Judge Blocks Doctors’ Move to USC Payroll

A hotly debated plan to eventually place all new physicians assigned to the county’s largest hospital on the USC School of Medicine’s payroll is invalid because it violates a 1978 voter-approved mandate, a Los Angeles Superior Court judge ruled Thursday.

Judge Warren H. Deering held that the Los Angeles County Board of Supervisors must show that such an employee shift--ordered May 12 and set to begin next week--is both feasible and cost-effective. Under the plan, about 215 new interns assigned to County USC Medical Center were scheduled to become paid employees of the School of Medicine.

As a result of the court order Thursday, county officials said the transfer plan is in doubt and could take place only after a scaled-down pilot program lasting up to four years.

Ruling on Health Cuts

In a separate ruling across the courthouse hallway, Superior Court Judge Ricardo A. Torres ordered the supervisors to postpone a June 8 hearing on nearly $55.8 million in proposed health service cuts. Torres, agreeing with patient rights lawyers, said that before hearings can be held, the county must fully publicize details of any proposed reductions. The judge found that a notice released three weeks ago was insufficient to satisfy state law.

The ruling could delay the hearings until mid-July, when the supervisors will also consider a proposed $7.2-billion county budget, county officials indicated.

The two court rulings represented the third time in as many days that the Board of Supervisors has lost in court over health service-related issues. On Tuesday, Torres ordered the board to recast a vote after finding that a $20,000 contract had been improperly denied to a private organization that has been providing AIDS education to the black and Latino communities.

In Thursday’s decision on the new physicians, Deering agreed with attorneys for the 1,400-member Joint Council of Interns and Residents that the board-approved payroll shift to the USC School of Medicine had failed to adhere to a 1978 voter-approved county Charter amendment. That amendment permitted the county to contract out services performed by civil servants, but only after showing that such moves would be both feasible and cost-effective.

Conservative Majority

Over objections by both the interns’ and residents’ union and Supervisor Ed Edelman, the board’s conservative majority of Pete Schabarum, Mike Antonovich and Deane Dana approved the employee shift, contending that the new doctors were technically not county employees and therefore not covered by the Charter amendment. They also contended that until the shift actually occurred, there was no accurate way to assess whether such a move was cost-effective.

But Deering rejected those county arguments, ruling Thursday that the interns and residents do indeed fall under the umbrella of the Civil Service system and therefore also under the county Charter amendment’s contracting-out provisions. He said that the county may someday decide to shift the new physicians to USC’s payroll, but added, “The court cannot find the proposal is so innovative or unique that such a contract is exempt (from the Charter amendment).”

USC had reluctantly agreed to accept the payroll shift as part of a three-party agreement reached last year for the construction of a specialty care hospital near the medical center. Under that agreement, National Medical Enterprises will build and manage the 283-bed facility while USC’s medical school faculty will staff it.

Dennis Kazarian, executive director of the doctors’ joint council, said the ruling effectively halted an attempt by the board majority to “force down everyone’s throat” the employee shift. Union officials had charged that the move was an effort by the board conservatives to eventually silence an effective voice for indigent patient care because in a matter of years about half the union’s members would become USC employees.

Edelman also applauded the ruling: “This decision sustains the position I took when it came before the board. . . . The board will have to show that this will save the county money and is cost-effective.”