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Change is happening in South LA, and the award-winning MLK Community Hospital is leading the way. Learn how MLKCH brought high-quality care and hope to a community with some of the worst health indicators in the nation – as well as what we have planned for the future.
On Wednesday, June 5, 2019, CAHEC held their annual awards ceremony at the Grandover Resort & Conference Center in Greensboro, North Carolina. For the last 18 years, we have been honored to recognize outstanding organizations and individuals for their contributions to the affordable housing and community development industry.
The 2019 Outstanding Community Impact Award was presented to the Robinson Grand Performing Arts Center, Clarksburg, West Virginia.
Supv. Mark Ridley-Thomas, L.A. City Council President Herb Wesson, MLK Hospital CEO Dr.Elaine Batchlor, community activist Sweet Alice Harris participated in the groundbreaking ceremony. (Martin Zamora/Board of Supervisors)
L.A. County Supervisor Mark Ridley-Thomas led the groundbreaking ceremony for the newest addition to the Martin Luther King, Jr. Medical Campus in Willowbrook: a medical office building that will increase access to healthcare in South Los Angeles by creating more space for physicians to care for patients.
Scheduled to open in 2020, the MLK Community Health Medical Office Building will provide primary care for the local community, as well as valuable services to treat chronic conditions. Outpatient services will include dialysis, wound care, and imaging. There will also be an ambulatory surgery center, a retail pharmacy, and a space for community health education.
The 52,000-sq. ft. MLK Community Health Medical Office Building will be the new home of the MLK Community Medical Group, which recruits doctors from prestigious medical centers across the nation who have a desire to serve in a safety-net community. “When you talk about best practices in community health, the evidence is overwhelming that access to primary care is a critical piece of the puzzle,” said Ridley-Thomas, the driving force behind the medical campus.
“With the creation of the MLK Medical Group and this medical office building, we are creating an essential link between hospital patients and ongoing care following discharge.”
“The MLK Community Health Medical Office Building represents a fulfillment of our promise to this community,” MLK Community Hospital CEO Dr. Elaine Batchlor said.“This moment is about more than a building–it’s a milestone for improving health in South LA.”
Dr. Jorge Reyno, MLK Community Hospital’s Vice President of Population Health, is one of the doctors looking forward to having an office at the new building. “It will serve as a hub to improve outcomes, and an important bridge between inpatient and outpatient care, supporting our work in care management, and helping us achieve our goals for patient and community wellness,” he said.
Several members of the community expressed their enthusiasm for the project, including community organizer “Sweet Alice” Harris, Arna Fulcher of the Empowerment Congress, and Arturo Ibarra of the Watts/Century Latino Organization.
Developed in partnership with Trammell Crow Company, the project is expected to create 200 construction jobs. It is only the latest addition to the still-expanding MLK Medical Campus, which besides the MLK Community Hospital and MLK Outpatient Center, also includes the MLK Center for Public Health, the MLK Mental Health Urgent Care Center, and MLK Recuperative Care Center.
Link to original article: https://lasentinel.net/ridley-thomas-leads-groundbreaking-on-new-mlk-medical-building.html
The old church that once housed Nuestra Señora de Monte Carmelo, or Our Lady of Mount Carmel, will be the centerpiece of an affordable housing project that aims to serve the needs of the predominantly Latino community. (David Hernandez - U-T)
San Isidro - Located in the heart of San Ysidro, the white, stucco church that once housed Nuestra Señora de Monte Carmelo, or Our Lady of Mount Carmel, stands as a symbol of the border town’s rich history and culture.
Built in 1927, the landmark is set to be the centerpiece of a small affordable housing project that will include spaces for services and programs geared toward the predominantly Latino community.
“We want to integrate (the church) because of the huge historical significance in the community. It’s seen as an icon in San Ysidro,” said Teddy Cruz of Estudio Teddy Cruz + Fonna Forman, a research-based political and architecture firm that designed the project with Casa Familiar, a social services organization.
David Flores, Casa Familiar’s community development director, added: “We believe that culture exisits in a community — that you don’t bring culture to a community.”
Construction at the site on West Hall Avenue, just west of the San Ysidro Community Park, is expected to begin in October.
Cruz and Flores said they consider the small-scale development an important model for other housing projects in small communities like San Ysidro — one that puts residents’ needs first and aims to spur community engagement.
Plans for the $8.7 million project, named Living Rooms at the Border, include 10 apartments: four 3-bedroom units, three 2-bedroom units and three 1-bedroom units. Rents are estimated between $900 and $1,800.
