DHS' administrative headquarters in Downtown Los Angeles | |
Agency overview | |
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Formed | 1972 |
Preceding |
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Jurisdiction | Los Angeles County |
Headquarters | 313 N. Figueroa Street, Los Angeles, California 34°03′36″N118°15′00″W / 34.0599°N 118.25°W |
Employees | 22,085 (2016) [1] |
Annual budget | US$4,215,331,000 (2016) [2] |
Agency executives |
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Parent agency | Los Angeles County Health Agency |
Child agencies | |
Website | dhs |
Los Angeles County Department of Health Services (abbreviated DHS and LADHS) operates the public hospitals and clinics in Los Angeles County, and is the United States' second largest municipal health system, after NYC Health + Hospitals. [3]
DHS operates an extensive healthcare network throughout Los Angeles County, including four teaching and research hospitals affiliated with the Los Angeles General Medical Center, Olive View-UCLA Medical Center and Harbor-UCLA Medical Center, Rancho Los Amigos National Rehabilitation Center, and numerous outpatient clinics, including two ambulatory care centers and 16 local health clinics. DHS also runs the My Health LA health care program, which benefits approximately 150,000 residents, in partnership with over 200 community partners. [4] DHS' administrative headquarters is located in Downtown Los Angeles's Civic Center, at the corner of Figueroa and Temple Streets.
DHS provided healthcare services to over 643,856 unique patients and 2,457,174 patient visits in Fiscal Year 2015–16. [5] For Fiscal Year 2015–16, LADHS had an annual budget of US$3,832,724,000. [2] The County funds less than 15% (US$635,492,000) of LADHS' total annual budget. [2]
Municipal governments, under Section 17000 of California's Welfare and Institutions Code, are responsible as safety net health care providers. [6] In the 1860s, Los Angeles County appointed a County Physician, and a small hospital for the poor in Los Angeles was established. [6] The Department of Charities was formed in 1913 and included five Divisions: County Hospital, County Farm, Outdoor Relief, Olive View Sanatorium, and Cemetery Divisions. [7] The wide range of responsibilities of the Department of Charities eventually proved unwieldy, and in 1966 the department was split into the Departments of Hospitals and Public Social Services. Several institutions were acquired or established, including Rancho Los Amigos Poor Farm (now Rancho Los Amigos National Rehabilitation Center) in 1890, the General Hospital (now LAC+USC Medical Center) in 1932, two military hospitals, including the Harbor General Hospital (now Harbor-UCLA Medical Center, after World War II, Olive View Sanatorium (now Olive View-UCLA Medical Center) in 1970, and the Martin Luther King Medical Center (now Martin Luther King, Jr. Outpatient Center) in 1972, in response to the Watts Riots [6]
In the 1960s, the Los Angeles City Health Department merged into the county's Department of Health. [8] In 1972, the Los Angeles County Departments of Hospitals and Health, along with the Los Angeles County Veterinarian's Office, were merged into the Department of Health Services, to consolidate and integrate health services. [8]
On May 30, 2006, the Los Angeles County Board of Supervisors tentatively approved the establishment of Los Angeles County Department of Public Health (DPH) as a separate department, primarily to buffer DPH from DHS' recurring budget shortfalls and to separate public health functions, including enforcement of laws, from DHS. [9] DPH was formally established on July 7, 2006. [9] The department was formally separated on July 6, 2006. [10]
On January 3, 2011, Mitchell H. Katz, a physician, was appointed Director of Health Services for DHS. [11] Katz served 13 years as director of public health for the San Francisco Department of Public Health, where he designed and implemented the "Healthy San Francisco" program covering all San Franciscans with health care. [11] From 2008 to 2011, John F. Schunhoff, Ph.D. served as an interim director following Bruce Chernoff's resignation in May 2008. [12]
In 2011, DHS began enrolling hundreds of thousands of uninsured LA County residents in a publicly funded health program called Healthy Way LA (HWLA) and began a major overhaul of its health care system to increase emphasis on primary care instead of acute care. [13] These reforms are set to take place before the Patient Protection and Affordable Care Act takes effect in 2014. [13] Healthy Way L.A. provides a primary care provider team to members and expanded access to primary, preventative and specialty services, as well as access to hospital-based inpatient and outpatient services. [14] It is a county implementation of the state Low Income Health Program (LIHP). In the 2010-2011 fiscal year, DHS reported a budget surplus of $13.2 million. [15]
LADHS comprises a network of medical facilities throughout Los Angeles County, including four hospitals, two ambulatory care centers, six Comprehensive Health Centers (CHC), and 10 Health Centers (HC). [16] DHS' Ambulatory Care Network, which was created to provide primary care, outpatient specialty care, and ambulatory surgery, consists of DHS outpatient clinics (Multi-Service Ambulatory Care Centers, Comprehensive Health Centers, and Health Centers).
