No New Defections Expected in County Trauma Center Network

Los Angeles County’s troubled trauma center network will face no new defections--at least for the time being--despite Gov. George Deukmejian’s veto last week of legislation to bail the system out, county officials said Wednesday.

But a high-ranking official of Queen of the Valley Hospital in Covina said that facility could become the sixth trauma center--and the fourth this year--to pull out unless major remedies are applied, and soon. Queen of the Valley’s trauma center now serves a 130-square-mile area encompassing a population of 800,000 people.

Despite that warning, county Chief Administrative Officer Richard Dixon and Health Director Robert Gates voiced cautious optimism that the network will maintain its current 18-hospital membership, which includes three county facilities. Gates and Dixon said nearly $10 million in newly found property taxes, combined with a new policy to ease the financial burden on private hospitals caring for non-paying trauma patients, will help solve some of the network’s immediate problems.

Dixon said there is insufficient new funding, however, to entice a key defector--Daniel Freeman Memorial Hospital--back to the system. Claiming losses of more than $2.5 million, Daniel Freeman left last June, leaving a wide swath of the county’s western area outside a desired 20-minute ambulance ride to a trauma center. The centers provide emergency care using special medical teams and advanced technology.

Last week, Deukmejian vetoed legislation by Assemblyman Burt Margolin (D-Los Angeles) that would have provided $10 million in state funds, matched by an equal amount of federal money, for trauma centers statewide. Deukmejian said counties could instead use $110 million of discretionary funds to help their trauma networks. Los Angeles County supervisors already have decided to use their discretionary funds for other programs.

The governor in July also had vetoed $30 million in trauma care funding, contending the networks are not a state responsibility.

In the wake of those vetoes, officials in both the private and public sectors have been assessing whether the once highly touted network--created with much fanfare in December, 1983--will remain a viable emergency care force or collapse due to its thinning membership.

Additional Proposal Planned

On the plus side, Dixon said in the coming weeks, he will likely propose that about $9.8 million in newly discovered property tax money be set aside for the trauma network.

Current plans would provide about half that money to staff about 30 public hospital beds so private hospitals can more easily transfer stabilized indigent trauma patients to them, health director Gates said. The balance would help two county hospitals offset losses incurred from treating trauma patients that would have gone to Daniel Freeman, Gates added.

Dixon said more trauma care money may be available next July from new legislation changing the financing of local courts from a county to a state responsibility, which for Los Angeles county will mean an extra $115 million.

But officials of private hospitals are not convinced that local efforts will provide the permanent solutions necessary to save the trauma center system. Twice this year, they had counted on state funding only to be disappointed.

David Langness, vice president of the Hospital Council of Southern California, said that without a major infusion of state funds, the county is “only prolonging the inevitable” collapse of the network.

Queen of the Valley Shaky

The next possible defection is Queen of the Valley in Covina, which last week asked the county to reduce its service, or “catchment,” area from 130 square miles to 64 square miles. Hospital chief operating officer Pete Makowski also said the facility is seeking an unspecified amount to help offset anticipated losses of $2.5 million in 1987 and as high as $3 million in 1988.

Makowski said the 272-bed hospital did not present the county with an ultimatum, but added, “If they cannot reduce our catchment area and clearly there are no official funds, I will have to take that information back to the (hospital) board and let them decide.”

Makowski said Queen of the Valley’s service area more than doubled late last year when Pomona Valley Community Hospital dropped out of the trauma care system. As a result, the number of unreimbursed trauma patients served by the hospital increased by about 20%, he added.

If Queen of the Valley leaves, Makowski said two hospitals, Presbyterian Intercommunity in Whittier and Methodist Hospital of Southern California in Arcadia, would probably be called on fill in part of the void.

But county trauma network coordinator Virginia Hastings said part of the void would remain unfilled. She said that the entire city of Pomona would be left outside the desired 20-minute ambulance ride to one of the specially equipped and staffed emergency rooms.