Board of Supervisors Stands Behind the Affordable Care Act

The Board of Supervisors braced for a fight over the Affordable Care Act, days after a federal district court decision in Texas v. United States found the landmark law to be invalid. The Board voted to support California Attorney General Xavier Becerra’s efforts to oppose the ruling, and instructed their own lawyers to look into legal action that would appeal the decision, either as a plaintiff or as a friend of the court.

“If you believe, like I do, that healthcare is a right, then this ruling is a step backwards,” Supervisor Mark Ridley-Thomas, the motion’s principal author, said. “The ACA has already withstood relentless legal and political challenges, and I am confident that justice will prevail again and this widely popular law will be upheld. We can’t let political opponents, who have failed multiple times to take down the law through the democratic process, use legal maneuvering to undermine progress.”

Since President Barack Obama signed the ACA in 2010, LA County’s uninsured rate has been cut in half, from 21 percent to 10 percent. More than 1 million residents have gained coverage through the law’s expansion of Medi-Cal – California’s Medicaid program. Several hundred thousand residents have also obtained health insurance through Covered California, the state’s commercial insurance exchange that provides subsidized coverage for individuals and families.

“The ACA has already survived more than 70 repeal attempts in Congress and scrutiny by the Supreme Court,” said Supervisor Hilda Solis, who served as President Obama’s Labor Secretary when the ACA was signed into law. “After eight years of nonstop attacks, repeal votes, and lawsuits, Obamacare is still here, delivering life-saving care to 20 million Americans. Today’s action reaffirms our commitment to ensure health equity and access for every County resident, especially those with preexisting conditions. Last Friday’s ruling clearly shows that Congress must either protect the ACA or produce a credible alternative that provides coverage for those with preexisting conditions and equal access to care for all.”

On Friday, Federal District Court Judge Reed O’Connor ruled that because Congress eliminated the fine for failing to comply with the health insurance mandate specified by the ACA, the mandate is no longer permissible under Congress’s taxing power and therefore unconstitutional. He further concluded that since the individual mandate is “essential” to the ACA, the entire law was invalid. However, because the judge did not enjoin the ACA, the law’s provisions remain in effect nationwide, and the U.S. Department of Health and Human Services has indicated there will be no changes to coverage in the 2019 plans.

Judge O’Connor’s decision has already triggered a widespread backlash, and Attorney General Becerra has declared his intention to challenge the ruling.

Latest Addition to MLK Campus Will Serve Vulnerable Children and Families

Rendering of Child  and Family Wellbeing Center planned for the Martin Luther King, Jr. Medical Campus. 

In a unanimous decision, the Board of Supervisors voted to proceed with the construction of a Child and Family Wellbeing Center at the Martin Luther King, Jr. Medical Campus. Slated to open in early 2020, the 55,000-sq. ft. facility will house a medical clinic for children who have experienced abuse or are in the foster system, as well as an autism clinic, child psychiatry services, and a Family Justice Center.

“Too often, children and families in challenging situations need to piece together the medical, legal, mental health and social services they need,” Supervisor Mark Ridley-Thomas said. “The Child and Family Wellbeing Center will bring these important services together under one roof to make it easier for families in need to get back on track.”

The first floor of the new center will include a Pediatric Hub clinic that will serve as the primary care home for high-risk children. It will replace the existing Pediatric Hub clinic on the MLK Campus, which was constructed in 1974.  Los Angeles County’s network of Pediatric Hubs offers a national model for evaluating and addressing the medical needs of children in the foster care system and those who have experienced abuse.

“I am thrilled that advocacy efforts to support our communities have led to the creation of the Child and Family Wellbeing Center on the MLK Campus,” said Fred Leaf, the interim director of the LA County Health Agency. “This new state-of-the-art facility will offer a welcoming and beautiful space where children and families will be able to receive a wide range of high quality health and human services.”

On the second floor, two community organizations – the Special Needs Network and St. John’s Well Child and Family Center – will partner to serve both children in South LA who have autism spectrum disorders, as well as their families. Providers for children with autism are in short supply nationwide, particularly in urban communities.

“This will be a game-changer in the lives of thousands of kids with autism and other developmental needs,” said Areva Martin, president and co-founder of the Special Needs Network. “For too long, kids in South LA have not had access to high quality medical and developmental services in their own community. That changes with the opening of the MLK Child and Family Wellbeing Center.”

On the top floor, a Family Justice Center will provide respite for those experiencing domestic violence and other unsafe situations. There are already two such Centers in LA, one based at the LAC+USC Medical Campus and another in the San Fernando Valley. The new Center at MLK Campus will expand the program to residents in the southern part of the County. Consistent with the Center’s overall theme, the Family Justice Center will offer comprehensive medical, mental health, legal and social services all in one place.

“It is precisely during our moments of greatest challenge when we most need high quality, integrated, and holistic services,” Supervisor Ridley-Thomas said. “This auspicious new facility will create such a healing environment.”

More Physicians Coming to South LA

Dr. Francisca Mata received care at the former King/Drew Hospital as a child. Now, she’s providing healthcare in the community where she grew up, completing a new medical residency program at the Charles R. Drew University of Medicine and Science (CDU).

In partnership with the Los Angeles County Health Agency, the residency programs will train a new generation of doctors to serve patients in South Los Angeles and surrounding communities. For Dr. Mata and her colleagues, the need is great and the calling is personal.

Acting on a motion by Supervisor Janice Hahn and Board Chairman Mark Ridley-Thomas, the Board of Supervisors approved startup funds to establish residency programs in both psychiatry and family medicine. Dr. Mata is part of the first class.

