B as in Betrayal

Beatrice Dent couldn’t quite remember whether she voted for county Measure B two years ago. It was a brief moment in a crowded life of 79 years. Measure B, which passed in November 2002, raised property taxes to help pay for the county’s endangered trauma-care system.

As she pondered, Dent was standing in the front yard of the Willowbrook-area home she bought in 1946 for about $6,000. It’s not like she’d favor higher property taxes — she’s a retiree with medical bills, and with a daughter and grandkids crammed into her diminutive, well-kept home. In the distance, in front of her, rose the King-Drew Medical Center. The main building, with its bland, ’70s-style architecture, dominates the landscape.

Yes, she decided, she must have voted for Measure B. “We don’t need more taxes,” she said. “But to help the needy and the poor, I think I would have probably voted for it.”

Dent is among those in neighborhoods served by King-Drew who now feel uneasy, if not betrayed. County officials have begun a process to close the hospital’s trauma-care unit. They say the move’s necessary to save the rest of the troubled institution. Trauma patients, they insist, can be cared for elsewhere.

Some 73 percent of county voters supported Measure B, accepting it as very much a matter of life or death. Around Dent’s neighborhood, there’s no doubt which trauma-care unit they thought they were voting to preserve. King-Drew handles some of the region’s most violence-plagued areas. Only the huge County-USC Medical Center deals with more trauma cases — which are defined as patients in immediate, life-threatening danger from falls, car accidents, shootings and stabbings. These are cases where every second matters, including the minutes it takes to ride to a hospital.

“We worked hard to pass that measure,” said John Jackson, a community organizer with ACORN, a grassroots activist group. Jackson and crew walked precincts, manned telephone banks, and drew up lists of targeted voters to visit a second and third time. They held rallies on the lawn of King-Drew.

On Saturday, Jackson recounted ACORN’s efforts as he stood just outside Grant AME Church in Watts, about a mile north of the hospital. He was awaiting the imminent arrival of Congresswoman Maxine Waters, who had called Saturday’s gathering. Waters was running late, but some 100 residents and activists waited patiently in the church’s basement meeting hall. Some filled the time with testimony, offering counterevidence to recent disclosures about gross malpractice that have made headlines. These failings have put the hospital itself on life support.

Johnnie Simmons talked of how her son had entered the emergency room about two years ago with a severe headache and nausea. Doctors quickly recognized serious risk. After an examination, she recounted, they wheeled him into an operating bay. The surgeon, she said, used a newly developed technique and carried things off flawlessly. King-Drew doctors also had treated her son years earlier, after he was stabbed.

“My whole thing is, when they had bad doctors and bad nurses a long time ago, they got rid of them, but they kept the hospital,” said Simmons. “So if you got somebody who is not doing the job at a hospital that we need in this area, get rid of them. Get new ones. But leave our hospital.”

When she arrived, Representative Waters joined the chorus, vowing that any attempt to close the trauma unit would meet organized resistance.

COUNTY OFFICIALS say they’ve kept faith with voters on Measure B. “This is a medical issue,” said County Supervisor Zev Yaroslavsky, author of Measure B. “I’m surprised, frankly, that people aren’t outraged by the quality of service at King, including in the trauma center. When we all voted for Measure B, you weren’t voting for any one trauma center, we were voting to keep the trauma system.

“The trauma center is 4 percent of the hospital. If the whole hospital closes because of the lack of quality of care, trauma will go with it, and so will the emergency room and so will everything else.”

Supervisor Yvonne Brathwaite Burke, who represents the King-Drew area, acknowledges risk to the entire hospital, but added that the health department’s trauma-care alternatives proved less comprehensive, less satisfactory than senior staff led her to believe. Community members who question the county’s promise-keeping on Measure B “have a good argument,” she said. “And it must be recognized.”

The measure taxes buildings at 3 cents per square foot. For a 1,000-square-foot home, the tax increase, for example, works out to $30 a year. The ballot statement pledged that the dollars would maintain and expand the trauma-care network, improve responses to other medical emergencies, and deal with the threat of chemical and biological terrorism. At the time, the last bit seemed like a shameless ploy for the “scared of terrorists” vote, to help push the measure over the two-thirds approval threshold. Measure B was fundamentally about saving emergency medical services, including trauma care.

Measure B has one year of spending history. Some $140 million went to county hospitals. County-USC claimed the largest share: $86.6 million. Then came Harbor-UCLA at $27.5 million and King-Drew at $18.5 million. If K-D’s trauma center closes, most of its money could go elsewhere. Patients formerly served by King-Drew will not be shortchanged, said Carol Meyer, director of emergency services for L.A. County. The money will follow the patients, she said. The county won’t save money by cutting trauma at King-Drew, because those patients will still require care elsewhere, she added. The goal of closing the trauma center, said Meyer, is to take pressure off King-Drew, so the hospital can improve other services, including those in its emergency room, which handles about 25 times as many patients as the trauma unit.