LADHS operates three academic teaching hospitals and one rehabilitation hospital:
Harbor-UCLA Medical Center, LAC+USC Medical Center, and Olive View-UCLA Medical Center each provides inpatient, outpatient, and emergency services for men, women, and children. The Rancho Los Amigos National Rehabilitation Center provides physical therapy services to individuals around the country.
LADHS, through its Ambulatory Care Network (ACN), operates two outpatient care centers, which comprise an urgent care center as well as primary care and specialty care clinics: [16]
LADHS' Ambulatory Care Network operates a network of comprehensive health centers and health centers, which are community-based clinics that provide primary care to patients at their medical homes, throughout the county. [17]
These include six comprehensive health centers (CHCs): [16]
LADHS also operates 16 health centers (HCs): [16]
The Los Angeles County Board of Supervisors oversees the Department of Health Services. Christina Ghaly, M.D., leads DHS as the Director of Health Service and reports to the LA County Board of Supervisors.
DHS leadership also includes: Hal F. Yee Jr., M.D., Chief Deputy Director of Clinical Affairs; Nina J. Park, M.D., Chief Deputy Director of Population Health; Clemens Hong, M.D., Director of Community Programs; Shari Doi, Director of Patient Access; Allan Wecker, Chief Financial Officer; Kevin Lynch, Chief Information Officer; and Elizabeth Jacobi, Administrative Deputy [5]
Two hospitals in the DHS system, Harbor-UCLA Medical Center and the Rancho Los Amigos National Rehabilitation Center, were ranked "best" in the 2012-13 rankings of U.S. News & World Report's America's Best Hospitals:
Rancho Los Amigos National Rehabilitation Center has consistently been ranked as one of "America's Best Hospitals" since 1989. [20]
All four hospitals in the DHS system are currently accredited by the Joint Commission:
Harbor-UCLA Medical Center has consistently received the Joint Commission's Medal of Honor for Organ Donation. [21] Most recently, it received a silver medal in 2012. [21]
DHS provides health services to over 800,000 patients [5] including many uninsured patients. [25] LAC+USC Medical Center provides care for half of HIV/AIDS and sickle cell anemia patients in Southern California. [26]
In 2012, the DHS system had a hospital bed capacity of 1,465. DHS hospitals had 74,811 admissions, 1,251,553 outpatient visits, and 4,850 births. Over the past 20 years, the number of births performed at DHS hospitals has declined substantially since Medi-Cal expanded coverage for pregnant women in the 1990s. [27]
In Fiscal Year 2011–2012, the DHS system (inclusive of MACCs) received over 300,000 emergency department admissions, over 2.6 million ambulatory care admissions and nearly 230,000 urgent care admissions. [28] DHS hospitals recorded 295,000 emergency department visits, 1.1 million outpatient hospital visits and 76,000 urgent care visits. [28]
Medical Center | Primary Service | Total Beds | Admissions | Outpatient Visits | Births | Personnel | Total Expenses |
---|---|---|---|---|---|---|---|
LAC+USC Medical Center [29] | Acute care | 633 | 35,636 | 571,245 | 2,055 | 6,050 | $1,440,644,952 |
Harbor-UCLA Medical Center [30] | Acute care | 350 | 22,064 | 418,435 | 939 | 3,199 | $675,671,267 |
Olive View-UCLA Medical Center [31] | Acute care | 275 | 13,913 | 225,760 | 1,856 | 2,218 | $499,333,490 |
Rancho Los Amigos National Rehabilitation Center [32] | Rehabilitation | 207 | 3,198 | 36,113 | 0 | 1,704 | $230,674,268 |
Healthy Way LA (HWLA) was a free public health care program available to underinsured or uninsured, low-income residents of Los Angeles (LA) County. The program was a Low Income Health Program (LIHP) approved under the 1115 Waiver. HWLA helped narrow the large gap in access to health care among low-income populations by extending health care insurance to uninsured LA County residents living at 0 percent to 133 percent of the Federal Poverty Level (FPL). Individuals eligible for HWLA are assigned to a medical home within the LA County Department of Health Services (LADHS) or its partners, thus gaining access to continuous primary care, preventive and specialty services, mental health services, and other support systems. HWLA was one of the few sources of coordinated health care for disadvantaged adults without dependents in LA County.
As a part of the Affordable Care Act, Medicaid Expansion will phase out the Healthy Way LA program. As a result, 252,379 Healthy Way LA members will automatically be transitioned into Medi-Cal on January 1, 2014.
