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The Most Important Office You May Know Nothing About

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Yesterday I spent some time at an often contentious debate in the race for the 2nd District of the LA County Board of Supervisors.  The two most high-profile candidates for the seat, State Sen. Mark Ridley-Thomas and former LAPD Chief and current City Councilman Bernard Parks, squared off in a pretty lively debate which featured a lot of sniping and criticism.

Why the heated exchanges in a county Board of Supervisors race?  Why is a state Senator and a very highly recognized City Councilman running in this race?  Why is Sheila Kuehl planning to run for the Board of Supes when Zev Yaroslavsky’s term is up in the near future?

Because these are unbelievably powerful positions.

Los Angeles County has 10.3 million residents, over a quarter of the whole state.  The county covers 88 cities and multiple unincorporated areas.  Ridiculously enough, there are only five seats on the county Board, meaning that each Supervisor represents over two MILLION people, more than 15 states and the District of Columbia.  I have to assume that these are the biggest districts in terms of population anywhere in the country.  Right now, seats on the board are held by Gloria Molina, Yvonne Brathwaite Burke, Zev Yaroslavsky, Don Knabe and Michael Antonovich.  LA County is immense and rich in diversity, the most in the nation according to the last US Census.  Burke, Knabe and Antonovich’s seats are up for re-election this year, but a sitting Supervisor actually getting challenged in a race is a rare event indeed.  Before term limits (now 3 terms or 12 years), the seat was practically a lifetime position.  The winner of the Parks/Ridley-Thomas race in the 2nd District will yield only the third Supervisor to hold that seat since 1952.

Given all this, what exactly does the Board of Supervisors do?  Well, the Board is the largest public employer in the state of California, serving 102,000 employees, including control of the pension funds.  They also provide services for the entire county, managing county lockups, county hospitals and a host of social services.  It’s a mammoth job and I can’t for the life of me imagine why it still contains only a 5-member board other than the fact that it increases incumbency protection.  When these seats are contested, the dollar sums are outrageous.  Parks and Ridley-Thomas raised well over six figures in the first quarter of 2008, and labor is spending immense amounts in favor of the state Senator.

Using a political tool that sidesteps campaign financing limits, Los Angeles labor unions have raised an unprecedented $2.5 million to elect state Sen. Mark Ridley-Thomas to the county Board of Supervisors.

Before voters head to the polls in June, union officials say they will add an additional $1.5 million to the “independent expenditure committee” pot.

“It is a tribute to my colleagues and brothers and sisters in labor,” said Tyrone Freeman, the head of Service Employees International Union Local 6434, one of the contributors to the Alliance for a Stronger Community.

Obviously, an office with such sway over public employees and county service contracts will catch the eye of labor, and they’ve gone almost all in for Mark Ridley-Thomas.  Councilman Parks voted against creating a living wage zone around LAX-area hotels, and has a history of pro-business policies on the City Council.  In yesterday’s debate, he sidestepped the question by saying that the zone shouldn’t be confined to the LAX area, while Ridley-Thomas said outright that “a lving wage law is a tool to fight poverty” and any effort to extend it ought to be taken.

It’s a very interesting race.  Parks has the higher profile and the support of a lot of local leaders, including Yvonne Burke, who has held the seat for 16 years.  Ridley-Thomas has the support of the entire Democratic caucus of the State Senate (every single one of them is down on his endorsement list) and much of the Assembly.  Parks has Maxine Waters’ support, and Ridley-Thomas has Diane Watson’s (she ran against Burke for the seat 16 years ago and lost).  The district includes Mar Vista and Culver City all the way down to South LA and Watts, the majority of residents in the district actually have Spanish surnames, yet this is a major contest in the African-American political community.

And these two appear to really, really not like each other.  The first question in the debate was about gang violence and gang activity, and while Parks stressed youth development and afterschool programs, Ridley-Thomas slyly noted that “some would say that the Los Angeles Police Department acted as a gang during Rampart” (a reference to a major scandal that happened under Parks’ watch as police chief).  It went pretty much downhill from there, with Parks claiming that Ridley-Thomas applauded the closure of King-Drew Medical Center and made sweetheart deals with developers as a City Councilman; with Ridley-Thomas hitting Parks on all sorts of issues (health care, environment, labor) and saying “He will know what leadership looks like when it’s working,” and on and on.  There are differences between the candidates, particularly on issues like the living wage ordinance, but both are stressing economic development for their depressed district, investments in education and health care access, transportation issues (even congestion pricing).

The fierceness of the contest reflects the importance of the race, and the fact that they’re running for what amounts to a 12-year term.  It may not be a sexy seat for progressives to pay attention to, but it has an incredible amount of importance.

Health Care, Los Angeles Area

Possible respite for King-Harbor Medical Center

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King-Harbor Medical Center in South Central Los Angeles is back in the news this week. As you may remember, King-Harbor’s, formerly known as King Drew Medical Center, funding was pulled at the end of June, when the hospital failed it’s final review.

