Yesterday, LA County health officials issued an annual report showing that the number of reported child abuse cases were up in 2007, over 2006—from 162,711 in 2006 to 167,325 in 2007, a 3 percent increase.

Reported doesn’t mean verified so it’s unclear if the increase means only that more cases are being reported—or if there’s more abuse of kids actually occurring.

According to the City News Service, the experts who presented the report cautioned that the declining economy could lead to an actual increase in child abuse cases.

“We are now facing a horrific economic downturn, and I think we just have to be poised to once again see the impact of that on our children as families struggle to make ends meet,” said Dr. Carol Berkowitz, a pediatrician and co-chair of the Child Death Review Team which also presented its annual report today.

The new child abuse report suggests that child abuse cases increase with poverty, said Deanne Tilton Durfree, executive director of the Inter-Agency Council on Child Abuse and Neglect.

Not a happy thought.

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The California prison system has been in such bad shape in so many ways for such a long time, it’s almost shocking to find one element of the system that seems to be working. That element is the fire camps.

The California Department of Corrections and Rehabilitation runs 42 adult fire camps-–37 of them with the California Department of Forestry and Fire Protection, five more with the LA County Fire Department. Upwards of 4,400 inmates work on 200 fire crews that log in three million person hours a year battling wildfires, and other emergencies. Several of those crews worked this past weekend’ to help contain the Corral fire in Malibu.

The fire camps seem to succeed on multiple levels. Their inmates are less likely to return to prison. Correctional officers like working in the camps. And, instead of costing the state of California more than $42,000 per offender per year, as is the case inside prison, fire camp’s per inmate price tag is around half that or less. Moreover, with the work they provide, the fire camp inmates actually save the state money—approximately $80 million a year. Not exactly chump change.

Ken Cox and Janette Cox (who are neither married nor related to each other) were two of the correctional officers who accompanied the firefighting crews from Camp Ishi in Northern California’s Tehama County, to the Malibu base camp. They both told me they are ardent fans of the program.


“The camps are the best system in the CDC,” said Ken. “The inmates get out a place like Ishi with real skills that they can take into the world after they’re released. We have guys who go out and get jobs as Hot Shots in the Federal system afterwards.”

Sergeant Dan Billeci, who also came with the crews from Camp Ishi, agreed. Even those who don’t pursue firefighting, he said, gain a sense that they can succeed at something, “which means they’re less likely to come back to the system”

Not everyone succeeds, of course. “A lot of guys come back to us,” said Ken. But fewer fire camp graduates stay stuck in the revolving door than the 70 percent who return to California’s prisons after they’re paroled.

Both Coxes also say that they like working at the fire camps, in part, because the relationships between correctional officers and inmates are far less adversarial then elsewhere in the corrections system. “In the camps they come and talk to us,” said Janette. “Whereas in prison,” said Ken, “they don’t because they’ll be seen as snitches if they talk to us to much.” And prisoners often need to talk, said Janette. “It’s healthier.”

The only problem with the camps, according to the Coxes and Sergeant Billeci, is that most of them are rarely full. This is not, the officers say, for lack of applicants. “Lost of people want to come to the camps,” said Ken. But the bar for entry is set so high that many of those who might thrive in the firefighting program are prohibited entry.

In general, the rules are as follows; the applicants must be physically fit (sensible) and can have no history of arson (Duh!), or sex offenses (okay, good call). But even those in for low level drug offenses often don’t qualify if they have a violent or a gang crime somewhere in their pasts. Yet sometimes those with no violence in their past are kept out too. “The selection system is very inconsistent,” said Ken Cox.

Certainly appropriate caution must be used in choosing applicants for the fire camps. Everyone wants to protect the program. Yet, the officers suggested in the course of our conversation that, in a state with catastrophically overcrowded prisons, maybe we could design a more responsive selection criteria so that guys (and women) who might otherwise succeed aren’t routinely rejected.

Put another way, if we want to maximize the program’s potential to save money and rehabilitate lives, we need to open the fire camps’ doors a little wider.

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As we’ve all heard by now, it was the third blaze in Malibu this year, and the worst Malibu fire in a decade and a half —with 53 houses burning so quickly they may as well have made of cellophane, and another score badly damaged. We also know that due to the fact that an appropriately jittery Schwarzenegger ordered firefighters to Southern California early last week in advance of the Santa Anas, massive amounts of resources—both in terms of ground crews and equipment—arrived on the scene with remarkable speed.

