Public Enemies

It's become an awfully familiar sight: a group of somewhat nervous-looking bureaucrats and assorted suits facing a roomful of angry South-Central citizens, chiefly black and Latino, who pepper them with questions about why an essential community institution is being dismantled without the community’s awareness or approval, to say nothing of a regard for its needs. The suits offer explanations and assurances that they are only acting in the community’s interests; the people sigh, grumble, hiss, jeer. An MC calls for calm. Various elected officials come to the mike to express their solidarity with their constituents, of course, and to vow to fight alongside them to save the institution — that they have played some role in the failure of the institution is an irony put aside for the moment. After a couple of heated hours, the evening is over, and though it has been somewhat cathartic, it ends on a note of irresolution fueled by a couple of still-burning questions: What now? And who will suffer the most?

This scene played out earlier this week, but not before the county board of supervisors, and not because of the latest proposal to downsize King/Drew Medical Center in Willowbrook — that happened last week. This was at Crenshaw High School, a campus that recently got the bad news that it was being stripped of its accreditation because of a failure to substantially improve its academic performance, curriculum and the like since it was put on notice in 2003. Crenshaw is the first public school in 30 years to lose accreditation; graduates will get their diplomas, though they will be seriously devalued — making official what has long been true about the value of urban education. King/Drew lost its accreditation earlier this year, and after a series of attempts by the board of supervisors to allegedly fix things, is now facing the loss of three more departments — neonatology, obstetrics and pediatrics — a proposal from Zev Yaroslavsky, via county health department director Thomas Garthwaite, that’s supposed to be the latest fix. Those rallying to restore King and Crenshaw are denouncing such logic as Orwellian, and more evidence of a wider trend of shutting down, rather than shoring up, public institutions that historically serve people of color. “It may take the intervention of federal courts,” says Marc Ravis, an attorney working on behalf of a group called Friends of King/Drew to keep the medical center open. “This is a federally recognized, under-served area. Litigation may be the only solution.”

Talk about déjà vu. King/Drew is the product of an era when blacks were finally getting the last vestiges of unequal treatment purged from law; Crenshaw should be the healthy fruit of Brown v. Board of Education, the 1954 Supreme Court decision that outlawed segregated, subpar schools (theoretically, anyway) and got the whole civil rights ball rolling. The pro-King forces say it is this ongoing fight for equality that drives them, though the media — notably the Los Angeles Times — have largely portrayed such forces as a gang of racial hysterics who refuse to concede that King/Drew has major problems.

Congresswoman Maxine Waters, a prominent voice in the fight and a target of much of the media criticism, says the issue was about how to craft solutions and was never that black and white. It is now, at least in part, with Gloria Molina joining Yvonne Burke in opposing Yaroslavsky’s rush to close the three additional wards; the board is now split along racial and gender lines on the King question, two women of color against three white men. It’s a moment rife with symbolism, including the fact that the women are objecting to the closure of departments that serve women and children almost exclusively. Yet that actually obscures bigger questions about the county’s shifting rationale for closing and/or whittling away King/Drew, which supervisors once pledged to preserve as a full-service hospital in a community permanently in need of one. (King/Drew has already lost accreditation of several residency programs, including general surgery.) That is clearly no longer the case; some say it never was.

“When we first started fighting this, we always thought the county wanted to close the hospital, and they said, ‘No, no, we just have to decompress, relieve the pressure,” says Waters, who spearheaded the unsuccessful attempt to keep the board from closing King’s trauma unit, which shuttered in March. “We forced them to do a community hearing, and 3,000 people showed up. Unfortunately, we lost. The bottom line is, these white men don’t believe their constituents can be hurt by this issue, that it’s something only the folks in the 2nd supervisorial district have to deal with, and they won’t lose votes.” Waters also questions why the county is going against the sentiment of Navigant, the consulting firm it hired for $15 million to crisis-manage King/Drew, and its own hospital advisory board, made up of community health professionals, medical folk — and Garthwaite himself. Theories accounting for the board’s increasing recalcitrance range from ongoing federal threats to pull funding — without accreditation, King stands to lose some $200 million — a severe county budget deficit looming in ’06, and the upgrades in neonatology being made at Harbor-UCLA county hospital to the south (when supervisors voted to close the trauma unit last year, much was made of the fact that the board was simultaneously supporting opening a new trauma unit at California Hospital downtown).

But to King's supporters, none of this justifies slashing services in the hood. Garthwaite maintains that the reductions will help remake King into a leaner, more effective operation focused on outpatient services treating prevalent conditions among blacks and Latinos, such as high blood pressure and diabetes. But however effective that may turn out to be, “outpatient” doesn’t quite have the same ring as “hospital.” Nor does it serve the same vision.

“What bothers me is that the county keeps saying that King/Drew can’t be fixed, and nobody challenges that notion,” says Marqueece Harris-Dawson, executive director of the Community Coalition and a member of the Coalition for Health and Justice, a group of community health advocates formed this year. “The board could say, ‘Okay, we’re going to spare no expense to fix this, here’s what we’re going to do.’ But nobody’s taken that position. The most we’ve gotten is, ‘How much are we going to close?’ Public institutions that serve the wealthy, when they screw up, nobody talks about shutting them down — LAPD screwups cost the city millions every year, but nobody proposes shutting down or privatizing the department. That’s just silly. But the remedy for the poor is to shut down, to take away the expectation that it should be there at all.”

Before voting on the cuts, the county is obligated to hold a community forum known as a Beilenson hearing; it’s scheduled for October 18, almost exactly a year after the Beilenson forum held before the vote to cut the trauma unit. Interested parties can submit an alternative plan to the cuts by September 30, which Waters says she and other King supporters are working diligently to do. Meanwhile, community and progressive forces at Crenshaw High are mobilizing too; a group of concerned parents and teachers called the Crenshaw Cougar Coalition are already demanding more accountability, transparency and resources from the school district, as well as more direct involvement with the Western Association of Schools and Colleges, the accrediting body, on matters affecting Crenshaw’s standing. The school can and will appeal the association’s decision, and Crenshaw may be re-assessed next spring. But one has to wonder: If Crenshaw falls, why not worse-off schools like Locke, Manual Arts, Jefferson? Obviously, shutting down the whole system is not a workable option. But making an example out of one — with Crenshaw, with King/Drew — hardly seems like a practical solution either. It remains to be seen, as Harris-Dawson said, whether the powers that be are interested in finding a middle.


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