King-Harbor had been under scrutiny for quite a long time for sub standard care, but it was the reporting of the death of Edith Isabel Rodriguez at the hospital that appeared to be the straw that broke the camel’s back with regards to the survival of the Medical center. The Los Angeles Times documented the travails of King harbor in a Pulitzer winning series of articles.

This past Saturday a community meeting was held at the hospital to discuss the possible fate of the hospital. The meeting had been called for by Rep. Laura Richardson and Rep. Maxine Waters. Los Angeles County Board of Supervisors member Yvonne B. Burke made some interesting comments, including a statement that the Board of Supervisors might have kept the hospital open, despite the loss of funding had it not been for the revelation of death of Ms. Rodriguez. Along with another incident, which she refused to elaborate upon.

She told the crowd of hospital supporters that there had been an array people doing their best to make sure the hospital closed.

“It was almost like it was a conspiracy,” Burke said.

Burke told the crowd that in October the County would would try to find a private entity to run the hospital, who would then turn around and petition the County to run the facility.

King-Harbor served over 40,000 patients annually in South-Central Los Angeles every year. The majority poor and uninsured. And, unfortunately, many of those residents are currently facing a situation where they will be receiving no health care at all. Hopefully there is some truth in the story about the reopening of the hospital.

Health Care, Los Angeles Area

King-Harbor on the road to shutdown

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You never know when the traditional media will latch on to a story, but they’ve certainly raised the case of L.A.’s King-Harbor Medical Center to new heights by publicizing the tragic story of a woman who died while waiting in the lobby of the emergency room while hospital staff casually walked by her.  It’s become a powerful symbol of our broken health care system.  In fact, King-Harbor has been troubled almost since the moment it opened in 1972, and the tales of woe emanating from the medical center are numerous. 

Among the cases cited:

•  One patient in King-Harbor’s emergency room told a triage nurse on April 30 that he was seeing “aliens and devils” and that he was thinking about drinking bleach to commit suicide. He was left in the lobby for more than an hour and not seen by a physician for almost seven hours. A mental health evaluation was not completed for 17 hours after he arrived, according to the federal report.

At that time, the patient denied being suicidal and was discharged without receiving treatment.

•  A female patient went to the emergency room on March 8 complaining of two weeks of stomach pain. She said she had nausea and rated her pain as a 10 on a scale of 1 to 10. “The patient identified that the pain she was experiencing was constant and that nothing provided relief.”

Even so, she was given no treatment to alleviate pain or reduce her fever. Two hours later, she was checked again and again offered no treatment. She was not seen by a physician until nearly seven hours after she arrived. “The patient experienced severe pain throughout her [emergency stay],” the report said. Eleven hours after she arrived, she went to surgery.

•  A patient went to the emergency room on May 11 complaining of spotting during pregnancy. An hour later, a triage nurse saw her, gave her a pregnancy test and sent her back to the waiting area. When staff called her name two hours later, she had left without being seen.

Three days later, the same woman returned to the hospital with complaints of vaginal bleeding and severe pain. A nurse didn’t evaluate how much she was bleeding and had her wait four hours without pain medication. During an ultrasound, she had a miscarriage and was discharged a short time later.

So today, state regulators have moved to close the hospital.  But is that the right thing to do?

over…

Both the governor and a portion of the LA County Board of Supervisors seem resigned to King-Harbor’s closure:

Two of the five members of the Los Angeles County Board of Supervisors said Thursday that they now support closing the hospital without delay.

“I think it’s over for us,” Supervisor Gloria Molina said. “I’m in fact terrified that somebody else might be hurt or neglected or abused at Martin Luther King hospital.”

Supervisor Mike Antonovich agreed. “The time has come to put patients’ lives before incompetent employees or political agendas,” he said.

The state’s decision, which was approved by Gov. Arnold Schwarzenegger, is subject to appeal. That process could take six months to a year.

So for the next year, King-Harbor would remain open until the process is complete.  But what would be in place in the wake of any closure?  In the CA-37 debate, the district which includes the area around King-Harbor, almost all of the candidates stressed the fact that there are few options for the low-income residents that King-Harbor serves.  Most of them use public transportation and can’t afford an ambulance to take them to the next closest hospital.  And the trauma centers in the area are already overburdened, and another 47,000 ER visits per year (the approximate average at King-Harbor) could create the very problem regulators are seeking to avoid.  If there is an extended, year-long process to close King-Harbor, plans MUST be made to provide for some replacement access for the citizens who would be left with practically no alternative should they become sick or injured.  Community advocates are saying the same thing.

“We are playing with not only fire, we have gasoline in the other hand,” said Lark Galloway Gilliam, executive director of Community Health Councils. “That emergency room, you can’t let that go. Closure to me is not an option.”

Finally, this really stresses the need for a better safety net for all citizens than a crippled emergency room system that acts as a faux-universal care apparatus.  People deserve better than this.  They need to have access to preventative care instead of going to the ER for a fever.  King-Harbor’s problems are part of the larger health care crisis in America.