Although there were all those homes the firefighters couldn’t save, once they were on site in full strength, they worked with well-coordinated precision, and got the upper hand on the flames before the day’s light began to bleach from the sky. As early as 3 pm on Saturday, the dark, roiling smoke that had characterized the fire’s earlier hours, had changed to hazy gray plumes. By Sunday evening, the fire was at 70 percent containment.


This latest local inferno was called the Corral fire, presumably because it started on a dirt road in Corral canyon, just north of Malibu. It must be challenging for those tasked with naming these fires to keep coming up with different monikers—as opposed to calling Saturday’s blaze….say….Malibu XXII.

I became aware of the fire at 6:30 a.m Saturday morning after I was startled out of a very pleasant sleep by a phone call from my neighbor, Rebecca, who told me that the nearby hills were once again burning. Whenever Malibu burns, we in Topanga Canyon get jumpy. We know from experience that if the wind starts blowing the wrong direction, we could easily be next. In 1993, for example, the fire started in Old Topanga Canyon, raced to Malibu faster than a man could run, then blew right back to us in a big and scary way.

But when, by 10:30 a.m. the flames appeared to be in no immediate danger of moving anywhere near to Topanga, I poured myself one more cup of coffee, packed my dog in the car, and drove to Malibu to chat up some firefighters.

The people who had come from all over California and beyond to battle our latest conflagration were, in their downtime, a friendly and talkative bunch. Here are a few of my notes—along with some photos I snapped while chatting. I’ve not quoted anyone by name, although only one person asked me not to. I figured there was no sense in taking a chance on…well….burning the people who were kind and courageous enough to do a very risky job in our behalf.

Here’s what they said:

Read the rest of this entry »

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Now that many of the fires are contained, accusations and complaints are surfacing from Orange and San Diego counties that some of these disastrous fires of October were made worse by the fact that firefighters certain areas didn’t have adequate air support.

The way it works is, each county has its own fire-fighting air fleet. Then when a true disaster strikes, the county or city draws from the state fleet and, in some cases, beyond.

For the record, LA County’s fleet consists of three Sikorsky Firehawks, four Bell 412 helicopters, and another Bell Jet ranger.

This fire season, in addition to the copters it had in its own hanger, LA County Fire Department had access to a couple of Erickson Sky Cranes, a Super Scooper or two (leased from Quebec), and some other fixed-wing planes that swoop over and drop fire retardant. (The Daily News has a basic rundown of what was most recently being used.)

Over the past few days, these planes and ‘copters were bounced around between LA area fires, “depending upon where there were structures threatened,” LA County Fire spokes guy Sam Padilla told me.

And although there were homes and structures lost in LA County, as yet, there have been no big complaints that it was for lack of resources. The truth is, sometimes, in spite of everyone’s best efforts, the fire does what it wants.

Yet, Orange county fire authority chief Chip Prather has been widely quoted as saying that with the arson-started Santiago Canyon fire in particular, a lack of air support in the fire’s early stages made a crucial difference.

“If we had more air resources,” he said, “we would have been able to control this fire,” he said. “Instead we’ve been stuck in this initial attack mode on the ground where we hopscotch through neighborhoods as best we can trying to control things.”

Similar complaints are surfacing around San Diego’s destructive Harris fire.

So why didn’t the OC and SD have what they needed and LA did?


Out of curiosity, I called Orange County’s fire authority and asked what kind of air fleet the OC had. Angela, a very cheerful and sleep-deprived OCFA spokesperson told me, “Two helicopters.”

To make sure I hadn’t heard wrong I asked again. Two, she repeated, and they definitely aren’t Firehawks. “I wish!” she said.

Asked why OCFA didn’t get the additional resources they needed, Angela laughed dryly. “That’s the big question,” she said. “Let me know when you find out.”

Even now, she added, the efforts to control the still-burning fires are plagued by a lack of the Right Stuff.

So what’s the deal? Certainly the LA fires started sooner, so equipment came to us first. Plus we have a bigger fleet to begin with. But that doesn’t really explain the situation.

Fire resources are controlled in layers. First city, the county, then state, then—if a fire is big or nasty enough to be “federalized”—by region. And with each successive layer, there’s a formula for allocation.

In other words, determining what caused these resource short falls is a complicated business that will take time to sort correctly.

But for now we need to make sure we ask the right questions, and keep asking them.

POST SCRIPT: Here’s the LA Times write-up on the equipment that the State of California didn’t buy, since 2003, against the advice of its Blue Ribbon Fire Commission, all hand picked to make such recommendations.

I’ve heard from back door sources that the what the firefighters believed would have made all the difference in routing the 2003 SD fires before they got so tragically out of control—was early air support, specifically the super scoopers and the air cranes.