The Community Partners Program is a collaboration between the LADHS and private, community-based providers (Partners) to provide quality health services in a culturally and linguistically appropriate environment to low income and uninsured communities. This program is part of a Medicaid Demonstration Project designed to provide LADHS with federal fiscal relief to preserve vital community clinic capacity, to increase access to primary, dental, and specialty care services, and to develop Community Partners for the provision of these services. The Community Partner Program provides Primary, specialty, and dental care services are available to people of all ages who reside in Los Angeles County and whose net family income is at or below 133-1/3% of the Federal Poverty Level (or are General Relief (GR) Recipients), and who do not qualify for Medi-Cal or any other government or third-party assistance programs. Patients are strongly encouraged to make an appointment at one of the Partner sites to find out if they are eligible for Community Partners or other funded health care services. [33]
Housing for Health is a LADHS program that provides chronically homeless patients with housing. A chronically homeless person is defined as a homeless individual with at least one disabling condition that has been continuously homeless for one year or has had at least four episodes of homelessness in the past three years. Housing for Health began enrolling participants on March 1, 2007 and is funded by LA County Homeless Prevention Initiative.
The Housing for Health program reduced emergency room visits by 77%. Inpatient visits were also reduced by 77% and there was an 85% reduction the number of days of these visits. Participants in the Housing for Health program used an average of $32,000 less of DHS acute medical services. [34] DHS will operate a primary care clinic and a supportive housing development lab in the Star Apartments, which is a 100 unit apartment complex in Downtown Los Angeles' Skid Row under construction for the chronically homeless by the Skid Row Housing Trust.
Ambulatory care or outpatient care is medical care provided on an outpatient basis, including diagnosis, observation, consultation, treatment, intervention, and rehabilitation services. This care can include advanced medical technology and procedures even when provided outside of hospitals.
Los Angeles General Medical Center is a 600-bed public teaching hospital located at 2051 Marengo Street in the Boyle Heights neighborhood of Los Angeles, California, and one of the largest academic medical centers in the United States. The hospital facility is owned by Los Angeles County and operated by the Los Angeles County Department of Health Services. Doctors are faculty of the Keck School of Medicine of USC, who oversee more than 1,000 medical residents being trained by the faculty. Additionally, the United States Navy sends doctors, nurses and corpsmen to train at the hospital, working alongside staff in the trauma center.
Charles R. Drew University of Medicine and Science is a private university in Willowbrook, California, focused on health sciences. It was founded in 1966 in response to inadequate medical access within the Watts region of Los Angeles, California. The university is named in honor of Charles R. Drew.
The Keck School of Medicine of the University of Southern California teaches and trains physicians, biomedical scientists and other healthcare professionals, conducts medical research, and treats patients. Founded in 1885, it is the second oldest medical school in California after the UCSF School of Medicine.
Children's Hospital Los Angeles (CHLA) is a nationally ranked, freestanding acute care children's hospital in the East Hollywood district of Los Angeles, on Sunset Boulevard at the corner of Vermont Avenue. The hospital has been academically affiliated with the Keck School of Medicine of the University of Southern California since 1932 and the hospital features 401 pediatric beds. The hospital provides comprehensive pediatric specialties and subspecialties to infants, children, teens, and young adults generally aged 0–21 throughout California and the west coast. The hospital also sometimes treats adults that require pediatric care. The hospital has a rooftop helipad and is an ACS verified level I pediatric trauma center, one of a few in the region. The hospital features a regional pediatric intensive-care unit and an American Academy of Pediatrics verified level IV neonatal intensive care unit.
The University of Vermont Medical Center (UVMMC) is a five-campus academic medical facility under the corporate umbrella of the University of Vermont Health Network that is anchored by a 562-bed hospital in Burlington, Vermont. UVMMC is based in Burlington and serves as both a regional referral center and a community hospital. The hospital was formerly known as the Medical Center Hospital of Vermont and later as Fletcher Allen Health Care until getting its current name. It is affiliated with the University of Vermont's Robert Larner College of Medicine and its College of Nursing and Health Sciences.
Rancho Los Amigos National Rehabilitation Center is a rehabilitation hospital located in Downey, California, United States. Its name in Spanish means 'Friends' Ranch'.
The University of California, Los Angeles School of Medicine, also known as the David Geffen School of Medicine at UCLA (DGSOM), is an accredited medical school located in Los Angeles, California, United States. Founded in 1951, it is the second medical school in the University of California system, after the UCSF School of Medicine. The school was renamed in 2001 in honor of media mogul David Geffen who donated $200 million in unrestricted funds.
The Martin Luther King Jr. Outpatient Center, formerly known as Martin Luther King Jr. Multi-Service Ambulatory Care Center, Martin Luther King Jr./Drew Medical Center (King/Drew), and later Martin Luther King Jr.–Harbor Hospital, was a public urgent care center and outpatient clinic and former hospital in Willowbrook, an unincorporated section of Los Angeles County, California, north of the city of Compton and south of the Watts neighborhood of Los Angeles. It closed in 2007.
