Patient Care
MCA Clinical Programs and Services
As a private-public partnership between the University of Southern California and Los Angeles County Department of Health Services, MCA provides comprehensive multidisciplinary care to women, men, children and adolescents and their families, regardless of their ability to pay, in a culturally sensitive environment and incorporates research at all levels. Family-centered, primary and subspecialty medical care along with a strong psychosocial component are provided by a multidisciplinary team of providers from the Departments of Pediatrics, Obstetrics/Gynecology, Family Medicine, Psychiatry, Social Work and Nutrition. Through this collaboration, a full spectrum of HIV care is provided in one setting to all infected patients and their affected family members regardless of their ability to pay, including those not covered by insurance.
- Free on-site confidential rapid testing for all persons seeking an HIV test and all partners and children of known HIV+ persons
- Free STD testing and treatment is available either as a walk-in or with an appointment
- Testing is done in a culturally and linguistically non-stigmatizing environment
- Because it is a family-centered clinic where HIV is not advertised in name or signage, people are comfortable requesting an HIV test
- Full assessment, development of an initial care plan
- Primary and specialized HIV care
- Full check-ups
- Immunizations
- TB screening
- Lab tests including HIV-specific monitoring and genotypic resistance
- Anti-HIV medications
- Antiretroviral therapy (ART) adherence counselling
- Opportunistic infections prevention and treatment
- Assessment and treatment of acute medical conditions
- Individualized treatment plans
- Sexually transmitted infection (STI) screening and treatment
- On-site transition of youth to adult care
- Specialized youth/adolescent services
- Pre- and post-exposure prophylaxis (PEP and PrEP) for HIV
- Treatment and monitoring of other infectious diseases, including hepatitis B and hepatitis C, and TB
- MCA provides PEP services to children, adolescents and adults with non-occupational exposure to HIV which includes consensual and non-consensual sex and needle sharing.
- PEP must be initiated within 72 hours of the exposure and MCA facilitates patient visits with same day or next day appointments.
PrEP stands for Pre-Exposure Prophylaxis for HIV and involves taking a pill called Truvada every day to prevent HIV infection:
- MCA provides PrEP services to adolescents and adults at risk for HIV infection including men who have sex with men, transgender women, individuals who use injection drugs, women with multiple partners or who are at increased risk for HIV, anyone with an HIV+ sex partner.
- PrEP services includes full testing for sexually transmitted infections and HIV.
For PEP and PrEP appointments call (323) 409-2200 or text our outreach line at (323) 455-9454
For after-hours or weekend exposures in need of PEP, treatment can be arranged by calling or texting our outreach line at (323) 455-9454 or calling (323) 409-2200 and requesting the physician on call.
- On-site prenatal and perinatal care
- Reproductive health care
- On-site colposcopy
- Family planning, contraception including the availability of long-acting removable contraception (LARC)
- Preconception counseling
- PrEP for HIV-negative pregnant women at risk for HIV
- Gynecologic care of HIV positive women and adolescents
- Adherence support and counselling
- Expert assistance with complicated drug regimens
- Pre and postpartum home visits
- Retention in care
- Adherence counseling
- Direct admissions to the Los Angeles General Medical Center
- Coordination of care during hospitalization with individualized discharge planning
- Comprehensive mental health care
- Clinical case management: Housing, food access, transportation
- Psychiatric assessments and treatment
- Developmental evaluations
- Support groups
- Individual counseling
- Assistance with partner notification
- Access to clinical research trials
- Nutritional counseling
- Dental referrals to on-site dentist, USC School of Dentistry, and others
- On-site playroom with child life specialists coordinating age-appropriate art activities
- On-site computer program for children
- Access to transportation (bus tokens, emergency taxi)
- Financial screening/benefits coordination
- Services available in Spanish, French, Creole and other languages
- Medi-Cal and other health plans accepted
- Application assistance for supplemental health plan coverage program
- An Infectious Diseases/Immunology California Children’s Services (CCS) Center
- Medication coverage assistance (ADAP Program)
- Community pharmacy referrals (home delivery of medications and medical supplies available)
Visiting the Center
MCA Clinic
2010 Zonal Avenue,
OPD 5 West
Los Angeles, CA 90033
Tel: (323) 409-2200
Fax: (323) 226-3971
After hours answering service: (323) 265-7709
Pediatric Infectious Diseases (ID) Service
The Pediatric ID service encompasses an inpatient consult service at the Los Angeles General Medical Center, an outpatient clinic at MCA, and an antimicrobial stewardship program. Staff are also involved in the Department of Pediatrics educational and academic activities including training students, residents and fellows, participating in academic conferences, providing didactic lectures and precepting and mentoring residents in developing and implementing research projects. The Pediatric ID service collaborates closely with the Infection Control Service, Hospital Epidemiologist, Microbiology Department and Adult Infectious Diseases Service. The ID outpatient clinic collaborates closely with the Pediatric/Adolescent HIV clinic. Consult services are available 7 days/week, 24 hours/day.