“In neighborhoods like San Ysidro, housing cannot just be units on their own,” said Cruz, a public culture and urbanization professor at UC San Diego. “They need to be embedded in an infrastruture of social, cultural, educational and economic programming.”
To that end, plans call for the church to be restored and used for visual arts and theater programs run by theater company Teatro Mascara Magica and a UCSD program named Community Stations. The space, which will be re-named El Salon, or The Hall, will include a recording studio.
Plans also include an open-air pavilion called Casa Patio, where UCSD would put on art-related programs and activities for the community.
“This is about developing programs, developing participation and developing engagement,” Cruz said.
Also included in the plans are five office spaces, reserved primarily for community services. Casa Familiar intends to use two spaces to offer immigration services and a third to house a coffee cart, which would provide barista jobs to youth.
Casa Familiar has not yet designated a use for the two other office spaces, although the nonprofit has considered leasing to San Ysidro Health for a small clinic.
Other aspects of the the project that aim to draw the community include walkways and courtyards.
Cruz and Flores said they hope the the project encourages more urban development in San Ysidro and beyond.
“It’s about respecting the small-scale fabric of the historic center, the heart of San Ysidro,” Cruz said.
The project dates back to 2000, when Casa Familiar purchased the land on which the church stands. In 2001, Casa Familiar bought an adjacent property, with a ramshackle house on it.
Cruz and his partner Fonna Forman, a UC San Diego political science professor, pointed to various aspects that contributed to the time frame of the project.
“This is not a developer-driven project, which from the beginning has budgets and a process all in place,” he said. “For this project, Casa Familiar has to construct a process: advocating for the right housing agenda, fundraising for acquiring land, approaching policy makers to raise awareness about the relations between housing and social services, and developing outreach efforts in collaboration with others like UCSD and foundations. To put in place the right financial composition that could support an unorthodox housing project.”
The project was one of five selected by the city of San Diego as part of a development planning effort, named the “City of Villages” initiative. The initiative began in 2002 and later fell apart. Despite the loss of support from the city, Casa Familiar moved forward with the project.
In 2010, the project gained national attention after it was showcased as part of an exhibition named “Small Scale, Big Change” at the Museum of Modern Art in New York.
Casa Familiar, which has developed six housing projects, including two in National City, received funding for the project from the PARC Foundation and Civic San Diego’s New Market Tax Credit program.
The project is expected to be completed in a year.
Link to original article: https://www.sandiegouniontribune.com/communities/south-county/sd-se-livingrooms-border-20180822-story.html
South Los Angeles hasn’t historically been top-of-mind when it comes to investment opportunities. The more than $6 million of investments made through the federal New Markets Tax Credit Program (NMTC) for the Martin Luther King, Jr. Community Hospital (MLKCH), are an important signal of change to that thinking. Investors include Citi, Chase, Beyond The Bottom Line Group & Aszkenazy Development, Stonehenge Capital, and U.S. Bank.
MLKCH uses the funds to support expansion of healthcare services, taking direct aim at areas of high patient need. Capital projects completed with NMTC funding allow the hospital to offer care for conditions before they progress, putting patients back on the path to health.
“Creating a healthier community requires strong local leadership that inspires outside investment. New Markets Tax Credit allocations are an innovative addition to traditional philanthropy as a means of attracting dollars into communities like South Los Angeles.” –Kyle Walton, president of Classic Lake Consulting & Investments
Created to bring capital investments into low-income communities around the United States, the federal New Markets Tax Credit Program offers incentives to businesses that finance projects aimed at generating local jobs and meeting needs in distressed communities like South Los Angeles. Two of the investors, Beyond The Bottom Line Group and Aszkenazy Development, are based in southern California.
MLKCH has begun to create permanent jobs related to the expansion of healthcare services supported by these investments. In South Los Angeles, where nearly a third of the population lives in poverty and more than half of adults are unemployed (“Key Indicators of Health,” LA County Department of Public Health, January 2017), adding living-wage jobs also supports population health.
Kyle Walton, president of Classic Lake Consulting & Investments in Los Angeles and a member of the MLK Community Health Foundation’s board of directors, was a driving force behind the hospital’s success in securing the allocations.
“Creating a healthier community requires strong local leadership that inspires outside investment,” said Kyle. “New Markets Tax Credit allocations are an innovative addition to traditional philanthropy as a means of attracting dollars into communities like South Los Angeles.”
“Leveraging this funding option is one more example of the skilled and determined leadership we have here at MLKCH,” said Dyan Sublett, President of the MLK Community Health Foundation. “Innovation is part of our organization’s DNA. We’re grateful to Kyle, as well as to all of the investors using NMTC to bring new assets and resources to our community.”
