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LA County Proposes Merger between Three Health Departments

Posted by Ine Collins, Healthcare Systems Policy Analyst on February 12th, 2015

Dorothy Chandler Pavilion, John Ferraro Building (LADWP Headquarters), and Los Angeles County Department of Public Health Services building

Photo credit: flickr user jann_on (CC BY-NC-SA 2.0)

In an unforeseen move at the January 13th board meeting, the Board of Supervisors approved the concept of unifying the Department of Health Services (DHS), Department of Public Health (DPH), and the Department of Mental Health (DMH) into an agency model. Unbeknownst to the public, in December 2014 Dr. Mitch Kitz of DHS was tasked with developing an initial model. In his memo he favored full integration of the three departments into one department, but conceded the logistical challenges that it involved. Instead he proposed an agency model in which all three departments maintained their executive, mission, and independent budgets and select administrative functions and service delivery would be integrated. The three department heads would report to the agency director who would report to the Chief Executive’s Office, and the CEO in turn to the Board of Supervisors.

Many people have expressed concern about DMH and DPH losing their voice in this effort to integrate because they wield a smaller budget than DHS. The County previously operated with all three departments combined and separated them in 2006 in order to give DPH and DMH more autonomy. At the same time, some proponents of the agency model have pointed out the cost-savings opportunities and ability to deliver more seamless, comprehensive care especially between DMH and DHS through an integrated agency model.  It is important that whatever the County decides that the end result be an improved provision of care to the people the County serves, and that DMH and DPH‘s priorities and mission carry equal weight as DHS’.

The Office of Health Care Integration has been established for the planning effort and is led by Christy Ghaly [cghaly@ceo.lacounty.gov]. There is an internal stakeholder process which consists of interdepartmental workgroups and also an external stakeholder process which is still being developed. However, they have made it known they will not be meeting with individual providers, only umbrella organizations, e.g. CCALAC, etc. After the draft report is submitted on March 13, 2015, a 30-day public comment period will commence until April 13th. The final report taking into account the public comments will be submitted May 12, 2015 to the Board of Supervisors. Information regarding integration will be updated regularly at priorities.lacounty.gov.