County Plan for Hospital Hits Snag

A plan to build a county hospital in Baldwin Park is in limbo because Los Angeles County and state officials have not settled their quarrel over whether the facility should have 60, 80 or 125 beds.

If the dispute is not resolved soon, one of the parcels of property on which officials hoped to construct the county’s first new public hospital in decades will instead become the site of a new Save-On drugstore.

The proposed hospital was hailed in July as a boon to the county’s growing uninsured population, as well as a solution to the long-running argument over the size of the hospital planned to replace County-USC Medical Center in Boyle Heights. Medical experts, Supervisor Gloria Molina and Latino state legislators complained that the quake-damaged hospital was being rebuilt at too small a size to serve the Eastside and San Gabriel Valley. But the rest of the Board of Supervisors disagreed, saying anything larger than their planned 600-bed facility could bankrupt Los Angeles County.

The dispute led to an all-out war between Sacramento and the county, with legislators holding up millions of dollars in medical aid to the county in a futile effort to force supervisors into reconsidering their decision.

This summer a compromise arose: build an “extension” of County-USC on the site of a shuttered Baldwin Park hospital. The extension could provide medical services to the uninsured residents of the San Gabriel Valley, who now have to travel up to 30 miles for treatment at County-USC. The county offered to build a 60-bed hospital if the Legislature restored state funds it was withholding from the county; the state countered with a 125-bed proposal and offered to fund the $12-million difference. Officials believed the problem was nearly solved.

But in the past two months the two sides have been unable to agree on the number of beds, and the Legislature ended its business for the year Friday without approving any funding for the Baldwin Park hospital. At Tuesday’s board meeting, Molina tried to prod her colleagues into compromising with the legislators, contrasting the hospital stalemate with the board’s approval of an $8-million annual subsidy for the Disney Concert Hall project in downtown Los Angeles.

But other supervisors sharply complained that without passing a bill, Sacramento had given them no concrete assurances that it could fund the new hospital.

Officials say there is still hope but admit that the chances of reaching a compromise have dimmed significantly, with some privately saying the deal is all but dead.

“It’s still alive,” said Assembly Speaker Antonio Villaraigosa (D-Los Angeles), “but the patient is in need of resuscitation.”

Resuscitation seemed far away at Tuesday’s meeting, in which state legislators urged supervisors to purchase the property. Supervisors were skeptical after legislators acknowledged that they could not guarantee funding for construction of the new facility.

Molina urged her colleagues to take Villaraigosa at his word and approve the 125-bed facility. If the speaker can’t find the money, she said, the county could keep the hospital small.

“If they can’t deliver, we will have to live with less beds in our facility,” Molina said. “Put the monkey on the Legislature’s back. There are members who are willing to pay for it.”

But other supervisors, visibly frustrated at Molina’s linking the hospital and the Disney Hall project, rejected that approach.

Citing a finding by county medical staff that an 80-bed hospital was all that is needed, Supervisor Zev Yaroslavsky in an interview said it would be a waste of state money to fund a larger facility.

“It’s not just about money, it’s about what medically works in our system,” Yaroslavsky said. “I’d rather see the [state] money spent on outpatient care and children’s health care than on another 20 beds so someone can score a political victory.”

Noting that the state would have to pay a lump sum of $500 million for a 125-bed hospital, Supervisor Yvonne Brathwaite Burke said it would be absurd to buy property and then build a hospital that could remain empty if the state failed to find the money. “We don’t want to go out and sign a contract to buy property based on that,” she said. “Every time we offer to do something, nothing happens. There’s a different demand.”

In 1997, as the county recovered from a fiscal crisis that almost sent it into bankruptcy in part because of its reliance on costly hospitals, the board decided to rebuild County-USC at 600 beds rather than at the 750-bed level Molina and county health staff initially sought.

Molina fought the decision furiously, angering her colleagues on the consensus-minded board. An unusually united coalition of Latino legislators pitched in, holding up $200 million in construction money in an effort to force the county into building a 750-bed structure.

Recently, Molina suggested building a compromise hospital in Baldwin Park, and board Chairman Don Knabe began negotiating with Villaraigosa over the number of beds that facility would have.

As the legislative session ended last week, Yaroslavsky and Burke suggested an 80-bed facility to Villaraigosa, based on the county’s medical analysis. Villaraigosa said that his own health advisors, who met with county staff over the appropriate size, favored a facility with “more toward 100” beds.

Villaraigosa in an interview said he was baffled at the county’s refusal to accept a bigger hospital since the state would fund it. “I don’t understand that, they’re asking us to pay for it,” he said. “The good news is we’re still talking.”

Knabe also stressed that negotiations are still open, though he said he sees the 60-bed proposal as “the only offer on the table” because it is the only one with a funding mechanism in place.

At Tuesday’s meeting Assemblyman Martin Gallegos (D-Baldwin Park) and Assemblywoman Gloria Romero (D-Los Angeles) urged supervisors to keep the dialogue open.

“If governmental bodies put their minds toward getting something done, something will get done,” Gallegos said.

The legislators also urged supervisors to support a motion by Molina to delay approval of a new agreement with the backers of Disney Concert Hall until the hospital issue is resolved. Molina said she is troubled by the thought of approving an $8-million subsidy for a concert hall while balking at spending a similar amount of money to close the gap between the proposed hospitals. The county by contract cannot cut the subsidy.

“Both facilities are in my district and are important. . . . But today, only one facility is expected to be approved,” said Molina, noting the growing gap between the rich and poor in Los Angeles. “Disney Hall will proceed, but the San Gabriel Valley hospital is not likely to remain an option. I cannot support this imbalance in the county’s priorities.”

But Molina joined her colleagues in approving the Disney Hall deal, noting that she had approved the initial contract and has longed supported government aid for the arts.

“As a child, unlike my child, I never had an opportunity to visit the Hollywood Bowl or the Philharmonic,” she said. “But I did wait in line at a county health clinic. . . . I was hoping that by putting both the hospital issue [and Disney Hall] on the table, we could end this horrible dispute.”