Hot Seat
L.A. County Health Department gets new director just ahead of scheduled King/Drew inspections
By Bobbi Murray
Moving quickly to fill a power vacuum at the top of L.A. County's vast health department, the Los Angeles County Board of Supervisors on Tuesday appointed Dr. Bruce Chernof as acting director and chief medical officer of the county Department of Health Services. He replaces Dr. Thomas Garthwaite, who resigned last month. Chernof had been serving as senior medical director for the department.
The supervisors also asked Chernof to find a recruiting firm to conduct a nationwide search to find Garthwaite's replacement. That may not be easy. Two things are striking about Garthwaite's resignation: few front-row observers were surprised, and fewer would blame him for bolting.
Like his predecessors, Garthwaite became the focus of a time-honored ritual at Board of Supervisors meetings: a public drubbing by his bosses every Tuesday morning. Dr. E. Richard Brown, director of the UCLA Center for Health Policy Research, described it as "bringing the director of the department before them and beating him up" until he resigns. There have been three different chiefs in less than a decade.
Garthwaite has accepted a job with Catholic Healthcare East in Pennsylvania, a move he said was about being close to his family.
But Garthwaite's end-of-year departure raises questions for one of the most seriously ill patients in the county's system: King/Drew Medical Center, the troubled facility founded three decades ago in response to the official neglect that helped spark the 1965 Watts riots. It faces two essential inspections in early 2006 that may result in the loss of its accreditation. Garthwaite was so concerned about King/Drew's ability to pass that he explored the possibility of a takeover of its operations by the Catholic Healthcare West chain. (CHW is unrelated to Catholic Healthcare East, Garthwaite's new employer.)
"Hopefully it won't have any effect," says John Wallace, director of external relations for the L.A. County Department of Health Services, about Garthwaite's departure. "Dr. Garthwaite really hasn't been involved in the day-to-day operations of King/Drew for quite a while now."
But observers outside of the department worry about the timing. One Garthwaite critic has been Sylvia Drew-Ivie, a noted public-health professional who was a member of the Hospital Advisory Board appointed by the supervisors earlier this year to help change the culture at ´´ King/Drew, then suspended in October. Despite disagreements with Garthwaite about approaches to fixing the medical center, Drew-Ivie says having him in place during the review processes would have been helpful. She hasn't worked with Chernof closely enough to offer an opinion, but calls Garthwaite "an effective, credible presenter of ideas. He would have presented the progress made at King/Drew in a good light."
But Drew-Ivie is encouraged by new King/Drew CEO Antoinette Smith-Epps, who took over in October and has impressed community health advocates and public officials alike with her political deftness and hands-on approach to reorganizing the troubled hospital.
Lark Galloway-Gilliam, executive director of the Community Health Council and a spokeswoman for the Coalition for Health Justice, is heartened that Epps stepped in and initiated no-nonsense basic accountability practices - such as chart reviews signed off by doctors and proper dietary supervision. These are the kinds of things, Galloway-Gilliam says, that inspectors look for. "The best thing the supervisors could do," she says, "is just let Ms. Epps handle that and give her the support she needs."
The upcoming reviews at King/Drew are an immediate challenge, but the health department faces other potential storms as well. Critics of the supervisors' handling of King/Drew in particular and the healthcare system in general would prefer that the board let a hospital authority run the healthcare system. A budget deficit looms, and the old facility at County General faces extensive and costly revamping.
Supervisors are seriously considering a proposal to split the department in two, a move that advocates like Drew-Ivie fear will endanger healthcare access for the most vulnerable populations. Galloway-Gilliam says, "They've got some big stuff coming up."Published: 12/15/2005
DIGG | del.icio.us | REDDIT
