1. EMS and Global Healthcare Issues Los Angeles County
Robert G. Splawn, MD, MPH, FACEP
Chair, EMS Commission, LA County
Director, HealthCare Partners Institute

2. Hospital Closures in LA County 2002-2006
2002 St. Lukes Medical Center
2003 Granada Hills Community Hospital
2004 Santa Teresita Hospital
Century City Hospital(reopened in 4/06)
Community Hospital of Gardena ED
Northridge Hospital-Sherman Way
Robert F. Kennedy Medical Center

3. Hospital Closures LA County 2002-2006
2005 Suburban Medical Center
2006 Centinela Freeman Regional Medical Center, Freeman Campus

4. Issues Large number of uninsured Increased ED demand Longer wait times
Increase in ambulance diversion
Increase in LWBS
Boarding admitted patients in ED’s
Regional variations in disease states, access, and healthcare services

5. Issues
IT infrastructure
Malpractice
Reimbursement
Quality

6. Action Plans
Work with local jurisdictions to seek a reduction in City/County business tax for physician providers who work in medically underserved areas.
Examine the efficiency and efficacy of service areas in the County of Los Angeles to better manage volume surges.
Work with the State Legislature, CHA, and other key stakeholders to address the negative financial impact of the County’s “lateral transfer” policy on the private sector and seek financial solutions

7. Action Plans Seek passage of Prop 86
Develop/Implement solutions to improve operational efficiencies of hospitals and ED’s
Develop a web-based community health care resource directory
Seek increased funding for providers to work in medically underserved areas

8. Action Plans
Develop a state-wide task force of key stakeholders to develop potential solutions to improving health access in medically underserved communities within the State and to ensure that these solutions are enacted. These solutions include, but are not limited to:

9. Developing medical enterprise zones
Institute a developers fee for healthcare services as we do for schools, sewage, public works, and other essential services
State funding for healthcare providers who commit to working in medically underserved communities
Address the Medi-Cal reimbursement disparity rate

10. Develop a mechanism of oversight to review hospitals financial performance on a periodic basis to better monitor hospitals that may be in financial trouble and to better develop a plan of action before closure is warranted
Improve planning efforts between the public and private sector when “rightsizing” healthcare services for a geographic community