County Hospitals Chief Ousted After Critical Disclosures

Carl A. Williams was removed as head of hospitals for the County Department of Health Services on Monday in the wake of disclosures revealing fiscal mismanagement and poor conditions in the public facilities.

Los Angeles County Health Director Robert C. Gates ousted Williams, who oversaw the county’s six public hospitals that serve thousands of mostly poor people each day. Gates said he removed Williams because “we’ve had many problems in his area of responsibility.”

Edward J. Foley, a veteran administrator in the county hospital system, has been named Williams’ successor, effective Wednesday.

The hospitals have been hit by a series of crises in recent months. The Board of Supervisors has been sharply critical of Gates and his deputies, including Williams, for allowing the situations to get out of hand, and for failing to alert the board to developing problems.

In explaining Williams’ transfer to an unspecified “staff role,” Gates referred to evidence of poor patient care at two county hospitals, Rancho Los Amigos Medical Center in Downey and Los Angeles County-USC Medical Center in Boyle Heights.

Last month, state inspectors cited Rancho’s 40-bed nursing home for violating 67 federal regulations governing patient care. Supervision there was so lax that some patients were found wandering along a highway, inspectors said, and others were living in conditions of filth and neglect.

The supervisors have also been highly critical of conditions in the county hospitals’ emergency rooms and psychiatric units. The Times reported last month on dangerous levels of overcrowding in psychiatric units, which are run by the Department of Health Services under contract to the county Department of Mental Health. One doctor at Psychiatric Hospital--part of County-USC Medical Center--described “near riot” conditions in the psychiatric emergency room there.

Severe overcrowding at County-USC’s General Hospital, meanwhile, resulted in patients--some of them naked and shackled to gurneys--being left for hours in a public hallway on Jan. 20. The widely publicized incident followed reports by doctors there of seriously ill people waiting as long as 24 hours in the emergency room. The doctors said the hospital was so jammed that several patients had died in the emergency room while waiting for an operating room.

“Generally, these are all problems that have come to the attention of the Board (of Supervisors) and that need correcting,” Gates said.

Foley, 58, has been administrator of the county’s Harbor/UCLA Medical Center in Torrance for nearly 12 years. His previous posts in the county system include four years as administrator of Rancho Los Amigos and a stint as the department’s director of human resources.

In an interview Monday night, Foley said he hopes to improve coordination of services among the hospitals. Medical staff, he said, will have a key role in shaping policy.

“I see the function of the hospital as to take care of the patients, and I see the doctors as the primary leaders in fulfilling that responsibility,” he said.

Gates informed county supervisors of Foley’s appointment and Williams’ reassignment in a memorandum he personally delivered Monday afternoon.

“I believe these changes will move us in the direction of resolving many of the issues which have recently confronted the department,” Gates wrote.

Gates himself has recently come under fire from supervisors. Before Gates removed Williams on Monday, Supervisor Gloria Molina had called for the county Citizens Economy and Efficiency Commission to conduct a management audit of his department.