WASHINGTON, D.C. – The spending bill for fiscal year 2008 signed into law by President Bush December 26, 2007, included a provision that protects the Medicare-funded graduate medical education residency positions allotted to Martin Luther King Jr.-Harbor Hospital. This will ensure that any future occupant of the facility would retain them once they took over the hospital.
Representative Xavier Becerra (CA-31), the Assistant to the Speaker of the House and the only member of Congress from Southern California on the Committee on Ways and Means, authored the provision and fought hard for its inclusion.
“South Los Angeles needs a hospital,” Rep. Becerra said. “By preserving the same number of Medicare-funded GME positions, we have created an important incentive for health care providers interested in occupying MLK-Harbor.”
The August 15 closure of MLK-Harbor resulted in a significant number of modest-income patients in Los Angeles County having no access to a nearby hospital. Between 1980 and 2000, 20 percent of the county’s emergency departments have closed. In the past four years, eight more hospital emergency department and one trauma center in the county have closed. At the same time, the number of emergency room patients in L.A. County has soared. The result is an average emergency room wait of eight to 12 hours. MLK-Harbor closing has only exacerbated this problem.
“Because of the large number of uncompensated care and Medi-Cal patients located in the area surrounding the hospital, many of the potential suitors for the MLK-Harbor hospital will locate to the site only if they are able to obtain the same number of Medicare funded GME slots as MLK-Harbor had before its closure,” Rep. Becerra said. “GME positions are important because they allow the hospital to train doctors.”
Prior to Rep. Becerra’s provision becoming law, a scenario to keep the positions in place would have been impossible because new hospitals are limited to obtaining only as many GME slots as they average in their first three years of starting a GME program. Since MLK-Harbor had 18 different GME training programs and over 200 Medicare full-time equivalent positions, it is highly unlikely that any new occupant could build as robust a program within three years. Therefore, retaining the Medicare residency slots has become a critical component of discussions and negotiations between LA County and facilities interested in opening a hospital on the MLK-Harbor site.
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