BILL ANALYSIS                                                                                                                                                                                                    






                                 SENATE HEALTH
                               COMMITTEE ANALYSIS
                       Senator Elaine K.  Alquist, Chair


          BILL NO:       ACR 2                                        
          A
          AUTHOR:        Hall                                         
          C
          AMENDED:       As Introduced                                
          R
          HEARING DATE:  June 17, 2009
          CONSULTANT:                                                 
          2
          Dunstan/cjt                                                
                                                                       
                                          
                                        
                                     SUBJECT
                                         
                 Management of Martin Luther King, Jr. Hospital

                                     SUMMARY  

          Urges the University of California to expedite negotiations  
          with the Los Angeles County Board of Supervisors and  
          Charles Drew University of Medicine and Science (Drew  
          University) regarding future management of MLK-Harbor  
          Hospital.


                             CHANGES TO EXISTING LAW  

          Existing law:
          Authorizes the board of supervisors in each county to  
          establish, maintain, and operate a county hospital.   
          Existing law also authorizes the board of supervisors of  
          any county to transfer the maintenance, operation, and  
          management or ownership of the county hospital to the  
          University of California, or to any other public agency or  
          community, non-profit corporation empowered to operate a  
          hospital facility, upon a finding that the community  
          services provided by the hospital could more efficiently,  
          effectively or economically be done by the transferee than  
          the county.  

                                                         Continued---



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          The California Constitution provides for the University of  
          California as a public trust under the governance of the  
          Board of Regents, subject to limited legislative control  
          and direction.

          This bill:
          Makes various findings related to the need for the Los  
          Angeles County, Drew University and the University of  
          California to jointly operate MLK-Harbor Hospital and urges  
          the University of California to expedite negotiations with  
          the Los Angeles County Board of Supervisors and Drew  
          University regarding the future management of MLK-Harbor  
          Hospital.
          

                                  FISCAL IMPACT  

          According to the Assembly Appropriations Committee analysis  
          there will be absorbable costs for the University of  
          California to continue its ongoing discussions with Drew  
          University and other parties. 


                            BACKGROUND AND DISCUSSION  

          According to the author, when MLK-Harbor closed, the 1.7  
          million residents of Service Planning Area 6 of Los Angeles  
          County were left without a public hospital in their area.  
          The author believes that the University of California  
          should administer MLK-Harbor because of its success in  
          administering public hospitals and the need for medical  
          doctors and other health professionals to be trained and  
          work locally. 

          Background-MLK Harbor
          MLK-Harbor is located on South Wilmington Avenue in Los  
          Angeles in an area known as Willowbrook.  The hospital and  
          the Charles R. Drew University of Medicine and Science  
          (Drew University) were created in the aftermath of the 1965  
          Watts riots in which 32 people died and 1,000 people were  
          injured.  In December 1965, the McCone Commission,  
          established in the wake of the riots, issued a report  
          citing the lack of adequate health care facilities as a  
          contributing factor to the civil unrest.  This prompted  
          city and state officials to put in motion plans to build a  
          medical school and teaching hospital in the Watts  




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          community.

          On March 27, 1972, the hospital opened its doors to the  
          community as a full-service medical center.  The hospital  
          expanded in 1998, by opening a state-of-the-art Trauma and  
          Diagnostic Center that is dedicated to treating patients  
          who have sustained accidental and intentional trauma  
          injuries.  At its peak, the hospital had a licensed bed  
          capacity of 537 beds and through it's partnership with Drew  
          University, had become a teaching hospital.

          The hospital began to face significant difficulties,  
          culminating in the 2007 vote by the Los Angeles County  
          Board of Supervisors to close MLK-Harbor because of the  
          difficulties facing the hospital, including losing its  
          funding or the possibility of losing its license over  
          allegations of substandard care.  Since the closure of  
          MLK-Harbor in August 2007, the County has been working on  
          developing options to provide hospital services at that  
          site.  In the spring of 2008, at the direction of the Board  
          of Supervisors, the county approached the University of  
          California to assist in this effort.  

          Representatives from the University, Los Angeles County and  
          the Schwarzenegger Administration have been discussing an  
          arrangement that would allow MLK-Harbor to reopen as a  
          viable health care facility.  According to an informational  
          item presented to the Board of Regents at its March 2009  
          meeting, a new non-profit entity would be established to  
          operate the re-opened hospital with a 120-bed capacity and  
          an emergency room.  The University of California would  
          enter into a contractual agreement with the non-profit  
          entity to establish standards pertaining to quality  
          assurance and the provision of physician services. All  
          parties to the negotiations have agreed that the University  
          of California will not provide start-up or ongoing  
          financial support for the hospital. 

          Previous legislation
          ACR 159 (Dymally) of 2008 was identical to ACR 2.  This  
          resolution was never set for hearing.
          
          AB 1749 (Dymally) of 2007 would have allowed the Department  
          of Public Health to appoint a temporary manager an acute  
          care hospital in underserved communities.  AB 1749 was  
          changed to a different subject.




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          AB 55 (Dymally) of 2008 would have authorized the Los  
          Angeles County Board of Supervisors to establish the Los  
          Angeles County Hospital Authority to operate Martin Luther  
          King, Jr. Harbor Medical Center, specifies the appointments  
          to the authority's governing board of various entities, and  
          provides the authority with specified powers and duties.   
          AB 55 was changed to a different subject.
          
          AB 166 (Ridley-Thomas) of 2005, as introduced would have  
          given the Board of Supervisors the authority to establish a  
          health authority separate and apart from the county as a  
          means for the delivery of medical care and services to the  
          Medi-Cal population and to other populations receiving  
          health care services from the County of Los Angeles.  This  
          bill was held in Assembly Rules Committee.

          AB 201 (Dymally) of 2005, as introduced, was substantially  
          similar to AB 166.  AB 166 was subsequently amended to a  
          different subject.

          Arguments in support
          The Charles Drew University of Medicine and Science argues  
          that the closure of MLK hospital not only left the 1.7  
          million uninsured and underinsured residents of South Los  
          Angeles without access to hospital or medical care, but  
          also exacerbated a major existing health care crisis in the  
          county by straining capacities at other county hospitals.   
          They argue that there are immediate and obvious steps that  
          can be taken to address this issue, one of these being  
          expediting negotiations between the University of  
          California, the Board of Supervisors of Los Angeles County  
          and the Charles Drew University for the purpose of  
          discussing the future management of Martin Luther King, Jr.  
          Hospital.

                                  PRIOR ACTIONS

           Assembly Floor:     73-0
          Assembly Appropriations:16-0
          Assembly Higher Education:9-0


                                     COMMENTS
           
          1.  The resolution urges the University of California to  




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          expedite negotiations.  
            The opening of MLK-Harbor will require agreement of two  
            other parties, Charles Drew University and the County of  
            Los Angeles.  It is not clear why the resolution singles  
            out the University of California.
                                         


                                   POSITIONS  
                                        
          Support:  American Federation of State, County and  
          Municipal Employees
                 Charles Drew University of Medicine and Science


          Oppose:  None received

                                   -- END --