Harbor–UCLA Medical Center is a 570-bed public teaching hospital located at 1000 West Carson Street in West Carson, an unincorporated area within Los Angeles County, California. The hospital is owned by Los Angeles County and operated by the Los Angeles County Department of Health Services, while doctors are faculty of the David Geffen School of Medicine at UCLA, who oversee the medical residents being trained at the facility.
Olive View–UCLA Medical Center is a hospital, funded by Los Angeles County, located in the Sylmar neighborhood of Los Angeles, California. It is one of the primary healthcare delivery systems in the north San Fernando Valley, serving the area's large working-class population. Olive View is also the closest county hospital serving the Antelope Valley after High Desert Hospital was converted to an urgent care clinic in 2003.
University of Missouri Health Care is an American academic health system located in Columbia, Missouri. It's owned by the University of Missouri System. University of Missouri Health System includes five hospitals: University Hospital, Ellis Fischel Cancer Center, Missouri Orthopedic Institute and University of Missouri Women's and Children's Hospital — all of which are located in Columbia. It's affiliated with Capital Region Medical Center in Jefferson City, Missouri. It also includes more than 60 primary and specialty-care clinics and the University Physicians medical group.
Spartanburg Regional Healthcare System(SRHS) is one of South Carolina's largest healthcare systems. SRHS draws patients primarily from the areas of Spartanburg, Cherokee, Union, and Greenville counties (all located in the Piedmont region of South Carolina), as well as Rutherford and Polk counties (located in western North Carolina). Spartanburg General Hospital was organized under the authority of the South Carolina General Assembly in 1917. It officially became the Spartanburg Regional Health Services District, Inc., a political subdivision of the State of South Carolina, by the charter granted by the Secretary of State of South Carolina on May 1, 1995.
MedStar Health is a not-for-profit healthcare organization. It operates more than 120 entities, including ten hospitals in the Baltimore–Washington metropolitan area of the United States. In 2011 it was ranked as the private sector employer with the largest number of local employees in the region.
The Local Initiative Health Authority for Los Angeles County is a public agency that provides health insurance for low-income individuals in Los Angeles County through four health coverage programs including Medi-Cal.
Healthy Way LA (HWLA) was a free public health care program available to underinsured or uninsured, low-income residents of Los Angeles County. The program, administered by the Los Angeles County Department of Health Services, was a Low Income Health Program (LIHP) approved under the 1115 Waiver. HWLA helped to narrow the large gap in access to health care among low-income populations by extending health care insurance to uninsured LA County residents living at 0 percent to 133 percent of the Federal Poverty Level (FPL). Individuals eligible for HWLA were assigned to a medical home within the LA County Department of Health Services (LADHS) or its partners, thus gaining access to continuous primary care, preventive and specialty services, mental health services, and other support systems. HWLA was one of the few sources of coordinated health care for disadvantaged adults without dependents in LA County. HWLA was succeeded by My Health LA, a no-cost health care program for low-income Los Angeles County residents launched on October 1, 2014.
Martin Luther King Jr. Community Hospital, also known as MLK-LA, is a 131-bed public community hospital in the unincorporated Willowbrook neighborhood of southern Los Angeles County, California, just outside of the Los Angeles city limits. It was planned and designed to especially serve the surrounding South Los Angeles communities' needs, including those of underinsured or uninsured patients.
A safety net hospital is a type of medical center in the United States that by legal obligation or mission provides healthcare for individuals regardless of their insurance status or ability to pay. This legal mandate forces safety net hospitals (SNHs) to serve all populations. Such hospitals typically serve a proportionately higher number of uninsured, Medicaid, Medicare, Children's Health Insurance Program (CHiP), low-income, and other vulnerable individuals than their "non-safety net hospital" counterpart. Safety net hospitals are not defined by their ownership terms; they can be either publicly or privately owned. The mission of safety net hospitals is rather to provide the best possible care for those who are barred from health care due to the various possible adverse circumstances. These circumstances mostly revolve around problems with financial payments, insurance plans, or health conditions. Safety net hospitals are known for maintaining an open-door policy for their services.
UCLA Mattel Children's Hospital (MCH) at Ronald Reagan UCLA Medical Center is a nationally ranked pediatric acute care children's hospital located in Los Angeles, California. The hospital has 156 pediatric beds, is affiliated with the University of California, Los Angeles David Geffen School of Medicine, and is a member of UCLA Health. The hospital provides comprehensive pediatric specialties and subspecialties to pediatric patients aged 0–21 throughout California. Mattel Children's also sometimes treats adults that require pediatric care. UCLA Mattel Children's Hospital features an ACS verified pediatric level 1 trauma center. The UCLA Mattel Children's Hospital is located on the third and fifth floors of the newly constructed Ronald Reagan UCLA Medical Center.
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