more doctors and specialists."

molly.hennessy-fiske@latimes.com

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