Mercedes Kaufman was not planning on giving birth at Martin Luther King Jr. Community Hospital. The Hawthorne resident had hoped for a water birth, but her midwives recommended MLKCH after Kaufman experienced complications with her blood pressure in 2022. She was pleasantly surprised with her experience.
“I did have reservations with going to a hospital … because of all the stories of Black women not really being protected in these type of spaces in hospitals,” she said. “But I felt secure being [at MLK].”
After the comprehensive care and kind treatment Kaufman said she received " in the maternity ward, she said she would “definitely” go back to MLKCH if she were to give birth again.
But by this time next year, that might not be possible.
MLK Community Hospital, a 131-bed hospital that primarily serves publicly insured patients like Kaufman, is running out of funds. To assist, the Los Angeles County Board of Supervisors unanimously approved a motion on Jan. 24 to invest $20 million in MLKCH over the next four years. But even with $8 million infused immediately, the hospital has a little under a year left if their funding situation does not change.
Located just north of Compton in Willowbrook, MLKCH is a safety-net provider for underserved South Los Angeles communities like South Central, Carson and Inglewood. MLK Community Healthcare’s 2023 Community Health Needs Assessment said that more than 90% of South L.A. residents are Hispanic or African American, and almost 96% of patients in 2022 were covered by Medi-Cal, Medicare or were uninsured.
Because the hospital mainly relies on Medicaid reimbursement — which is notoriously low in California — it has continued to take massive fiscal losses. Medi-Cal reimbursement has been unable to offset the costs of “essential services such as emergency care and maternity deliveries,” according to MLK Community Healthcare.
Kaufman is not the only mother concerned about what MLKCH closing could mean for her future. San Pedro resident Angelica Brightmon was taken to MLKCH when her water broke unexpectedly. Similar to Kaufman, Brightmon expressed that despite initially not wanting to give birth at this community hospital, she would choose MLKCH again if she were to have another baby.
Brightmon was not previously aware of the hospital’s precarious funding situation. Her reaction was shock and overall confusion. “No way. Oh my god,” Brightmon said. “I did not know that that was an issue … I did not hear about that.”
MLKCH’s maternity care is trusted among many women of color in the South L.A. area, especially during a pattern of California hospitals closing their maternity wards. The hospital was awarded the international Baby-Friendly designation by Baby-Friendly USA, and it has been placed on the Cal Hospital Compare Maternity Honor Roll since 2019, noted for its low C-section rates.
Kaufman noted that she had a sense of “reassurance” going into MLKCH because several family members and other people told her that they had positive experiences. She also said that “feeling heard” as a Black woman in a medical setting is an important factor for her.
“It was just good to see a lot of people that look like me in those spaces,” said Kaufman, referring to her clinicians at MLKCH. “Because that doesn’t happen a lot. Or sometimes, at all. So it was really good.”
When Kaufman saw an Instagram post about MLKCH being in danger of closing down, she said she was upset — and unsure of her future plans.
“There’s not a lot of hospitals on this side of town,” Kaufman said. “If I have a baby again, where am I gonna have my baby at? It sucks.”
MLKCH is an accessible care provider for low-income Medi-Cal patients, but it is also a pillar of trust for its South L.A. communities. Toni Vargas, an associate supervising attorney at the Health Consumer Center of the Neighborhood Legal Services of L.A. County (NLSLA), provides free medical-related legal aid for L.A. residents. She said that MLKCH’s position within Los Angeles cannot be glossed over.
“This very special neighborhood doesn’t travel far, and it doesn’t trust well. And people don’t lightly enter into that community because of the environment,” Vargas said. “[MLKCH] still sustains and retains the only trusted place people in this immediate community will go.”
In addition to its bustling maternity ward, MLKCH’s emergency room is known for being one of the busiest in the country. The emergency department receives more than 100,000 visits a year, which is nearly double industry performance standards and triple the number estimated when MLKCH first opened, according to MLK Community Healthcare’s 2023 Community Health Needs Assessment.
Clinicians in the emergency room have had to adapt to the high patient volume. Tiffany Hsia, an ER technician at MLKCH, said the night shift is “pretty minimally staffed.”
“We only have 21 beds in the emergency room,” Hsia said. “We’ve accommodated by setting up extra little lobby treatment areas and having a discharge lounge trying to get patients seen as quickly as possible. … We just make do with what we have.”
MLKCH’s emergency room is a vital source of care for low-income patients. Factors like long work hours and access to transportation can prevent low-income, working class and/or unhoused people from seeking treatment early on until they are left with no other option. Many patients, Hsia said, come to the ER as a form of primary care — especially with a shortage of nearly 500 primary care doctors in South L.A. — or as an ultimate last resort for treatment.
“A lot of patients don’t know about urgent care or have primary care doctors. They’re not aware because they don’t have the education,” Hsia said.
The loss of MLKCH would likely see worsened health outcomes and increased premature deaths as an immediate effect, according to Lavonna Lewis, a professor and the vice dean of diversity, equity and inclusion at USC’s Sol Price School of Public Policy.
“People will die prematurely because they couldn’t get the care that they needed, and there will be additional costs to our healthcare system,” Lewis said. “We’ve seen over and over again that early intervention is better for both the patient and the system because we save money.”
Lewis also said the absence of MLKCH would also probably increase the patient volume of nearby hospitals.
“People aren’t going to quit being sick,” she said. “They’re just going to have to find other places to go.”
The nearest hospital to MLKCH is the St. Francis Medical Center in Lynwood, about three miles away. St. Francis, however, is a trauma hospital, which means that an influx of regular emergency patients on top of their trauma patients would pose a burden to the facility and its clinicians — especially when MLKCH’s emergency room alone currently sees over 100,000 patients a year.
An increase in emergency department saturation at surrounding hospitals could be the start of a vicious cycle, according to Adam Blackstone, the senior vice president of communications and event management at the Hospital Association of Southern California, which MLKCH is a member hospital of.
“It could lead to delaying care or not getting care,” Blackstone said. “It has a ripple effect to the nearest hospital, and so on and so forth. So it’s not like it just happens in one area. It has a profound impact across the system.”
MLKCH’s struggle with funds reflects a continued national trend of urban safety-net hospital closures. Philadelphia’s Hahnemann University Hospital and Washington, D.C.’s Providence Hospital, for instance, closed their inpatient services in 2019 after experiencing similar fiscal losses. Like MLKCH, Hahnemann and Providence served a primarily low-income and Black and brown patient population.
Lewis said safety net facilities like these are critical because they are designed to serve historically underserved patients in the United States.
“In a healthcare system that relies on the market, what happens with those folks for whom it is not profitable to provide care for them?” Lewis said. “That’s why we get the safety net, to catch people who fall through the gaps that are caused by the market-based mindset.”
As MLKCH is projected to lose another $13 million for 2024, the future of the hospital — and its patients — is unclear. Dylan Sublett, president of the MLK Community Health Foundation, told Capital & Main that the hospital has until June 2025 if nothing changes.
If it does close and she has another pregnancy, Kaufman said she would likely try going to a midwives facility again, though she is uncertain if her blood pressure complications would return. Brightmon said she would look into a different hospital she initially considered, but believes that nothing could compare to MLKCH’s care and hospitality.
For Hsia, the towering possibility of losing her job has been “scary” — but she is more worried about MLKCH’s patients.
“[I] can always find another job because hospitals are always gonna exist. For me, I think it’ll be okay,” Hsia said. “But I think [MLKCH] is more important for the actual community. It’d be very devastating to see.”