County narrows health job hunt

More than two years after the last permanent chief of Los Angeles County’s massive Department of Health Services quit unexpectedly, officials may finally be close to hiring a replacement.

Los Angeles county’s chief executive, William T Fujioka, said Monday that he believes he has identified the right person to lead the $3.4-billion-a-year operation: Dr. Mitchell H. Katz, the director of health for the city and county of San Francisco.

“Given the system that he runs in San Francisco and the similarities in both the mission and the type of services provided, he would be an outstanding candidate,” Fujioka said.

Fujioka said he plans to present his choice early next month to the Board of Supervisors -- which has rejected other candidates without bringing them to a vote. If Katz is appointed, he would start in January, Fujioka said.

Filling the job that longtime observers say can be thankless, political and, most of all, daunting has proved challenging. It took months for the county to hire a search firm, and then that firm told county officials that viable candidates were repelled by the perceived dysfunction between the department and county leaders.

Katz, 50, a Brooklyn, N.Y., native who describes himself as “pro-union,” said he hopes to overcome the “historically tense relationship” between the board and the health services chief.

“When people don’t trust the leader, then they try to know all the details and that can be difficult for both sides,” Katz said. “My job would be to let them know that I was managing well so they didn’t have to worry about the day-to-day issues.”

Katz was hired by San Francisco’s public health department in 1991 and served as chief of research and director for the AIDS office, interim medical director of the Emergency Medical Services Agency and director of the department’s health and safety branch before becoming chief in 1997.

“The value of being at every step in a process allows him to understand how programs and services are delivered in a setting like ours,” Fujioka said.

In San Francisco, Katz oversees about 8,600 employees and a $1.5-billion budget. He earns $260,000 a year and answers to a seven-member health commission appointed by the mayor and an 11-member county Board of Supervisors.

In Los Angeles, the health services chief supervises about 18,421 employees. If Katz is hired, he would get a salary increase from his current position, although Fujioka said negotiations would not start until the process was further along. He would report to the five-member Board of Supervisors, which has a long history of being tough on its health chiefs, and immediately face a $400-million deficit even as demand for services increases.

“He knows California, he understands the financing. There will be no learning curve,” said Jim Lott, executive vice president of the Hospital Assn. of Southern California.

Katz would succeed interim Director John Schunhoff, 63, who took over after the abrupt departure of Dr. Bruce Chernof in April 2008. Fujioka said Schunhoff is expected to stay on at the department.

Among the top challenges facing a new chief will be the push to reopen a new Martin Luther King Jr. Hospital in Willowbrook by 2013.

“He impressed me as being more knowledgeable about MLK than any other candidate to date,” said Supervisor Mark Ridley-Thomas, who declined to say whether he plans to support Katz but said Katz “seems to be making a very favorable impression in a variety of quarters.”

In San Francisco, Katz partnered with Mayor Gavin Newsom in 2007 to create Healthy San Francisco, the nation’s first city-run universal healthcare plan. The plan provides medical access to most of the city’s uninsured, about 54,000 people, including people in the country illegally.

“I’m very proud of what I’ve achieved in San Francisco,” Katz said, “But Los Angeles has more than a million uninsured people. Part of what I’d be interested in is seeing is if what we have done here could benefit Los Angeles.”

Katz has drawn criticism for supporting a hospital project with spiraling construction costs and also has been criticized for making cuts and layoffs to meet budget expectations.

“I say the job of the health director is to do the very best with the available resources,” he said.

Some local leaders said they were reassured by Katz’s record.

“From all I’ve heard, he has the credentials, the skill, the experience, the knowledge about public safety net healthcare in California, particularly in urban areas, to do this job,” said John Tanner, executive director of Service Employees International Union, Local 721, which represents many health services workers.

“It’s urgent that the Board of Supervisors act to fill this key leadership position,” Tanner said.

Katz said Los Angeles needs to shift toward providing more outpatient services and improve customer service along the Kaiser Permanente model of managed care.

“Poor people are entitled to the same quality of medical care as anyone else. In particular, for safety nets to survive they have to start thinking of their patients as customers who will soon have a choice,” Katz said.

Katz is expected to travel to Los Angeles to meet with supervisors when they consider his appointment in closed session, possibly as soon as their board meeting Oct. 5, Fujioka said.

molly.hennessy-fiske@latimes.com