Willowbrook, MLK

LA County’s First Behavioral Health Center

Twelve years after its closure, the original Martin Luther King, Jr.  Hospital building will be repurposed into the state-of-the-art Martin Luther King, Jr. Behavioral Health Center with a groundbreaking scheduled on October 23.

The Board of Supervisors on Tuesday unanimously approved entering into a contract with Bernard Bros. Inc. to design and build the 500,000 sq. ft. MLK Behavioral Health Center, envisioned to provide fully-integrated inpatient, outpatient and supportive services for some of Los Angeles County’s most vulnerable populations, including those struggling with mental illness, substance use disorders and homelessness, and those who have been in the criminal justice system.

“I can think of no better way to breathe new life into the building that previously housed the original Martin Luther King, Jr. Hospital than to transform it into a one-stop-shop for helping our community members with a variety of mental and physical health needs,” said Supervisor Mark Ridley-Thomas, who spearheaded the project.

The MLK Behavioral Health Center will be the latest addition to the 42-acre MLK Medical Campus in Willowbrook, which already houses the MLK Community Hospital, Outpatient Center, Recuperative Care Center, Mental Health Urgent Care Clinic, and Center for Public Health, which includes the Community Healing and Trauma Prevention Center. The Child and Family Well-Being Center and the Medical Office Building are under construction and will open next year.

Over the last decade, well over $1 billion has been invested in Willowbrook, dramatically improving the community’s amenities. In addition to the still-expanding MLK Medical Campus, Willowbrook has also seen improvements in its public transportation system, streets, parks and libraries, as well as a significant expansion in its pool of affordable apartments.

“Over the last decade, we have transformed the MLK Medical Campus into a center of excellence that provides holistic care for our community,” Supervisor Ridley-Thomas said. “With the MLK Behavioral Health Center, we are intent on establishing a cutting-edge continuum of care that promotes mental health, recovery, trauma prevention, rehabilitation, and many other essential wrap-around services that foster long-term wellness for our patients and the community at large.”

MLK Behavioral Health Center Open House at the MLK Center for Public Health on August 7, 2019. Photo by Martin Zamora / Board of Supervisors

The $335-million MLK Behavioral Health Center will house clinical and behavioral staff from the Departments of Mental Health, Public Health and Health Services. The Probation Department, Office of Diversion and Reentry (ODR), and Workforce Development, Aging and Community Services (WDACS) will sponsor rehabilitative, vocational and training opportunities intended to give people the skills they need to reintegrate into society. This is the first time all of these County services will be available under one roof.

“We are revitalizing the former King/Drew Hospital as a collaborative resource for behavioral health that will set a new standard for how a public system can deliver on its promise to provide restorative care and at the same time invest heavily in community reintegration,” LA County Mental Health Director Dr. Jonathan Sherin said. “With an arc of services across all levels of treatment intensity alongside an array of opportunities that support recovery, LA County is stepping up to address the needs of its most vulnerable populations. The MLK Behavioral Health Center will not only bring hope and healing to individuals, but to a community and a region that has been underserved for far too long.”

“With the opening of the MLK Behavioral Health Center, we will continue to work together to transform how services are delivered to LA County residents,” added LA County Health Services Director Dr. Christina Ghaly. “Having the ability to screen and assess depression to motivate healthier behaviors and provide comprehensive care for those with serious mental illness is an essential component of high-quality, financially sustainable healthcare and the future of population-based healthcare.”

LA County Public Health Director Dr. Barbara Ferrer said, “We are uniquely positioned to offer hope for our residents struggling with behavioral health concerns through an integrated approach that places patients at the center.”

LA County Probation Chief Terri McDonald added, “The ability of Probation staff to connect our clients to critical onsite reentry services, such as behavioral health counseling and job training, improves client outcomes and community safety.”

“The Behavioral Health Center will enable us to strengthen critical services for older and dependent adults,” said WDACS Acting Director Otto Solorzano.  “We are thrilled to be part of this visionary effort to establish comprehensive behavioral health services for communities served by the Martin Luther King Jr. Community Hospital.” ODR Judge Peter Espinoza (ret.), said, “With the MLK Behavioral Health Center, the people we serve will have an easily accessible location in the community from which to take advantage of the critical mental health, substance use, housing and job readiness services that they need to successfully reenter society after a stint in the criminal justice system.”