Link to article: http://mlk-chf.org/nmtc-investment/
The Robinson Grand Performing Arts Center is closing a major chapter in funding. Today, within Council Chambers, City Manager Martin Howe presented an overview of New Market and Historic Tax Credits which were used to assist in financing the Robinson Grand as equity towards the overall project.
In attendance for the presentation were members of the community, Clarksburg Development Authority, Urban Renewal Authority, Clarksburg Uptown, City Council, representative from Senator Capito’s office as well as members of the media.
Historic tax credits are one of the most effective tools to ensure the viability of rehabilitation projects.
Rehabilitation tax credits – available from both the federal government and state – are dollar for dollar reductions in income tax liability for taxpayers who rehabilitate historic buildings. The federal credit is 20% of qualified eligible expenses for income-producing properties that are certified historic structures (like the Robinson Grand). The state credit is 10% of qualified eligible rehabilitation expenses for income producing buildings. The State Historic Preservation Office (SHPO) administers both the federal and state tax credit programs in West Virginia. The National Park Service, Department of Interior, has final approval of the Federal Historic Tax Credits.
The New Market Tax Credits (NMTC) is a very competitive program and the entity must meet certain criteria, such as being located within an eligible Census Tract. The NMTC’s assist in revitalizing distressed properties and to develop new opportunities for its community. The NMTC is a valuable source of funding to have an immediate and direct impact within the community.
Multiple partners were retained as well as cultivated to facilitate securing these funds. Some of those partners are:
Brian Wishneff & Associates – Tax Credit Consulting Firm
Spencer Fane – City’s legal representation retained by Brian Wishneff & Associates
Novogradac & Co., LLP – CPA firm specializing in Tax Credit programs.
PIFS – People Incorporated Financial Services - $10,000,000 NMTC Allocation
CAHEC – Community Affordable Housing Equity Corporation - $10,000,000 NMTC Allocation
US BANK – purchased all tax credits
TWAIN Investment Fund
MVB Bank – Bond Anticipation Notes (BANS) – Provided 1 day loan $10,000,000
Through securing both the New Market and Historical Tax Credits, the City reduced the overall cost of the performing arts center which provided a net gain of $6,550,607.
The Robinson Grand Performing Arts Center will develop many new opportunities for our community through assisting in developing and embracing the cultural arts community and providing a strong educational component.
The Robinson Grand is one of North Central West Virginia’s largest economic development projects. Located in Clarksburg’s Central Business District, the center is undergoing a $15 million renovation and restoration with an opening slated for Spring 2018.
Link to Article: https://www.therobinsongrand.com/single-post/2017/11/09/City-Secures-6550607-in-Tax-Credits
LOS ANGELES — If you want a glimpse into the future of American hospitals, this corner of South Central Los Angeles might seem an unlikely stop. Caught between Compton and Watts, the Willowbrook neighborhood is better known for a history of gang violence and race riots. Its previous hospital, the old Martin Luther King Jr./Drew Medical Center, was dubbed "Killer King” and shuttered in 2007 after horrific stories of patients being given the wrong drugs, preventable deaths and other incidents of mismanagement or incompetence.
Los Angeles County Supervisor Mark Ridley-Thomas, widely credited as the elected leader most responsible for the hospital's rebirth, walks through the farmer's market located at the entrance of the new Martin Luther King, Jr. Community Hospital. | Nancy Pastor for POLITICO
Today, that building is still there, a hulking concrete carcass that represents one of the bleakest chapters in Los Angeles County's health history. And next to it is a gleaming new hospital that opened its doors two years ago, reorganized and built from scratch.
Though King/Drew ultimately failed the community, the county-run hospital was also the only source of health care for hundreds of thousands of residents of this poverty-riven area of the city. Its emergency department had been the place mothers went to deliver babies, children were brought if they had high fevers and gunshot victims were sewn up. Its closure effectively left one of the city’s most vulnerable communities without access to health care.
So when a group of community leaders and elected officials started to plan for King’s replacement, they did something bold: Instead of even considering fixing up the old hospital, they decided to start fresh and build a new one. And to do that, they would have to rethink the very concept of what a hospital is and what it does.
The new private, nonprofit Martin Luther King Jr. Community Hospital is a nearly $300 million medical center that shares the same county-owned grounds as the old hospital, but little else.
For one thing, the new hospital is much smaller, with just 131 beds compared with the old hospital's 233 beds. Instead of being the sole source of a whole area’s medical needs, the new hospital is designed as the hub of a wide network of clinics, neighborhood outposts designed to provide the day-to-day care residents need. The hospital itself focuses instead on acute-care and highly specialized services for a smaller but sicker group of patients.
