Friday, August 10, 2007

MLK Blows The Inspection

Los Angeles, CA

Anyone not see this one coming? No? I thought not.

Martin Luther King Jr.-Harbor Hospital has fallen on troubled times. The only hospital in a violent and underserved area of Watts, the hospital has been on the chopping block for some time, desperately trying to get its shit together to stay open. They already had their trauma ward shut down, had their affiliated King-Drew school come under fire, have lots of preventable deaths, and managed to lose a radioactive diaper.

In July a federal inspection from the U.S. Centers for Medicare and Medicaid Services was conducted. Announced today were the findings that the hospital failed 8 of 23 points needed to maintain compliance with federal standards. Think about that for a second. The hospital went below Medicaid's standards. Considering that we have one of the shoddiest public health systems in the entire world, that's pretty fucking sad.

So what does this all mean?

Well, first of all, the hospital will be getting no Federal funding. Half the hospital's budget has come from the Feds to the tune of about $200 million. Buh-bye. Wave to the money folks. It's going away.

And that's actually a good thing. This place is a shithole. It is offering sub-standard care to a segment of the population that desperately needs help. These people are the uninsured and the uninsurable. They come to the hospital because it's their last shot. They don't see a doctor until things are so bad simply because they can't afford it. Emergency room visits have been known to last days.

Then there's the community infighting between the black and Latino population of Watts. They can't seem to see eye to eye with each other enough to help turn the hospital into a fucking hospital and not a political bullet point. I honestly wonder some times if people want a hospital or just something else huge to bitch about.

Thank god the trauma center was already closed. Don't get me wrong, I think the trauma ward was the only good thing about the place. But gangbangers would just kick their buddies out of the car when they got shot up too much to just get a couple stitches. The trauma center was a nightmare factory for the doctor's and nurses, patching up the same kids over and over again, losing too many people to multiple GSW's and stab wounds. Let Harbor handle it. At least there they've shown that they can handle the after care with something resembling competence.

MLK needs to be shuttered. It has proven, time and again, that it can't keep itself in order, its patients safe, or deliver even the lowest standard of quality care. It needs to be replaced from the ground up. Close the hospital, fire the staff, hire new doctors and nurses. Enough of them this time. And ones that have been trained somewhere else than at MLK. Sink some money into competent security. Take the control away from the fucking County Health Department and give it to someone who knows how to handle a hospital and treat patients.

This farce has gone on for too many years. It needs to change. The people deserve it, the city deserves it. Close the place down.


Christa M. Miller said...

I was going to make a smartass comment about radioactive diapers, but this is too serious.

I wonder if the solution is, as government agencies (notably jails) elsewhere in the country are finding, public-private partnership. Whether a corporation owns the facility and lets the government run it, or vice versa. Your thoughts?

Stephen Blackmoore said...

God, there have been so many back and forth semi-solutions that I don't even know where to start.

I think the biggest challenge, next to money, of course, is getting the community to support a plan. Right now the politics are such that it's almost impossible. The hospital has so much political symbolism attached to it (it was built in direct response to the Watts Riots in 1965) that any proposal creates such a public outcry that it slows down any actual solutions.

All solutions are mine fields. Going private is met with the fear that people will be shut out of gaining the medical care they need for lack of insurance and a loss of County oversight (like that's ever helped in the past). Getting additional funding from other sources doesn't solve the problem of substandard care and lack of security.

When it comes down to it, MLK is a field hospital in a war zone. They get cases that could have easily been treated and not become a problem, but because people are poor, uninsured, and uneducated, they're waiting until it's so severe that they have to go to the hospital. So they get the worst cases in there.

My solution, go private. Keep the building, keep the equipment. Fire EVERYONE. Doctors, nurses, janitors, receptionists. The whole fucking lot of them. Bring in a private health care company in a deal with the county, the city and the state that will allow them to get the same funding MLK had, and offer services to the underinsured and those on federal and state insurance plans. And they could run it as a for profit hospital because a large part of their operating expenses will be handled with government dollars right from the get-go. Tack on the Medicaid dollars and patient Medicaid patients and it might work.

Of course, that also means greater outreach to an already antagonistic community, and that requires that the community (including the city as a whole) work to clean up the crime and poverty which is one of the chief reasons the hospital got into the mess in the first place.

The simplest, and the way I suspect they'll actually go, will be to close the whole place down and tell people they need to go to Harbor. They already did that with their Trauma center, and as of 7:00 tonight the Emergency Room is closing down for good. I think they'll do it piecemeal, shuttering services and sending them over to neighboring hospitals that are further afield.

I know they're looking for a private company. Whether they find one willing to run it or not is something else.

Anonymous said...

What an embarrassment. I know the people in MLK work under very difficult circumstances, but even its most ardent defenders have to admit some of the stories are inexcusable.
Will ANY of the politicians, esp. Cong. Waters and Supervisor Burke, EVER be held accountable for ALWAYS resisting reform, but NEVER fighting for better healthcare treatment? Probably not, because the people they represent are apparently too stupid to realize what is in their own best interests. Looking at the photos over the years of the protest groups with "Save King" signs is just pathetic... these people didnt have a clue.
THis is a real embarassment to the black community. Maybe when the place reopens they should run it based on competency and not race.