Breaking Ground on a First-of-its-Kind Child and Wellbeing Center in South LA

Hundreds of people came out to celebrate as Supervisor Mark Ridley-Thomas led the groundbreaking ceremony for the first-of-its-kind Martin Luther King, Jr. Child and Family Well-being Center, slated to open in Willowbrook in April 2020.

The three-story, 55,000 square foot building will have a Pediatric Medical Hub Clinic on the first floor, an Autism Wellness Center on the second floor, and a Family Justice Center on the third floor, staffed by several Los Angeles County Departments and community-based service providers to maximize collaboration and service integration.

Supervisor Ridley-Thomas speaks at the groundbreaking ceremony. Photo by Diandra Jay / Board of Supervisors

“This Center represents the latest in a series of transformational investments in human infrastructure,” Supervisor Ridley-Thomas said. “We are continuing our commitment to the health of the mind, body and soul of this community. I contend that these are the most critical investments we can make, especially when we focus on children, adolescents, and families.”

The first floor of the Child and Family Well-being Center will replace the three trailers currently serving as the MLK Pediatric Medical Hub Clinic, which provides outpatient clinical services for at-risk pediatric and adolescent patients and their families. The County Departments of Health Services (DHS), Mental Health (DMH), Public Health (DPH), and Children and Family Services (DCFS) will all have staff at the new Center to provide services such as pediatric and adolescent health care for foster youth, and forensic medical examinations, hearing and vision screenings, trauma-informed mental health services, family visitation, and Parent-Child Interactive Therapy.

“The MLK Pediatric Medical Hub Clinic on the MLK Medical Campus is one of the busiest in the County’s system, situated in the region of LA County with the highest density of DCFS cases and managing over 8,000 referrals a year,” County Health Services Director Christina Ghaly said. “Given its critical role in evaluating and caring for children in the DCFS system, DHS is thrilled to be breaking ground on a new state-of-the-art facility that will allow for an expanded set of services that will be provided in an integrated, collaborative manner by County and community-based organizations. Through greater partnership, we will be able to better meet the comprehensive health needs of these most vulnerable children.”

Breaking ground for the Martin Luther King, Jr. Child and Family Well-being Center. Photo by Diandra Jay / Board of Supervisors

“The MLK Child and Family Well-being Center is very specifically designed to help DCFS succeed in addressing a multitude of the challenges faced by those engaged in the child welfare system, with a particular focus on the prevention and mitigation of trauma,” County Mental Health Director Jonathan Sherin said. “It heralds a new era of partnership between key LA County departments and the private sector, recognizing that we must always put the wellbeing of our kids and households at the center of everything we do.”

The second floor will house an Autism Wellness Center operated by St. John’s Well Child and Family Center, and the Special Needs Network (SNN). The Autism Wellness Center will provide comprehensive screening, medical, dental, and behavioral health services for special needs children, teens and adults. Other high quality services will include Applied Behavior Analysis, speech and occupational therapies, outdoor sports courts, a yoga center and music, technology and creative spaces.

“Finally, South Los Angeles will have a state-of-the-art health and development center for children with autism and their families that will provide high quality medical and dental care as well as developmental services to an area and a population that has lacked these critical services for far too long,” St. John’s Well Child and Family Center CEO Jim Mangia said. “St. John’s is honored to partner with SNN and Supervisor Mark Ridley-Thomas to create this unique and comprehensive program.”

SNN founder and president Areva Martin speaks. Photo by Diandra Jay / Board of Supervisors

“If you should speak to anyone affected by autism, a learning, intellectual or developmental disability, chances are you will hear stories of hidden suffering, shame and discrimination in nearly every sector of their lives. The SNN Autism Wellness Center seeks to change that,” SNN founder and president Areva Martin said. “Through a holistic approach and comprehensive mix of personal and community health and justice, this one-of-a-kind center will provide the kinds of much needed early diagnostic and intervention services sorely missing in communities of color—the kinds that will have a lasting impact on the health of the entire County of Los Angeles.”