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My full column for the LA Weekly on last Friday’s closure of Martin Luther King Jr.-Harbor Hospital is online now. (Some of the stuff we’ve already discussed here at WLA.) I’ve posted a healthy chunk of it below. (NOTE: “Chernof” is Dr. Bruce Chernof, the director and chief medical officer of the LA County Department of Health Services. He is also pictured in the photo above.)

,,,In all, the report painted a picture of a hospital that had been in deep water for a long time and, despite warning after warning, had not made the most basic of changes needed to save itself. As the federal officials pointed out in a summary letter, “Repeated certification surveys and complaint investigations have identified serious health and safety violations and documented the hospital’s inability to comply with these federal standards.” As a consequence, the feds saw no choice but to pull the hospital’s Medicare provider agreement and, with it, $200 million in federal funds MLK needs to operate. “This decision is final,” said the letter — in case anyone hoped there might still be wiggle room.

But although most of MLK is closed, the county faces substantial community and political pressure to find a way to reopen it. Thus, on Monday, Chernof outlined a plan for the hospital to eventually be resurrected.

The idea, he said, was to find a “non-county operator” — maybe a private hospital or university — to take over. Or, failing that, to find some outside entity to supervise the hospital’s makeover, using “reconfigured county leadership” — an apparent reference to the feds’ finding that the Board of Supervisors is one of MLK’s problems. Some of the board members pushed Chernof to set a reopening timetable, but he demurred, and sources close to the board admitted to the L.A. Weekly that the county is a long way from finding a partnership.

“Trust me, it’s not that easy,” agrees Downey hospital’s Guest. “At best, this will take a while.”

Through much of Monday’s meeting, politicians such as Supervisor Yvonne Burke and U.S. Congresswoman Maxine Waters repeated the mantra that everyone should “just move forward” and “we should not place blame.”

But others wondered privately if a little blame placing might not be crucial to the hospital’s recovery, if it is ever to recover. After years of multipage reports issuing dire warnings — not to mention the board’s expenditure of $18 million in taxpayer funds on consultants — and after scores of broken promises, perhaps residents of Los Angeles County deserve to know why, as of last Friday, MLK still had nurses on its staff who could not mix medicine.

“We were told that Harbor-UCLA would take over management of Martin Luther King,” said state Assembly Member Laura Richardson when it was her turn to address the county supervisors. “And that never happened. Well, why didn’t it happen?”

On Tuesday, the Weekly asked county health department spokesman Mike Wilson those same questions. Why were the majority of MLK staff — who were supposed to receive rigorous off-site retraining — never retrained? Why were a significant percentage of MLK staff — who were supposed to be laid off or transferred — never laid off or transferred? And why, after officials announced that the respected Harbor-UCLA Medical Center was taking the reins of MLK — and even changed the hospital’s tainted name from King-Drew Medical Center to Martin Luther King Jr.–Harbor Hospital — did that transfer of power fail to occur? Who stopped it?

“I don’t know,” an exhausted-sounding Wilson said finally. “Dr. Chernof made all those requests.”

Yet someone chose not to put Chernof’s vital “requests” into practice. It was clear this week that county officials, and some of the most powerful politicians in California, had no idea who prevented the ordered changes, or why. If Martin Luther King Jr.–Harbor Hospital is ever to successfully rise from its own ashes to serve the communities that need it, those and other questions must still be answered.

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I’ll post more on this tomorrow when my very quick and dirty MLK-Harbor postmortem goes up on the LA Weekly website. But, in the meantime, for the morbidly curious, you can read the entire 124-page final survey report in which CMS (federal Centers of Medicare and Medicaid Services) listed MLK’s failures that led to the feds yanking their Medicare certification, and the $200 mil that went with it.

At first, county officials had no intention of handing over the CMS report. But when a lot of press and community members threw fits at this withholding behavior, County Supervisor Gloria Molina wisely urged the board to release the thing at Monday’s special Board of Sups meeting. So, Monday night the full report quietly appeared in PDF form on the Board’s website.

The CMS report describes in dizzying detail a staggering level of incompetence. For instance, inspectors found MLK nurses who were unable to “correctly calculate dosages for medication” to be given to pediatric patients, and worse, other nurses incapable of locating “critical equipment and medications on the pediatric emergency cart.”

CMS also outlined how MLK patients were “placed at serious risk for exposure to contagions, such as tuberculosis” because of such basic lapses in hospital hygiene as the staff’s failure to “clean and track” bronchoscopes.

