Los Angeles County Department of Health Services (abbreviated DHS and LADHS) operates the public hospitals and clinics in Los Angeles County, and is the United States' second largest municipal health system, after NYC Health + Hospitals.
DHS operates an extensive healthcare network throughout Los Angeles County, including three teaching and research hospitals affiliated with the Keck School of Medicine of USC and Harbor-UCLA Medical Center, Rancho Los Amigos Rehabilitation hospital, and numerous outpatient clinics, including two ambulatory care centers and 16 local health clinics. DHS also runs the My Health LA health care program, which benefits approximately 150,000 residents, in partnership with over 200 community partners. DHS' administrative headquarters is located in Downtown Los Angeles's Civic Center, at the corner of Figueroa and Temple Streets.
DHS provided healthcare services to over 643,856 unique patients and 2,457,174 patient visits in Fiscal Year 2015–16. For Fiscal Year 2015–16, LADHS had an annual budget of . The County funds less than 15% () of LADHS' total annual budget.
History
Municipal governments, under Section 17000 of California's Welfare and Institutions Code, are responsible as safety net health care providers. In the 1860s, Los Angeles County appointed a County Physician, and a small hospital for the poor in Los Angeles was established. The Department of Charities was formed in 1913 and included five Divisions: County Hospital, County Farm, Outdoor Relief, Olive View Sanatorium, and Cemetery Divisions. The wide range of responsibilities of the Department of Charities eventually proved unwieldy, and in 1966 the department was split into the Departments of Hospitals and Public Social Services. Several institutions were acquired or established, including Rancho Los Amigos Poor Farm (now Rancho Los Amigos National Rehabilitation Center) in 1890, the General Hospital (now LAC+USC Medical Center) in 1932, two military hospitals, including the Harbor General Hospital (now Harbor-UCLA Medical Center, after World War II, Olive View Sanatorium (now Olive View-UCLA Medical Center) in 1970, and the Martin Luther King Medical Center (now Martin Luther King, Jr. Outpatient Center) in 1972, in response to the Watts Riots
In the 1960s, the Los Angeles City Health Department merged into the county's Department of Health. In 1972, the Los Angeles County Departments of Hospitals and Health, along with the Los Angeles County Veterinarian's Office, were merged into the Department of Health Services, to consolidate and integrate health services.
On May 30, 2006, the Los Angeles County Board of Supervisors tentatively approved the establishment of Los Angeles County Department of Public Health (DPH) as a separate department, primarily to buffer DPH from DHS' recurring budget shortfalls and to separate public health functions, including enforcement of laws, from DHS. DPH was formally established on July 7, 2006. The department was formally separated on July 6, 2006.
On January 3, 2011, Mitchell H. Katz, a physician, was appointed Director of Health Services for DHS. Katz served 13 years as director of public health for the San Francisco Department of Public Health, where he designed and implemented the "Healthy San Francisco" program covering all San Franciscans with health care. From 2008 to 2011, John F. Schunhoff, Ph.D. served as an interim director following Bruce Chernoff's resignation in May 2008.
In 2011, DHS began enrolling hundreds of thousands of uninsured LA County residents in a publicly funded health program called Healthy Way LA (HWLA) and began a major overhaul of its health care system to increase emphasis on primary care instead of acute care. These reforms are set to take place before the Patient Protection and Affordable Care Act takes effect in 2014. Healthy Way L.A. provides a primary care provider team to members and expanded access to primary, preventative and specialty services, as well as access to hospital-based inpatient and outpatient services. It is a county implementation of the state Low Income Health Program (LIHP). In the 2010-2011 fiscal year, DHS reported a budget surplus of $13.2 million.
Facilities
LADHS comprises a network of medical facilities throughout Los Angeles County, including four hospitals, two ambulatory care centers, six Comprehensive Health Centers (CHC), and 10 Health Centers (HC). DHS' Ambulatory Care Network, which was created to provide primary care, outpatient specialty care, and ambulatory surgery, consists of DHS outpatient clinics (Multi-Service Ambulatory Care Centers, Comprehensive Health Centers, and Health Centers).