But perhaps the biggest difference is the vision. The hospital is just one part of a larger system to improve the lives and protect the health of its residents—a system that extends well beyond medical care. The county is creating new senior housing and additional services, working with the hospital to bring healthier food options and even more jobs to the area. Meanwhile, the hospital is working to provide more outpatient services outside its walls and to support the county in revitalizing the community.
In fact, in many ways, the hospital of the future is an un-hospital. Instead, it’s a wellness network with a small hospital at the center, providing critical care for the small number of acute illnesses and injuries that can’t be addressed in any other setting.
"Hospitals are actually a very small part of the solution for health in most communities," said Mitch Katz, an internist who heads L.A. County's Department of Health Services and oversaw the reimagining and rebuilding of the new hospital.
"Because hospitals are these large buildings, people tend to equate health with hospitals when, in fact, you go to a hospital when you're not healthy."
The vision isn’t complete yet, but it already includes some components that might not normally fall under a hospital’s purview. On a recent day, L.A. County Supervisor Mark Ridley-Thomas, widely credited as the elected leader most responsible for the hospital's rebirth, paid a visit to the campus and pointed out what parts already exist and which are in the works.
In front of the new hospital was a farmer's market—an effort sponsored by the county to combat the neighborhood’s lack of fresh fruits and vegetables. A new behavioral health center will soon open in the concrete building that housed the old hospital. Ridley-Thomas pointed to existing structures across the street – near the King/Drew Magnet High School of Medicine and Science – and noted plans to build a new senior center, a community library and a new Willowbrook/Rosa Parks transportation hub.
Ridley-Thomas called it "a state-of-the-art way of operating a medical campus.” By the end of 2019, the county will have invested more than $1 billion in a revitalization effort that's expected to bring at least 2,700 jobs to the area.
That larger vision of trying to take care of the community – not just treating patients in the hospital – is what puts Martin Luther King Jr. Community Hospital in the forefront of where U.S. health care is going, said Bruce Leff, professor of medicine at Johns Hopkins University School of Medicine and director of the university's Center for Transformative Geriatric Research.
Leff described the new facility as having "a leg up" on other hospitals in trying to do that. Most hospitals are so established in their thinking and in their communities that it’s hard for them to rethink their mission. South Central had a chance to turn the tragedy of the old hospital’s closing into an opportunity to shed old thinking, an old facility and take a giant step into the future. And along the way it had a chance to figure out how to address the social factors that public health experts increasingly believe have more to do with your health than any hospital, factors like poverty, access to good food and education.
"Health systems are over time and into the future are going to take much more responsibility for dealing with the social determinants of health in the service of providing better wellness and better health, not just health," Leff explained. "In my view, that's the next frontier."
Needless deaths
The old King/Drew hospital opened in 1972 with the best intentions. Born out the 1965 Watts race riots, which left 34 people dead and more than a 1,000 injured in an area that had no medical facility, the King hospital and its affiliated medical school, Charles R. Drew University of Medicine and Science, served as a source of pride for the neighborhood just south of Watts, which at the time was predominantly African-American. It was named after two African-American icons – King, the civil rights leader, and Drew, a pioneering physician who developed blood banks.
The hospital was a huge boon to the neighborhood. Before the original hospital opened, 83-year-old Alice Harris, a community organizer and mother of nine known in the neighborhood as "Sweet Alice," remembers tending to her neighbors’ needs with a little bag filled with alcohol, Band-Aids, aspirin and cough medicine she made herself. "If a child got ran over in the street, he was going to die because it would be three hours before the rescue would come," said Harris, who at the time was working as a hairdresser in her home in the housing projects.
But over the years, King/Drew hospital's reputation dropped to the bottom ranking among American teaching hospitals and became rocked by allegations of incompetence, medical errors and needless deaths. A Pulitzer Prize-winning series published in 2004 in the Los Angeles Times recounted appalling stories: a meningitis patient being given a powerful anti-cancer drug for four days, employees pilfering and in some cases selling hospital drugs, nurses failing to monitor patients' vital signs. Medical mistakes, the Times reported, cost the county more than $20 million in malpractice payments from 1999 to 2003. In a particularly harrowing tale from 2007, a woman died after writhing in pain for 45 minutes on the waiting-room floor while the hospital's surveillance cameras show a janitor mopping up around her.
To many residents like Harris, those stories were overblown and, in her opinion, unfair or even fabricated. The hospital and trauma center filled their needs, and remained a point of pride.
