South L.A. Frustrated by Delays in New Hospital

Earlier this year, Joane Austin rushed her elderly mother to the emergency room for fear she was having a heart attack.

Austin normally would have made the short trip to Martin Luther King Jr./Drew Medical Center, the landmark hospital in South Los Angeles. But King/Drew has been closed for five years, so Austin drove several miles to the emergency room at Centinela Hospital Medical Center in Inglewood.

"I prayed all the lights would stay green," she said. "It was scary."

Once they arrived, doctors determined that Austin's mother needed emergency surgery to remove scar tissue around her intestines.

For years, King/Drew provided emergency, trauma and inpatient care to residents from throughout South Los Angeles. After a series of medical errors resulted in patient deaths, Los Angeles County closed it in 2007. County officials promised the community a better, safer new medical center in a few years.

But the opening has been repeatedly delayed, and the community is still waiting. Originally, officials hoped to have the new facility ready by 2010. Then it was pushed to 2012. Now, officials say they plan to have construction completed next year and the hospital opening its doors in 2014.

Without a nearby hospital, patients have had to travel to such places as Bellflower, Inglewood and Long Beach for emergency room and inpatient care.

Several local hospitals -- California Hospital Medical Center, L.A. County/USC Medical Center and Harbor-UCLA Medical Center -- received an influx of former King patients after the closure. The closest hospital, St. Francis Medical Center in Lynwood, reported an increase of 20% to 30% in emergency room visits since King/Drew closed, though other factors also may have contributed to the rise.

Getting to other hospitals has presented a challenge for many in the low-income neighborhood, said William Hobson, president and chief executive of the Watts Healthcare Corp. "Just the fact that it is a long way away may discourage them from going," he said.

The closure of King/Drew, which was born out of the Watts riots and opened in 1972, created a healthcare gap in a community where rates of chronic disease are high and vast swaths of the population lack insurance, said David Carlisle, president of the adjacent Charles R. Drew University of Medicine and Science. South Los Angeles has a shortage of doctors, inpatient beds and outpatient services, according to both experts and research.

Despite King/Drew's many medical lapses, which earned it the nickname "Killer King," many in the community remained fiercely loyal to the hospital and the services it provided.

Studies examining the impact of King/Drew's closure found that it led to delays in care for elderly blacks and Latinos and a dramatic increase in patient admissions at other trauma centers. Physicians throughout the county also reported more overcrowding in other emergency rooms and said they saw sicker patients who didn't know where to go or couldn't afford transportation elsewhere.

"It is fearful to think about how many lives may have been saved had this thing been opened by now," said Lark Galloway-Gilliam, executive director of the advocacy group Community Health Councils. "It shouldn't take five years to build a facility."

Patrick Wooten, 49, went to St. Francis when he had a dislocated kneecap a few years ago. Wooten, who is uninsured, said he received good care at the private hospital but then got a $3,200 bill. Wooten said he is frustrated that the new King hospital still hasn't opened and won't until 2014. "What you do until then, God only knows," he said. "Hopefully we can wait it out."

Last year, Sandira Gonzalez, 29, took her 5-year-old son to the Martin Luther King urgent care center when he had a fever. But when the center closed for the night, her son had to be taken by ambulance to Harbor-UCLA near Torrance, where he was treated for an infection.

Community members and advocates said they are disappointed by the long wait, caused by a combination of bureaucratic delays and the complexity of the project. But when it does open, they said, they are hopeful that it will be a better, and safer, hospital.

The county is building the hospital and will help support it financially but will not be responsible for day-to-day operations. Instead, an independent, nonprofit organization will run the facility, to be known as Martin Luther King Jr. Community Hospital, and the University of California will help staff it and ensure the quality of patient care. Construction is progressing, but the grand opening may still be nearly two years away.

"It will be a significantly different kind of institution, with the right kind of accountability," said Robert K. Ross, president and chief executive of the California Endowment. "Now we just need the institution to open up on budget and on time."

Los Angeles County Supervisor Mark Ridley-Thomas said it takes time to create a state-of-the-art hospital -- and a whole medical complex -- that could become a model for others around the nation. "A lot of eyes are on this," he said. "We want to do this well and we want to do it right.... Nothing else is acceptable."

The nonprofit's board recognizes how critical the facility is to the area, said board President Manny Abascal. "Every day this hospital is not open, people are suffering," he said. At the same time, he added, the board is committed to ensuring that the new hospital is a high-quality institution. "If you open it ... and there are some of the same problems you had before, then it's going to be devastating," he said.

Los Angeles City Councilman Bernard C. Parks, who ran for supervisor against Ridley-Thomas in 2008, said the long wait for the hospital is a "tragedy" for the residents of South Los Angeles. "Promises were not fulfilled," he said.

Ridley-Thomas said that conducting a land assessment and creating a master plan for the area slowed the process. Negotiations between the county and UC also took longer than expected, because the UC regents wanted to ensure that they were not putting the system at financial risk.

The agreement between UC and the county was signed in 2009, and the nonprofit's board was selected. Instead of hiring Kaiser Permanente or another established operator, the board decided to set up the hospital itself, making all of the decisions from start to finish.

Deciding on the design also took time, with differing opinions on the size and what the hospital should include.

The five-story inpatient tower will be smaller than the old facility, with only 131 beds instead of the previous 233. There will be an emergency room, an intensive care unit, radiology, surgery suites, inpatient rooms and labor and delivery areas, but no trauma center.

The hospital also plans to include health education and outreach programs to focus on prevention and target the rising obesity and diabetes rates in the community. "If you can keep the population healthy and keep them out of the hospital, that's better than having a huge hospital that people go to only because they don't have anywhere else to go," Abascal said.

Construction of the inpatient tower, which is costing more than $237 million, was supposed to finish this year but now won't be done until 2013, said David Howard, assistant deputy director of the county Department of Public Works. Howard said he wasn't happy about the delay but knew from the start that the schedule was aggressive and the project complicated.

The new hospital will be at 120th Street and Wilmington Avenue, in a reconstructed building that was part vacant and part used for trauma and other hospital services.

Aside from the construction, there is still much to be done before the hospital can open, including hiring staff, buying equipment, getting licensed and raising additional funds, said Elaine Batchlor, chief executive of the new hospital. She and the board also plan to continue working with physicians and clinics in the area. And they must do all of this in the midst of some of the most complicated changes to healthcare delivery, set in motion by the federal health law that takes effect in 2014.

Opening a hospital is a "complicated process," said John Stobo, UC's senior vice president for health sciences and services. "It is a lot easier to close it than it is to open it," he said.

Ross of the California Endowment, which has helped fund the new facility, said he witnessed years of "political jockeying and incompetence" around the old hospital. He said that's different now, and that he was optimistic about the caliber of the hospital's leadership. But he added that he would like to see a "different sense of urgency."

Despite the timeline, some community members and medical providers said they are encouraged by the ongoing construction.

Copyright 2012 - Los Angeles Times

McClatchy-Tribune News Service