Maternity Ward Addition for Rebuilt Sylmar Hospital Urged

The Los Angeles County Department of Health Services is now recommending that a maternity ward be added to the nearly completed $120-million Olive View Medical Center in Sylmar, although it was not originally planned.

The 34-bed unit, which would cost $2.5 million to $5 million to install, would save thousands of indigent San Fernando Valley women each year from having to travel to County-USC Medical Center near downtown Los Angeles to give birth. County-USC now is the closest county-operated hospital with a delivery room serving the poor.

The recommendation is expected to come before supervisors within the next few weeks. It has the endorsement of Supervisor Michael D. Antonovich, who represents most of the Valley, according to his deputy, Marcia Nay. For a proposal to succeed at the county level, it needs the support of the area’s supervisor.

“There is a definite need for it in the Valley,” Nay said.

If approved, the obstetrics ward could be open by mid-1987, Olive View administrator Douglas Bagley said. Under current plans, it could handle 3,500 deliveries a year.

Wing Left Unfinished

A 10,000-square-foot wing of the new hospital has been left unfinished pending a decision by the supervisors on the maternity ward.

Shortly after the supervisors decided in the early 1970s to rebuild the hospital, which was destroyed in the Sylmar earthquake on Feb. 9, 1971, there was discussion of putting a delivery room in the new Olive View. However, the county dropped the idea when the federal government agreed only to provide funds for a duplicate of the destroyed hospital. It had no delivery room, Bagley said. Since then, construction costs for the hospital have grown so much that federal money is paying for only about a third of the total.

The issue arose again in 1983 when supervisors decided to complete rebuilding the hospital, which had been stalled by uncertainty over county financing. At the time, supervisors put off the question in order to prevent any further delay in the hospital’s completion.

Since then, there has been an overall increase in births in the Valley, Bagley said.

In the 1983-84 fiscal year, 1,738 babies, or 10.4% of the total delivered at County-USC, belonged to Valley women, according to the Department of Health Services. Lake View Medical Center in Lake View Terrace and St. Joseph Medical Center in Burbank handled 600 and 300 deliveries, respectively, under contract with the county during the same period. Serra Memorial Hospital in Sun Valley was recently added as the third local private hospital under county contract.

Nay also said she has received unconfirmed reports about expectant mothers who, rather than take the long trip to County-USC, sit in the parking lot outside private hospitals in the Valley, waiting until they go into an advanced stage of labor in order to gain admission to the emergency room. Under law, private hospitals must admit anyone, regardless of their ability to pay, in an emergency.

Bagley said the county staff is pushing for a quick decision by supervisors because it would be less costly and less disruptive to start work on the maternity ward before construction crews leave the site and the hospital opens.

Need Cited

The proposal calls for the maternity ward to be in a wing of the 350-bed hospital now set aside for 34 beds for general medical needs. Bagley said, however, that there is greater need in the Valley for obstetrics beds than general medical beds.

Neither Bagley nor Nay would predict the proposal’s chances of winning approval.

“I am not aware of any opposition,” Bagley said. In any case, he said, the county probably will need to continue to contract with private hospitals for obstetrical care. Even with a delivery room at Olive View, Bagley said, the county will be unable to handle the expected increase in births.

However, Robert Armstrong, senior assistant administrator of St. Joseph Medical Center, questioned the need for an additional obstetrical service in the Valley.

“I just wonder how one can justify the need for additional obstetrical services,” he said. He asserted it would be “much more economical” for the county to contract for an existing surplus of beds in maternity wards at private hospitals in the Valley than to build a new facility.

Move to Block Rebuilding

Armstrong in 1981 led an ill-fated move by private hospitals to stop Olive View’s rebuilding, claiming it would be less costly to contract with the private hospitals for health care to the poor. However, a citizens’ committee appointed by Antonovich to study the rebuilding of Olive View disputed the hospitals’ claims about cost savings. Armstrong said he has no plans to lobby supervisors to defeat the addition of a delivery room at Olive View.

Helping the proposal’s chances of winning support from cost-conscious supervisors is a preliminary assessment by a staffer in the county’s chief administrative office that “it’s cost-effective.” However, Bill Kreger, chief of the capital projects division of the chief administrative office, said he could not provide any figures until he completes his analysis of the proposal.

“It’s hard to believe you’re providing a full-service hospital out there without an OB unit,” Kreger added. “It doesn’t make sense.”

Even if supervisors approve adding a delivery room at Olive View, they still may have to come up with a way to pay for it, Kreger said. County officials have yet to determine if there will be money left from the $107-million bond issue sold to finance the project or if they will have to find funds somewhere else.

Decision Reconsidered

In a related development, supervisors are reconsidering their decision to sell Mid-Valley Hospital in Van Nuys, a private hospital bought by the county in 1972 for $7.3 million for use pending the rebuilding of Olive View.

The county had planned to sell Mid-Valley after Olive View’s completion, using the proceeds from the sale to help pay for construction of the Sylmar hospital.

Supervisor Edmund D. Edelman, whose district includes Mid-Valley, has asked the county staff to study alternatives to selling the hospital, such as using the property for other county services, including a health clinic or shelter for the homeless.

“We have an opportunity now, while time still remains, to examine the approach the board originally approved and determine whether selling Mid-Valley is the best course for the county,” Edelman said.

“New developments and service requirements since we made our decision in 1977, plus the experience we have acquired in generating revenues and savings from county property, may lead us to conclude that the county’s long-term interests are better served by retaining Mid-Valley as a county asset.”