"We didn’t see what they seen. We didn’t see those problems," Harris explained. "Our children were being taken care of. We had the best trauma center in the world."
Allan Avant, who grew up in Watts, didn't think the "Killer King" moniker was related to its reputation for poor care. "A lot of people would go in there for gunshot wounds and end up dead," said Avant, 58, adding he always considered it to be a good hospital. But those breakdowns in care eventually caused the hospital to lose its accreditation and shut its doors. The closure forced many residents to travel longer distances for care, or simply to forgo it altogether.
Ridley-Thomas, a former state assemblyman and senator, was sworn in as a member of the Board of Supervisors on Dec. 1, 2008, charged with representing about 2 million people in Los Angeles’ 2nd District, an area that includes the hospital and some of the most marginalized and troubled parts of the county. He advocated for the hospital's closure, calling its substandard conditions "completely unacceptable" and "indefensible."
Today he looks at the new medical center like he still can't believe it's there. "When a hospital closes, particularly a public hospital closes, it does not open again," he said. "That which has been accomplished here is, in fact, contrary to the known and lived experience of patients, as well as hospital administrators and health care providers."
The challenges it faces are broad and deep. The new hospital's service area – approximately a three-mile radius from the hospital that includes residents of Los Angeles, as well as nearby cities such as Compton, Carson and Gardena – has some of the worst health outcomes and inequities in the state. There's a dearth of doctors, which is typical in underserved areas but exacerbated by the exodus of primary-care and specialty physicians after King/Drew closed. (A study conducted earlier this year found a shortage of more than 1,200 doctors in the area it serves.) Fewer than half the adults in the area speak mostly English at home, a statistic that requires the hospital to translate materials, have caregivers who speak Spanish and use technology to provide interpretation in less common languages and dialects. About a third of the region lives at or below the federal poverty level and more than 40 percent lack a high school diploma.
Health outcomes are also poor, with mortality rates for stroke and coronary heart disease about 30 percent higher than the county overall. The area lacks many of the features – access to healthy foods, safe spaces for walking and exercise – vital for good health and instead has too many liquor stores, high rates of crime and other factors that create stress and disease.
These might not seem like a hospital's problem, but ultimately that's where they land. Public health experts are increasingly convinced that addressing such issues—what medical and social scientists refer to as the “social determinants of health”—is crucial both for patients and for building a cost-effective health care system. Rather than just treating the illnesses that result from all these factors, they're looking for new models of health care that can address those problems at the root, as well as deliver more traditional medical services.
"Most of the health of the community is not related to what happens in the ICU," Johns Hopkins' Leff said. "Martin Luther King becomes an agent of both health care and the public trust by doing this kind of work."
New safety net
What’s new about the King hospital begins with who runs it. Most safety-net hospitals are public, run by a county or city government. The old hospital was run by L.A. County. The new hospital is governed by a private nonprofit entity. "You have a lot of existing hospital systems that build new facilities. They take a template and stamp out another hospital," said the medical center's CEO, Elaine Batchlor, also the hospital organization's first hire. "What we did here is create a whole new organization, a whole new stand-alone hospital organization, from the ground up. From scratch.”
The longstanding role of the public hospital is to serve as a safety net and take care of the community's most vulnerable patients, regardless of their ability to pay. But the bottom line is that government has been getting out of the business of running hospitals for decades because of financial and logistical challenges.
California, which has 58 counties, has only 15 county-run hospitals. Most safety-net hospitals are now run by private, nonprofit entities, or academic institutions like the University of California. Overall, nearly a fifth of California's hospitals are run by state or local governments, nearly 60 percent are nonprofit and about 22 percent are run by for-profit companies – which puts the state on par with the national average, according to the Kaiser Family Foundation.
Martin Luther King Jr. Community is the only hospital in the state operating under a public-private partnership with its county. The arrangement came out of its unusual circumstances, but Katz, head of the county's health services, believes what was done in L.A. County could be replicated elsewhere. "It's a model for communities where there's a need for public hospital, but there's not a capability to run a public hospital," Katz said, who knows of no other hospital structured like it. "This provides a model for how government and a private entity could open a successful hospital together."
Katz acknowledged that while government can do some things well, it's not very flexible and can be mired in red tape. King’s private structure allows the hospital to make decisions like who to hire and what technologies to purchase more swiftly and efficiently. It can fundraise more effectivel, since most people don't want to donate money to organizations they already fund with their tax dollars.