“We have a dramatic shortage of primary care and mental health clinicians in this nation, and this shortage is most acutely felt in communities such as South Los Angeles,”  Supervisor Ridley-Thomas said. “It is vital that we empower doctors-in-training to become medical leaders who promote wellness and healthcare equity in a compassionate manner.

“This residency program will create a new pipeline for our homegrown LA County physicians,” added Supervisor Hahn.

The Family Medicine residents will rotate through Department of Health Services facilities in the southern region of the County, including the Rancho Los Amigos National Rehabilitation Center, which will be their home base for inpatient rotations.

The Psychiatry residents will focus on ambulatory services in communities that comprise the County’s Service Planning Area 6, which includes Athens, Compton, Crenshaw, Florence, Hyde Park, Lynwood, Paramount and Watts. Their primary training site will be the Kedren Community Health Center in South LA.

CDU is an accredited Graduate Medical Education Sponsoring Institution. The Family Medicine residency started off with eight residents, but is expected to enroll 24 residents by 2020. The Psychiatry residency had four residents to begin with, but is expected to enroll 16 residents by 2021.

Empowerment Congress Café Promotes Mental Health

Empowerment Congress Mental Health Cafe held at the Los Angeles Child Guidance Clinic. All photos by Diandra Jay/Board of Supervisors.

Supervisor Mark Ridley-Thomas, the Empowerment Congress (EC) Mental Health Committee, and the Los Angeles County Department of Mental Health (DMH) hosted a café to highlight new and innovative ways of promoting positive health and well-being in the community.

Over 200 people attended the event, which featured interactive exhibits showcasing all five aspects of the mental health services the County provides, including psychiatry, psychology, nursing, social work, and peer resource.

“We want to ensure that you learn as much as you can today and that you also learn how to remain engaged,” said Supervisor Mark Ridley-Thomas.  “The County is counting on you to make “Your DMH” as dynamic, diverse and multidimensional as you are.”

“The EC Mental Health Committee is excited to host an interactive event with the community that highlights the new DMH,” said EC Mental Health Committee Chairman Dr. Jack Barbour.

The event also highlighted the critical services for particularly vulnerable residents, including Street Outreach and Engagement in Skid Row and the rest of the County, Outpatient Services, and Prevention and Early Intervention. DMH has also invested efforts into innovative and interactive technology tools that are being piloted including wellbeing apps.

“I used to be homeless but DMH help me to find a place, go to therapy, and get proper medication,” said Tammy Lee, a resident of South LA.

DMH Director Jonathan Sherin said, “We are very excited and proud about our investments to care for and support the well-being of our most vulnerable residents and communities. Today, we celebrate those efforts in South LA and look forward to having similar events throughout the county.”

Also highlighted were the capstone projects taking place in the Second District including the new DMH Headquarters in Koreatown and the transformation of the long-shuttered King Drew Hospital into a state-of-the-art Behavioral Health Center in Willowbrook.

The Empowerment Congress is a distinctive and deliberate national model of civic engagement built on the core principles of participatory democracy, reciprocal accountability, and intentional civility. It is a dynamic partnership among neighborhood groups, residents, nonprofit organizations, businesses, religious institutions, and community leaders within the diverse communities of Los Angeles County’s Second Supervisorial District.

Cracking Down on Nuisance Tobacco Shops

Acting on a motion by Supervisors Mark Ridley-Thomas and Janice Hahn, the Board of Supervisors voted to draft an ordinance expanding the regulation of nuisance tobacco shops.

They said the ordinance should:

• ban tobacco shops in residential zones;
• ban tobacco shops within a certain distance of residential zones, schools, parks, youth centers and other locations whose primary purpose is to serve children; and
• require tobacco shops to obtain a business license; and
• regulate retailers of electronic and flavored tobacco products.

“Our communities, particularly our youth, are facing new challenges to their health and safety with the rise of vaping and e-cigarettes, not to mention the challenges posed by existing nuisance tobacco shops,” Supervisor Ridley-Thomas said. “It is important that we craft a thoughtful and balanced approach to regulation.”

“My office gets many calls from residents dealing with nuisance smoke shops– shops that are advertising and selling to kids or blowing smoke into their homes,” Supervisor Hahn said. “This is a serious health issue and a quality of life issue and we need new tools to better protect our residents, their children, and their neighborhoods.”

Back in March, the Board directed the County’s Department of Public Health to work with the Department of Regional Planning, County Counsel, Sheriff, Treasurer and Tax Collector, and community stakeholders to assess the number and location of nuisance tobacco shops countywide, ways to monitor them, and best practices for regulating them. The Board also called for developing education and outreach strategies to reduce the use of tobacco and certain other substances.

Some of the workgroup’s findings and recommendations will form the basis of the ordinance, which will be submitted to the Board for approval within 180 days.

“The Public Health Department supports efforts led by Supervisor Ridley Thomas to protect our young people from harmful tobacco products that are often advertised and packaged to appeal to teenagers,” Public Health Director Barbara Ferrer said. “Limiting the proliferation of smoke shops can both reduce youth exposure to tobacco products and address the many concerns of residents living in close proximity to these businesses.”

County Regional Planning Director Amy Bodek added her department “fully supports healthy, thriving neighborhoods, and will advocate with the Board of Supervisors and DPH to implement appropriate regulations to curb the proliferation of tobacco use, particularly smoke shops.”

As part of the workgroup, the nonprofit Community Coalition held a forum to hear the public’s concerns about nuisance tobacco shops. Its director of organizing, Patricia Guerra, welcomed the drafting of an ordinance to address the problem. “It is time to put the people of LA County first and improve the health and safety of all communities by putting an end to the overconcentration of nuisance sites that foster crime and addiction,” she said.