The ID consult service provides consultative assistance in the care of Los Angeles General Medical Center hospitalized pediatric and adolescent patients with serious, complex or difficult to diagnose infections seen in the following locations:
- Pediatric ward
- Adolescent ward
- Pediatric Intensive Care Unit
- NICU and newborn nursery
- Pediatric ER
- Other places where pediatric/adolescent patients are hospitalized including the ER, Burn Unit, and Urgent Care
Consults are performed by the attending pediatric ID physician or medical students, residents and fellows under the supervision of the attending. The attending evaluates and examines the patient and participates actively in formulating the differential diagnosis and recommendations.
Services provided by the ID consult service include:
- Consultative evaluations
- Informational questions
- Antimicrobial stewardship and approval
Types of consultations include evaluation of patients with rare infections, difficult to diagnose (possible) infections such as fevers of unknown origin or Kawasaki disease, difficult to treat infections such as those involving resistant organisms such as ORSA, VRE or ESBL, locally endemic infections such as Murine typhus or coccidioidomycosis, infections in immunocompromised patients including hereditary immunodeficiencies such as chronic granulomatous disease, or acquired immunodeficiencies such as neutropenia due to chemotherapy or HIV infection, severe infections such as toxic shock syndrome or CNS infections and communicable diseases such as tuberculosis and varicella.
The Pediatric ID clinic provides outpatient care for infants, children and adolescents with serious, complex, chronic or difficult to diagnose infections. We provide 3 half-day sessions per week but when necessary can accommodate patients at other times. Patients seen in the clinic include:
- Follow-up patients from the hospital consult service, Emergency Department, or general pediatric or sub-specialty clinics
- Patients with chronic infections requiring long-term infectious diseases evaluations
- Patients referred from within the LAC Department of Health Services clinic system including the juvenile detention system and community referrals
- Patients receiving long-term antimicrobial therapy either IV or enteral, and chronic infections such as tuberculosis or coccidioidomycosis
- Patients with difficult conditions to diagnose or treat such as those with fever of unknown origin, chronic lymphadenitis, and brucellosis
Some of the diagnoses seen in the Infectious Diseases Clinic include:
- Tuberculosis
- Fungal infections
- Skin and soft tissue infections
- Bone and joint infections
- Infections requiring home intravenous antibiotics
- Sexually transmitted diseases
- Parasitic diseases and other travel related complaints
- Fever of unknown origin
Patients are seen by students, residents, fellows under the direct supervision of the attending. Clinic physicians serve as a resource to community physicians by answering questions or seeing referrals.
The pediatric ID faculty developed a Pediatric Antimicrobial Stewardship Program (Peds-ASP) as a subcommittee of the Los Angeles General Medical Center Infection Control Committee. The program includes members from multiple disciplines:
- Pediatric Infectious Diseases
- Core lab
- Microbiology
- Neonatology
- Pharmacy
- Obstetrics
- Epidemiology
- Nursing
The overall goals of the program are to:
- Establish research and data collection infrastructure
- Increase collaborations within Los Angeles General Medical Center and the Los Angeles County Department of Health Services (LACDHS)
- Enhance quality of care through optimizing patient outcomes
- Shorten antibiotic exposure (where appropriate), ventilator days and hospital stays
- Increase targeted antibiotic use and optimize antibiotic dosing and choice
- Decrease positive cultures with MDR bacteria and number of infections in long-stay patients
- Limit surveillance cultures
- Increase hospital cost savings
Current activities of the program include:
- Antimicrobial surveillance in the NICU, PICU and pediatric wards with Peds-ASP rounds to review antimicrobials on inpatients, offer brief interventions, refer for full consult as appropriate
- Study of breastmilk, respiratory and cord blood culture results
- Procalcitonin measurements in pediatric patients with development of reference range and clinical applications
- Developed guidelines for appropriate selection of antibiotics for pediatric patients to be implemented throughout LACDHS.