Batchlor, a Harvard graduate who received her medical degree from Case Western Reserve University and did her internship and residence at Los Angeles’ Harbor-UCLA Medical Center, served as the chief medical officer at L.A. Care Health Plan and was a vice president at the California Health Care Foundation, a nonprofit philanthropy in Oakland. She said she was drawn to King by the idea of creating a new hospital and organization, one that's entirely separate from the medical center's past reputation
The Affordable Care Act's expanded coverage and the hospital's partnership with the county and the state provide essential stability. The nonprofit hospital operates on an annual budget of about $250 million and has remained financially viable despite serving a patient population that relies heavily on government programs.
Batchlor is concerned about the ongoing threat to the ACA and the future of expanded Medicaid, but says she doesn't let that overwhelm her focus. "We're not stressed. We're doing fine and we manage our resources appropriately," she said, adding that the hospital receives special funding to support its safety-net mission and has raised more than $25 million in private contributions since it opened.
Batchlor made it a mission to make sure that every doctor who works at the hospital is board-certified to help ensure the consistency and quality of care that had been lacking under the old regime. In addition, staff members called navigators or "care coordinators" are assigned to every patient on admission, regardless of the level of care needed. Other hospitals tend to use navigators just for the sickest or most complex patients.
The hospital has been open for just two years, so it's difficult to gauge its impact on the community's health. Many of its innovative measures take time to assess. But Batchlor is proud of early signs that point to success. Nearly 90,000 people have been treated by the emergency room, more than twice what was initially projected. While the hospital hopes soon to be able to treat more people in outpatient settings, the high volume of ER visits speaks to the pent-up need in the community for care, as well as residents' confidence in the new facility, Batchlor said.
Unlike its predecessor, the new hospital does not have a trauma center, nor does it have any plans to build one. Trauma centers, which handle the most difficult emergency cases and require high levels of staffing with specialists, are especially costly to operate. Instead, the hospital’s leaders decided to focus on providing better preventative and primary care and to send complex trauma victims to California Hospital Medical Center, about 10 miles north in downtown L.A.
"You don't really know what all of your needs are going to be until you open your doors and start taking care of patients," Batchlor said. "Our doctors, many of whom had trained in hospitals that had similar patients, were surprised at how sick our patients were. Part of it's a reflection of the fact we don’t have enough doctors in the community taking care of people."
Drawing doctors back to the area is high on the medical center’s priority list. The hospital is working with the county to construct a new medical office building on campus to provide space for outpatient care. Meanwhile, in December, the hospital formed a medical group and opened its first outpatient center, a post-discharge clinic tucked away in temporary digs in a strip mall with a Fat Burger in nearby Compton. The medical group is small, with about a dozen physicians, but will grow, especially once it has a permanent home.
Juan Cabrales, the primary-care physician who runs the clinic, says it can be tough to recruit providers because most doctors don't think of South Central as a place they want to work. But that's also part of the draw. "I knew this community didn't have a lot of resources," said Cabrales, who trained at UCLA and is originally from Mexico. "I heard the mission and wanted to be part of the mission and bring highly trained providers, especially primary care, which is highly needed. We want to raise the level of health care delivery."
That mission, along with building a new practice from scratch, also drew Alan Kaplan, a urologist who completed his residency at UCLA and is working on his MBA. He started working at the hospital and the outpatient clinic on Aug. 1.
"It was that ability to craft the ideal practice around, ‘What should health care 2.0 look like in a community that needs it’?" he said. "We have the infrastructure. We have the people. We have the ability to do something very unique."
For Kaplan, technology could be a component of that mission. More than 80 percent of the people in the area have smartphones, and he imagines tapping into that in different ways to provide care and ensure follow up. "There are a lot of ways we can leverage technology and the IT we have to address the social determinants of health," he said. But the biggest challenge, Kaplan said, is convincing people who are used to going to an emergency department for care that they can get appropriate, or even better care in a clinic or doctor's office.
Kaplan said that's a challenge because many patients may have never had a regular primary-care doctor. They may not know they can get care in a clinic, but they know they can go to the hospital.
"There are tremendous challenges here that you just don’t have in West L.A.," he said, referring to the wealthier side of the county. "Everything in life is uncertain: jobs, housing, food, safety, health care, transportation, child care. Everything is a challenge, so when you have a medical issue, whether truly severe or not, there is a tendency to perceive it as supersevere, when maybe it’s not."
Hard sell
While the trend toward shifting care out of hospitals to less acute clinic settings has been going on for years, if not decades, around the country, it's still a hard sell and a balance that's difficult to achieve. Martin Luther King Jr. Community is attempting to build that, along with its larger vision of redeveloping the surrounding neighborhood over the next few years.