The third floor will house a Family Justice Center where a multi-disciplinary team of professionals will work together, under one roof, to provide supportive services to those affected by domestic, family, intimate partner, and sexual violence.

“We are grateful to be working with our County partners to establish the Family Justice Center,” County Public Health Director Dr. Barbara Ferrer said. “This wonderful resource for families and children in South LA will help residents confronting domestic violence, not just to assure immediate safety and legal needs, but also to promote long-term family health and well-being.  The Family Justice Center will apply the family-centered, compassionate, culturally-competent approach of the Well-being Center to families for whom domestic violence may be occurring against a back-drop of poverty, racism and other forms of social marginalization.

The MLK Child and Family Well-being Center is the latest addition to a still-expanding MLK Medical Campus, which already includes the MLK Community Hospital, MLK Outpatient Center, MLK Mental Health Urgent Care Center, MLK Recuperative Care Center, and MLK Center for Public Health. MLK Medical Office Building is currently under construction, and plans are underway for the MLK Behavioral Health Center.

Renderings of the Martin Luther King, Jr. Child and Family Well-being Center at the groundbreaking ceremony. Photo by Diandra Jay / Board of Supervisors

Breaking New Ground on MLK Medical Campus

Groundbreaking for the MLK Community Health Medical Office Building. Martin Zamora / Board of Supervisors

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.

Sweet Alice Harris speaks at the groundbreaking. Martin Zamora / Board of Supervisors

“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 Supervisor 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 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 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.

New Community Healing and Trauma Prevention Center

(left to right) Willowbrook Resident & Volunteers of America Prevention Coordinator Ebony Luchien, Supervisor Mark Ridley-Thomas, and Dr. Jan B. King. All photos by Bryan Chan / Board of Supervisors

Supervisor Mark Ridley-Thomas along with the Los Angeles County Department of Public Health, and community partners unveiled the new Community Healing and Trauma Prevention Center at the Martin Luther King Jr. Center for Public Health. The Healing Center will serve a community that experiences the highest rates of assault-related trauma and homicide in Los Angeles County. Homicide rates in South Los Angeles are nearly four times higher than the rest of the county.

Supervisor Mark Ridley-Thomas addresses over 100 attendees at the Community Healing and Trauma Prevention Center unveiling.

“The Community Healing and Trauma Prevention Center shows the County’s commitment not just to treating trauma after it occurs, but also to preventing it in the first place,” said Supervisor Mark Ridley-Thomas. “Our efforts represent a paradigm shift in how we address violence. Rather than managing violence solely through public safety approaches, we are counteracting it using evidence-based public health practices.”

The Healing Center was developed with input from community leaders to ensure that the services provided reflect the community’s desires and focus on both healing and organizing for change. Support was provided by various agencies including the Los Angeles County Departments of Public Health, Health Services and Mental Health, MLK Community Hospital, MLK Outpatient Services, Saint Francis Medical Center, and Charles R. Drew University. The Los Angeles District Attorney’s Bureau of Victim Services and members of the Community Action for Peace also participated in the development of the Healing Center.

Supervisor Ridley-Thomas high fives Dr. Barbara Ferrer during a tour of the Community Healing and Trauma Prevention Center during its opening.

“The Community Healing and Trauma Prevention Center provides a safe space where residents can access support and services, where young people can develop their leadership skills, and where community partners can work together to tackle the root causes of complex trauma in South Los Angeles,” said Barbara Ferrer, PhD, MPH, MEd, Director of Los Angeles County Public Health.

The Healing Center will build upon Trauma Prevention Initiative strategies in partnership with the community to create a comprehensive approach to violence prevention and intervention. For the past 3 years, the Trauma Prevention Initiative has been investing in community engagement and key violence intervention and capacity-building strategies to coordinate strategies across the lifespan, leverage resources of existing programs and develop innovative strategies, policies, partnerships, and strategic opportunities.

How ‘Killer King’ Became
the Hospital of the Future

A tough Los Angeles neighborhood shuttered its hospital,
and embraced something totally new.

Published with permission from POLITICO. Click here for the full story and photos.

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.

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.