Mental Health Services
The MCA Mental Health Program provides psychiatric, psychological, and psychosocial interventions to promote and maintain our patients’ physical and psychological well-being. Our interdisciplinary team addresses issues such as patient quality of life, STI prevention and education, youth specific educational activities, treatment adherence, and psychosocial obstacles to effective medical care. Our specific mental health services include:
- Psychiatric assessment
- Psychopharmacology
- Individual psychotherapy
- Consult/Liaison services
- Neuropsychological testing
- Individual psychotherapy
- Consult/Liaison services
- School and Regional Center advocacy
- Psychosocial assessments
- Development and follow-up of patient treatment plans
- Psychosocial therapy (including individual, couples, family, crisis intervention, and group therapy)
- Substance abuse screening and assessment
- Domestic violence assessment and referral
- Support groups and community building activities
- Coordination of social and medical services
- Advocacy and linkages to local community resources and services
- Health education
- Financial and housing assistance
- ART adherence counselling
- A youth-focused multifaceted group discussion model that incorporates principles of mental health, support group processes, and educational techniques
- Conducted in English and Spanish
- Teaches youth about living with HIV
- Empowers youth to become full partners in their own care
- Discussion topics include HIV 101, communication skills, love and sex, living with HIV, goal setting, homophobia, and disclosure
- A peer group experience with the opportunity to participate in educational and skills-building workshops and activities
- Activities have included trips to the movies, art museums, beach, and Dodger games
Prevention of Maternal-to-Child HIV Transmission (MTCT)
MCA has been a leader in the care of HIV+ pregnant women and their newborns for the past 28 years. It is the largest of only 3 designated perinatal centers in LAC and the only designated site for the Department of Health Services health care system that can provide coordinated care from preconception counselling, to prenatal care, delivery, and post-partum care to the mother and neonate. MCA provides these services without regard for ability to pay.
- Confirmatory HIV testing services for pregnant women with equivocal results in other clinics
- Counseling regarding the likelihood (extremely low) of MTCT of HIV, prognosis for healthy pregnancy, options for management of the pregnancy
- Education about the importance of having her children and partner(s) tested
- State-of-the-art prenatal care and HIV-specific individualized care by a team of physicians including HIV specialists in obstetrics/gynecology, internal medicine and pediatrics
- Fetal ultrasounds and non-stress testing (NST) performed in the clinic
- Deliveries by the MCA obstetrician at Los Angeles General Medical Center
- Nutrition counseling by a dietician
- Home visits by a home health nurse both before and within two weeks of discharge to evaluate the home setting
- Follow-up of the neonate and mother at MCA within one week of delivery
- Close follow-up in the post-partum period by their social worker/case manager to address barriers to care
Los Angeles General Medical Center does rapid HIV testing at labor and delivery for women without documentation of an HIV test during the pregnancy and rapid test for those without an HIV test in the 3rd trimester, even if negative earlier. Those testing HIV+ and their newborns are seen in the hospital by MCA physicians and referred to MCA for further testing and care.
Adolescent HIV Care and Prevention at MCA
MCA provides youth-sensitive, culturally and linguistically competent, coordinated, and developmentally appropriate medical and support services to HIV+ youth and to those at risk for HIV infection. MCA’s HIV primary care physicians and mid-level providers care for both perinatally and behaviorally infected youth.
Our social work and case management team addresses barriers to retention by aiding with transportation, food and housing insecurities, mental health needs and general support.
PEP and PrEP Services at MCA
PEP
- PEP stands for Post-Exposure Prophylaxis and involves taking HIV medication following a potential HIV exposure to prevent infection.
- MCA provides PEP services to children, adolescents and adults with non-occupational exposure to HIV which includes consensual and non-consensual sex and needle sharing.
- PEP must be initiated within 72 hours of the exposure and MCA facilitates patient visits with same day or next day appointments.
- For PEP appointments: (323) 226-2200
- For after-hours or weekend exposures in need of PEP, treatment can be arranged by calling or texting our outreach line at (323) 455-9454 or calling (323) 409-2200 and requesting the physician on call.
PrEP
- PrEP stands for Pre-Exposure Prophylaxis for HIV and involves taking a pill called Truvada every day to prevent HIV infection.
- MCA provides PrEP services to adolescents and adults at risk for HIV infection including men who have sex with men, transgender women, individuals who use injection drugs, women with multiple partners or who are at increased risk for HIV, anyone with an HIV+ sex partner.
- PrEP services includes full testing for sexually transmitted infections and HIV.
- For PrEP appointments: (323) 409-2200