Health care futurist Ian Morrison, who serves on the hospital's board of directors, actually floated this question to its founders before the medical center was completed: if care is being pushed outside the medical center, do they really need a new hospital at all? For now, at least, Morrison said, hospitals are still necessary. "If you look at the numbers, in even the most extreme sense of futurism, there are still going to be sick people who need acute care done on an emergency basis,"
Morrison explained. So far, he described the new hospital as being successful, calling it “a hub of excellence” in a community with a long history being medically underserved.
But beyond that, the health of underserved communities need to be tackled on a broader sense. Hospitals around the country are looking at different ways to manage issues such as connecting patients with lawyers to resolve legal or landlord-tenant issues that lead to poor health, such as mold abatement, or helping the homeless find permanent housing. But a lot of these efforts are handled piecemeal.
“Although our mission is really to provide acute care for the community, we are continually finding ourselves saying to do it well, we have to go beyond the walls and into social determinants of health and population health,” Morrison said.
Morrison hopes that Martin Luther King Jr. Community Hospital’s more holistic approach of involving the county and other partners in transforming the neighborhood will, within the decade, yield impressive results in improving overall health status.
“This whole notion of going upstream and dealing with causal factors [of health inequities], it can get too big to manage,” he said. “That's why having the county as a partner is so important because it speaks to such issues as housing and food security and homelessness and transportation.”
For “Sweet Alice” Harris, who never wanted the old hospital closed in the first place, she described having a new hospital back in her neighborhood as heavenly.
"We’re in Beverly Hills now. We never thought we would have something like this here," Harris said. “This is beautiful. This will make you well when you think you're going to die. That's how you can help people. Give them the best. Because giving them the best will change people, and bring the love back in. That's what the best will do."
Victoria Colliver is a health care reporter for POLITICO Pro based in California.
Link to Article: https://www.politico.com/agenda/story/2017/11/08/the-hospital-of-the-future-000572
The tone was joyous during the June 22 ribbon cutting ceremony for Loma Linda University Health – San Bernardino. An awareness and understanding of the area’s great need (it is the poorest city of its size in California) and commitment to the Loma Linda mission to continue the teaching and healing ministry of Jesus Christ inspired the project.
Not only will the campus serve as a clinical and educational facility, it has the potential to become the largest outpatient facility of its kind in the U.S., providing health care for 200,000 people each year.
As he spoke during the formal program, Richard H. Hart, MD, DrPH, president of Loma Linda University Health, recognized old and new friends: colleagues, educators, elected officials, donors and potential students. Together they represented relationships—some dating back more than 100 years—drawn upon to make the campus possible.
Before the Board of Trustees approved the project in May 2014, Hart met with colleagues at Loma Linda University Health and Social Action Community Health System (SACHS) as well as city officials and representatives of other organizations in small groups; planning sessions were carved into demanding schedules while others took place into the evening.
Hart’s message and words were formed with joy and with such deep gratitude that he paused. In that moment the audience spontaneously responded, showing their support with tremendous applause.
Hart explained that the new educational concept integrates vertical and horizontal teaching. San Manuel Gateway College students will complete clinical rotations alongside Loma Linda University students and physicians in specialty training.
While SACHS is the largest provider of health services in San Bernardino County, seeing about 50,000 patients a year, the new campus will more than triple its space, providing enhanced care for tens of thousands of patients who, because of their insurance status, would not otherwise be able to access it.
San Manuel Gateway College, the first of its kind in the United States, will integrate training programs in health careers with clinical experience, allowing students to benefit from hands-on training and mentoring by Loma Linda University Health faculty and students. The college is named after the San Manuel Band of Mission Indians, whose generous donation of $10 million toward Vision 2020: the Campaign for a Whole Tomorrow enabled its construction. The tribe is composed of the indigenous peoples of the San Bernardino Valley and the surrounding mountains, passes and canyons and part of the greater Serrano Nation whose aboriginal lands encompassed the majority of San Bernardino County.
A highlight of the ceremony was the singing of a selection of bird songs by five members of the San Manuel Band of Mission Indians and one from the Cahuilla tribe. In his introduction to the performance, Hart observed that, “The best relationships are the long relationships. This one goes back literally 110 years when we first started here in 1905 with the Serrano Indians.”
Tribal Member Tom Ramos expressed optimism that the new campus will be effective in “revitalizing San Bernardino and our whole community.” See elsewhere on this website for a feature article on the cultural and historical significance of bird songs to the people of San Manuel.
