Consolidating Health Care Services for L.A. County Residents

by Samantha Beasley and Shelby Thurston, L.A. Area Chamber of Commerce

The Los Angeles County Board of Supervisors is proposing a big change to the way Los Angeles County provides health care for its residents. On Jan. 13, County Supervisors voted unanimously to continue moving toward the merging of three different health departments. This proposal, championed by Supervisor Michael D. Antonovich and Mitch Katz, director of the L.A. County Department of Health Services (DHS), would merge the County’s public and mental health agencies with the DHS, which currently runs a number of hospitals and clinics in the L.A. region.
 
But such consolidation doesn’t come without its challenges. Mental health agencies especially are concerned that in merging, the department's patients will not receive the individual attention they need, and that the mental health needs of residents will get “buried”. Fears have also been expressed that consolidation would lead to job and service cuts for a number of County employees.
 
Yet many are optimistic that consolidation will provide a better system for County residents. Bob Schoonover, president of Service Employees International Union, Local 721, notes that "A consolidation done right could help cut through the bureaucratic delays that impact patients on a daily basis." Further, Supervisor Mark Ridley-Thomas reassures residents that, “This is not about cutting dollars or services. This is about maximizing the quality of care for the people of L.A. County, who depend on these critical services.”
 
Supporters of the consolidation remain steadfast that it will save the County a large amount of money, increase efficiency and give patients easier access to comprehensive health services. The new structure aims to benefit patients with symptoms that require treatment across multiple agencies. On Jan. 22, County officials released a previously confidential memo, in which a number of benefits are outlined, including:

1. Providing better care for L.A. County patients by integrating physical health care, mental health care and substance abuse treatment.
2. Improving prevention and early intervention strategies for physical and behavioral health by more closely linking them to clinical service delivery.
3. Better control of costs by improving coordination of services, leveraging economies of scale and decreasing administrative costs.
4. Increasing revenue by taking greater advantage of available local, state and federal funding streams.

In this, Director Katz reaffirmed his support stating, “The three departments would maintain separate budgets and have their own directors, but be overseen by a single director… Although the greatest benefits in care integration and financial savings through efficiencies would come from a full integration of the three departments, this would be a large undertaking that would be time consuming and disruptive of current activities. Instead, I propose the three departments operate as an agency, with the current director of health services serving as the director of this new unified health agency."
 
A briefing on the proposed structure and pros and cons of the consolidation is due in March.