County nar­rows health job hunt

Los Angeles Times - - Front Page - Molly Hen­nessy-Fiske

More than two years af­ter the last per­ma­nent chief of Los An­ge­les County’s mas­sive Depart­ment of Health Ser­vices quit un­ex­pect­edly, of­fi­cials may fi­nally be close to hir­ing a re­place­ment.

Los An­ge­les county’s chief ex­ec­u­tive, Wil­liam T Fu­jioka, said Mon­day that he be­lieves he has iden­ti­fied the right per­son to lead the $3.4-bil­lion-a-year op­er­a­tion: Dr. Mitchell H. Katz, the di­rec­tor of health for the city and county of San Fran­cisco.

“Given the sys­tem that he runs in San Fran­cisco and the sim­i­lar­i­ties in both the mis­sion and the type of ser­vices pro­vided, he would be an out­stand­ing can­di­date,” Fu­jioka said.

Fu­jioka said he plans to present his choice early next month to the Board of Su­per­vi­sors — which has re­jected other can­di­dates with­out bring­ing them to a vote. If Katz is ap­pointed, he would start in Jan­uary,

Fu­jioka said.

Fill­ing the job that long­time ob­servers say can be thank­less, po­lit­i­cal and, most of all, daunt­ing has proved chal­leng­ing. It took months for the county to hire a search firm, and then that firm told county of­fi­cials that vi­able can­di­dates were re­pelled by the per­ceived dys­func­tion be­tween the depart­ment and county lead­ers.

Katz, 50, a Brook­lyn, N.Y., na­tive who de­scribes him­self as “pro-union,” said he hopes to over­come the “his­tor­i­cally tense re­la­tion­ship” be­tween the board and the health ser­vices chief.

“When peo­ple don’t trust the leader, then they try to know all the de­tails and that can be dif­fi­cult for both sides,” Katz said. “My job would be to let them know that I was man­ag­ing well so they didn’t have to worry about the day-to-day is­sues.”

Katz was hired by San Fran­cisco’s pub­lic health depart­ment in 1991 and served as chief of re­search and di­rec­tor for the AIDS of­fice, in­terim med­i­cal di­rec­tor of the Emer­gency Med­i­cal Ser­vices Agency and di­rec­tor of the depart­ment’s health and safety branch be­fore be­com­ing chief in 1997.

“The value of be­ing at ev­ery step in a process al­lows him to un­der­stand how pro­grams and ser­vices are de­liv­ered in a set­ting like ours,” Fu­jioka said.

In San Fran­cisco, Katz over­sees about 8,600 em­ploy­ees and a $1.5-bil­lion bud­get. He earns $260,000 a year and an­swers to a sev­en­mem­ber health com­mis­sion ap­pointed by the mayor and an 11-mem­ber county Board of Su­per­vi­sors.

In Los An­ge­les, the health ser­vices chief su­per­vises about 18,421 em­ploy­ees. If Katz is hired, he would get a salary in­crease from his cur­rent po­si­tion, al­though Fu­jioka said ne­go­ti­a­tions would not start un­til the process was fur­ther along. He would re­port to the five-mem­ber Board of Su­per­vi­sors, which has a long his­tory of be­ing tough on its health chiefs, and im­me­di­ately face a $400-mil­lion deficit even as de­mand for ser­vices in­creases.

“He knows Cal­i­for­nia, he un­der­stands the fi­nanc­ing. There will be no learn­ing curve,” said Jim Lott, ex­ec­u­tive vice pres­i­dent of the Hos­pi­tal Assn. of South­ern Cal­i­for­nia.

Katz would suc­ceed in­terim Di­rec­tor John Schun­hoff, 63, who took over af­ter the abrupt de­par­ture of Dr. Bruce Ch­er­nof in April 2008. Fu­jioka said Schun­hoff is ex­pected to stay on at the depart­ment.

Among the top chal­lenges fac­ing a new chief will be the push to re­open a new Martin Luther King Jr. Hos­pi­tal in Wil­low­brook by 2013.

“He im­pressed me as be­ing more knowl­edge­able about MLK than any other can­di­date to date,” said Su­per­vi­sor Mark Ri­d­leyThomas, who de­clined to say whether he plans to sup­port Katz but said Katz “seems to be mak­ing a very fa­vor­able im­pres­sion in a va­ri­ety of quar­ters.”

In San Fran­cisco, Katz part­nered with Mayor Gavin New­som in 2007 to cre­ate Healthy San Fran­cisco, the nation’s first city-run uni­ver­sal health­care plan. The plan pro­vides med­i­cal ac­cess to most of the city’s unin­sured, about 54,000 peo­ple, in­clud­ing peo­ple in the coun­try il­le­gally.

“I’m very proud of what I’ve achieved in San Fran­cisco,” Katz said, “But Los An­ge­les has more than a mil­lion unin­sured peo­ple. Part of what I’d be in­ter­ested in is see­ing is if what we have done here could ben­e­fit Los An­ge­les.”

Katz has drawn crit­i­cism for sup­port­ing a hos­pi­tal project with spi­ral­ing con­struc­tion costs and also has been crit­i­cized for mak­ing cuts and lay­offs to meet bud­get ex­pec­ta­tions.

“I say the job of the health di­rec­tor is to do the very best with the avail­able re­sources,” he said.

Some lo­cal lead­ers said they were re­as­sured by Katz’s record.

“From all I’ve heard, he has the cre­den­tials, the skill, the ex­pe­ri­ence, the knowl­edge about pub­lic safety net health­care in Cal­i­for­nia, par­tic­u­larly in ur­ban ar­eas, to do this job,” said John Tan­ner, ex­ec­u­tive di­rec­tor of Ser­vice Em­ploy­ees In­ter­na­tional Union, Lo­cal 721, which rep­re­sents many health ser­vices work­ers.

“It’s ur­gent that the Board of Su­per­vi­sors act to fill this key lead­er­ship po­si­tion,” Tan­ner said.

Katz said Los An­ge­les needs to shift to­ward pro­vid­ing more out­pa­tient ser­vices and im­prove cus­tomer ser­vice along the Kaiser Per­ma­nente model of man­aged care.

“Poor peo­ple are en­ti­tled to the same qual­ity of med­i­cal care as any­one else. In par­tic­u­lar, for safety nets to sur­vive they have to start think­ing of their pa­tients as cus­tomers who will soon have a choice,” Katz said.

Katz is ex­pected to travel to Los An­ge­les to meet with su­per­vi­sors when they con­sider his ap­point­ment in closed ses­sion, pos­si­bly as soon as their board meet­ing Oct. 5, Fu­jioka said.


Dr. Mitchell H. Katz said he hopes to ease ten­sions with su­per­vi­sors.

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