In an interview recorded at the time of the groundbreaking for the new campus, Ramos recalled the days when physicians and nurses from Loma Linda made special trips to ensure that members of the tribe had access to quality health care.
“They came for us,” Ramos reported, “and now that we’ve been blessed with a great fortune, San Manuel is still very much a part of this community, and we really, wholeheartedly, love to give back.”
In calling Nancy Young, MHES, president and CEO of SAC Health System (SACHS), and Arwyn Wild, MA, executive director of San Manuel Gateway College, to the podium, Hart acknowledged that Young has been the administrator of SACHS for 17 years. Before joining Loma Linda University Health, Wild worked as a principal in the San Bernardino City Unified School District for 20 years.
As he began his address to the crowd, Wild said, “It is a privilege to be associated with such a great man,” pointing to Hart. Once the applause subsided, Wild noted that in the beginning, there was a group called the San Manuel Gateway College Task Force that was charged with dreaming and planning for what the new campus could be. “I’m proud to say that that group was made up of many different entities and organizations,” Wild observed.
After noting that it is a privilege to see all the knowledge, energy, and resources represented on the task force brought to bear on the creation of the new campus, Wild choked up when he said, “I would be remiss in making this about us. It’s not about us. It’s about the future. It’s about our kids. It’s about providing the light at the end of the tunnel. This opportunity is what San Manuel Gateway College is all about.”
At the end of his remarks, Wild asked a group of students from San Bernardino City Unified School District to stand. “This is for you,” he concluded.
“It’s an amazingly emotional day,” Young said at the beginning of her comments. “This building that we stand before is all of our dreams, for so many years, coming true, and it’s a remarkable, remarkable thing to be a part of this team!"
After thanking the medical residents from Loma Linda University Medical Center and Loma Linda University Children’s Hospital who have become an integral part of the SACHS family, Young praised Tonya Twyman, MSc., a project officer for HRSA, the Health Resources and Services Administration of the U.S. Department of Health and Human Services.
“In 2013,” Young explained, “we wrote to HRSA and asked for a teaching health center award so we could expand our ability to teach those residents. We were awarded that very year, and it’s been an amazing journey to share this with so many of our residents, whom we love so much.” Young then asked Twyman to stand and said, “She’s amazing, and has supported us so much! On July 1, SACHS will be the largest teaching health center across the nation. So God bless you, Tanya. Thank you so much!”
When it was his turn to speak, San Manuel Band of Mission Indians Tribal Secretary Ken Ramirez acknowledged the emotion of the morning and said, “It’s a new day in San Bernardino!”
Reminiscing about meeting with Hart to discuss what the new campus would accomplish, Ramirez commented, “To see it come to fruition today: what an honor! Today, we’re thinking about Loma Linda, San Bernardino, the county, as our larger family. Through these partnerships we are turning the corner on a new beginning in San Bernardino.
“It’s a very great thing to be a part of something from the beginning to the end,” Ramirez concluded. “And so from my tribal family to the larger family—OUR family—I say ‘Congratulations on a nice new building that’s going to provide services to a large community that went without for such a long time.”
After the ribbon cutting, the crowd dispersed in two different directions. Most people enjoyed the opportunity to mingle and enjoy refreshments inside the community resource center.
Members of the press, however, returned to the tent for a press conference followed by proclamations from a variety of government representatives and organizations including: Congressman Pete Aguilar, State Senator Mike Morrell, State Senator Connie Leyva, Fifth District Supervisor Josie Gonzales and the San Bernardino County Board of Supervisors, Assemblyman Mark Steinorth, San Bernardino County Superintendent Ted Alejandre, San Bernardino Mayor Carey Davis, the San Bernardino City Council and the Fifth District Supervisor Marion Ashley and the Riverside County Board of Supervisors.
Fine art photographer Michael Hardison paid visual tribute to his hometown in a series of photographs in the community resource center titled, “This Beautiful City.”
“A once-thriving city,” Hardison wrote, “San Bernardino is often depicted as a place of crime, corruption, and bankruptcy. In the days following the terror attack (Dec. 2, 2015), the negative interpretations continued, overlooking the good that still resided in the area—the people, the community, and the history of the region.”
Hardison concludes, “The inspiration behind 'This Beautiful City' stems from the resilience of the community; people coming together, reaching out, and moving forward, living in the Inland Empire.”
How fitting that these photographs, which convey such a positive message, are displayed on the very campus where this transformation will occur.
Link to Article: https://news.llu.edu/outreach/ribbon-cutting-ceremony-for-loma-linda-university-health-san-bernardino-celebrates-history-relationships-and-future