By Elizabeth Marcellino
September 29, 2015
LOS ANGELES >> The Board of Supervisors voted unanimously Tuesday to create a unified county health agency, integrating the operations of the public health, mental health and health services departments.
Proponents, including the plan’s earliest champion, Supervisor Michael Antonovich, said they believe an umbrella agency will improve patient care, streamline access and reduce costs.
Those opposed said it will create more bureaucracy and further stigmatize mental illness.
Supervisor Mark Ridley-Thomas said he was optimistic about implementing a structure in which three separate departments remain, with a lead agency driving integration.
“The Department of Public Health and the Department of Mental Health have raised their concerns and raised them pointedly in some cases,” Ridley-Thomas said. “These systems will talk to each other effectively ... about a year from now, we’ll see that we’ve done something good.”
Supervisor Sheila Kuehl acknowledged that “a lot of folks out there are still feeling a little nervous,” but assured those assembled at the Hall of Administration that “each department would continue to have direct contact with the supervisors” and communications would not be filtered through the lead agency.
Supervisor Don Knabe stressed that budgets for the three departments should be developed independently, and he charged interim county CEO Sachi Hamai with making sure that happens.
The board did not announce who would lead the agency, although Department of Health Services Director Dr. Mitchell Katz is widely assumed to be the frontrunner.
Katz, who managed a combined health agency in San Francisco, outlined a plan for consolidation in January and proposed that he head the group.
The Department of Health Services is responsible for the county hospital system, while the Department of Public Health is responsible for managing outbreaks of communicable diseases, runs programs to promote health goals such as childhood vaccination and inspects restaurants and nursing homes.
The county operated a single health agency until 1978, when mental health became a separate department. Public health and health services were run as a single agency until July 2006.
Strategic priorities for the combined agency were also spelled out Tuesday and will include:
-- improving patient access and experience;
-- developing an effective way to serve homeless individuals;
-- reducing emergency room overcrowding due to patients in psychiatric crisis;
-- tailoring care to residents from different cultures and speaking different languages;
-- diverting mentally ill patients at risk of jail time;
-- linking vulnerable children to health care; and
-- working to limit chronic disease and injury.