One particularly alarming section describes a psychiatric patient who was “observed through the window of the room door, cutting both arms with a scalpel.” When first questioned, MLK staff members insisted that the arm-gouging patient brought the scalpel in with him in “a bag of Doritos chips.” (Unfortunately, I’m not kidding about this.) Yet when the fed team looked a bit further they noticed \that the scalpel’s lot number matched that of other scalpels stored in MLK’s locked ER supply cabinet. In other words, the instrument came from the hospital—not a Doritos bag. And when the CMS people looked still further, they found that the psych patient had been observed alone next to a “gurney that had open drawers” —inside which there was a supply of “needles, ….tubes, and scalpels.”

Now remember, all this leaving of scalpels within reach of suicidal psych patients, and the inability to mix kids’ medicines, occurred during the feds’ make-or-break inspection–i.e., when hospital personnel were theoretically on their best behavior.

Not good.

We all truly hope that King-Harbor Hospital will eventually reopen, since the more than 45,000 emergency room patients that use its services each year, desperately need the facility back up and running—as does the County of Los Angeles, with its already overburdened emergency health system.

At Monday’s four-hour long, specially-convened County Board of Supervisors meeting, I talked privately to two of the heads of the hospital ERs that are expected to pick up MLK’s slack. They were somewhat freaked at the prospect.

And, as one county official said to me Tuesday, “Yeah, and what if LA had a real emergency medical crisis—like a terrorist attack. Then what would we do?”

What indeed?

Yet, if we are to have a prayer of MLK rising again Phoenix-like, we need to really understand what went wrong. And so far no county official in a position to know seems willing or able to tell us.

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Federal inspectors announced today that they are pulling the plug on $200 million in federal funding for Martin Luther King-Harbor Hospital.

It’s over.

The fat lady ain’t officially sung yet; the decision ultimately lies with the Los Angeles County Department of Health Services (DHS), which answers to the LA County Board of Supervisors. But that fat lady is warming up.

The hospital’s emergency room will shut down as of 7 pm Friday night

DHS director, Bruce Chernof has announced that he is requesting a “voluntary suspension of the hospital license.”

All of this has to be formally approved when the Board of Sups meets in special session on Monday. But it’s a done deal.

The cynical among us wondered if Dr. Chernof would actually pull the plug on MLK—if and when the feds pulled the money. There was the worry that political correctness and factional pressures would continue to win out. And that once more there would be a series of last ditch efforts and promises….

….but then, as has happened over and over, the fundamental changes needed would not be made.
(To illustrate, here is the LA Times timeline on MLK’s history.)

Nobody wanted to see it come to this. It’s tragic for the community, a failure for the city and county. But when 27 percent of all patients walking into MLK’s emergency room are considered at risk, it’s time to clear the table and start again fresh.

We can’t afford more horror stories like those of Juan Ponce and Edith Rodriguez.

Now the question is, where do we go from here.
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UPDATE:

NOTE: I’m working an analysis of all this for the LA Weekly, trying to make sense out of what we should take away from this, and where we DO go from here, and have been chatting with some of those involved in order to sort out some thoughts. Not that anyone in the entire town, as yet, has an answer.

Mike Antonovich, not usually among the most enlightened of men, was—of the County Sups—the most forthright in pointing the finger at his own board, himself, and some others in this city, for allowing the failures to go on unchecked for so long.

Chernof, in his official statement said that MLK will eventually reopen. “… the department is committed to reopening King-Harbor as a full-service hospital as soon as possible,” he said, “and is working to identify potential private operators, or options for County operation under a reconfigured model….”

Well, okay. Good luck. In the past, DHS has tried to find private operators with no cheerful takers. I’m not sure what exactly makes the prospect MORE attractive for private companies now that the situation has gotten worse, not better.

It’s a heartbreaker. But, so, so much money has been poured into a place where the clean-up job that was promised over and over again, was simply never done. The staff that was supposed to be fired….wasn’t. The people who definitely, positively, we swear on our mothers lives, were going to be retrained….weren’t. UCLA-Harbor, which was supposed to provide new management, never took over.

And so the awful mistakes continued, and the lies, the excuses, and the prevaricating….

And yet……

“It’s a very personal relationship this hospital and the community have,” a sobbing Lark Galloway-Gilliam, executive director of Community Health Councils, said to the LA Times. “People fought to have this place built, and it’s been employment for some people. It’s been a symbol that our community is somewhat whole, that the resources are there that you need when you want them.”

Well, not anymore.

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PS: This somewhat bumped the wild and woolly school story I promised today. Look for it early Monday morning.

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