LA Health Action (LAHA)[i] convened the Strategy Team for Access, Reform and Transformation (START) in the fall of 2010 to create strong, effective L.A. County partnerships to prepare local safety net institutions for federal health reform.


LAHA commissioned Harbage Consulting to conduct interviews with key thought leaders from Los Angeles County health care safety net systems to reveal key challenges, opportunities and needed first steps for ACA implementation.  The findings were summarized in a report released in July 2010,[ii]  which reinforced the idea that the Los Angeles public system, which provides episodic care, must evolve into an integrated delivery system including strong relationships with private agencies.  Stakeholders consistently called for a planning table for stakeholder interaction to improve communication and decision-making.

In addition, CMS awarded a five-year, $10 billion §1115 Medicaid Waiver to the state in November 2010 to serve a bridge to health reform. Los Angeles, along with other counties, is implementing various components of the waiver.

Dr. Mitchell Katz, the new LADHS director, provided a retrospective look at his first year with the department and future plans at a LAHA meeting in December 2011.  Key successes included: empanelling over 240,000 patients in medical homes; enrolling over 110,000 individuals in the Low Income Health Program (Healthy Way LA; HWLA); integrating mental health services at County and contracted community clinic sites using DSRIP and local MHSA PEI funds; developing supportive housing units for patients discharged from hospitals with assistance from the Corporation of Supportive Housing; preparing for the transition of 5,000 Ryan White beneficiaries into HWLA; and moving 20,000 specialty care patients who would be more appropriately treated in a primary care setting from the County to community clinic settings. Dr. Katz pointed out additional work that remains for ACA implementation in areas such as IT and streamlining HWLA enrollment.

Continue reading the full fact sheet

START_Fact_Sheet_01202012 START_Fact_Sheet_01202012.pdf

[i] Web site: and contact info:

[ii] Harbage Consulting, Preparing for Launch: Views on the Implementation of Federal Health Reform in Los Angeles County, LA Health Action, July 2010, available at