New L.A. County health services chief reports for duty, says he's ready for challenges
Wearing a blazer and tennis shoes, Dr. Mitchell H. Katz, the new head of the Los Angeles County Department of Health Services, received a warm welcome at his introduction to L.A. County supervisors Tuesday.
His first challenge? Getting here in time for his first day. Katz was driving south to L.A. from San Francisco on Sunday when the Grapevine was closed on Interstate 5 because of a snowstorm.
Instead of hunkering down in Bakersfield for the night, he drove through the Cuyama Valley, bounded by the La Panza Range to the north and the Sierra Madre Mountains to the south, to get to Santa Maria on the coast, and then took U.S. 101 to L.A.
“I’m a very persistent guy,” said Katz. “It took me 15 hours. I arrived about 2 a.m. I was determined that I was getting to Los Angeles.”
Katz, 51, the first permanent chief of the key county agency since 2008, is charged with managing the county’s sprawling $3.5-billion network of public hospitals and clinics. For years, the agency has been challenged by financial difficulties, overcrowding and questionable oversight of its troubled operations.
Katz began his $355,000-a-year job Monday. Before that, he headed San Francisco’s public health agency for 13 years.
“I’m really looking forward to working with you,” a smiling Katz told the supervisors at Tuesday's meeting. “People have been incredibly welcoming. I love living in Los Angeles. It’s only been now three days, but I am really happy here. And I look forward to being here a very long time and making the kinds of changes and improvements that we all want to see.”
Katz is the first new leader of the department since 2001, when Thomas Garthwaite was hired after leaving the top medical officer position at the Veterans Administration.
“Our challenges in that department are some of the largest challenges you’ll ever come across,” Supervisor Gloria Molina said. “But we look forward to working with you and being part of the solutions.”
“We look forward to working with you … in a very, very difficult role,” Supervisor Don Knabe said.
One factor helping Katz as he starts his job is the county’s recent victory with Washington: the announcement of a $10-billion plan from the Obama administration to help California modernize and expand its Medicaid health insurance program for the poor.
A portion of that money will be coming to L.A. County, which is helping to keep the county health services agency solvent. Former interim director John Schunhoff and his key deputy, recently retired chief network officer Carol Meyer, played a key role in the deal with Washington.
In a brief interview, Katz said one of his most important priorities over the next six months would be to fulfill a new federal requirement that disabled patients on Medicaid, the government insurance program for certain low-income people, be placed in managed care.
Currently, those patients can be treated in hospitals any time they become ill, and the county has no responsibility to follow up.
Creating a managed healthcare system for these patients will be a challenge. The county has no system right now to manage such care, such as giving the patients an assigned primary care physician to make sure Medicaid patients are getting routine checkups and that their lab tests and charts are centralized in one location.
“It requires the 30,000 people who are just coming and going, [that they] are now assigned to a specific provider in a specific clinic and are having their care managed. And that requires, for example, contracts. What if they need something you can’t do? It requires having an IT system that enables you to track whether or not they had an eye exam and, if they are a diabetic, whether they had a foot exam,” Katz said.
“The primary care home is a much better way to do it. But it requires that the organization be prepared to do it. That will be a challenge, but we will succeed,” Katz said.
-- Rong-Gong Lin II at the Los Angeles County Hall of Administration
Photo: Dr. Mitchell Katz pictured during his commute to work at his previous job as San Francisco's public health chief. Katz began work in L.A. on Monday, after snowy conditions contributed to his 15-hour drive from the Bay Area. Credit: Gina Ferazzi /Sept. 17, 2010