Huntington Memorial Hospital in Pasadena announced Friday that it will not withdraw from the county's trauma-care system, and county officials said negotiations are under way to encourage four other hospitals to rejoin the troubled network.
The development signaled the first step toward the possible revival of the trauma system once considered a model for other metropolitan areas.
The spurt of negotiations follows a decision by the county to provide funds to private trauma centers through Proposition 99 revenues and to limit the area each trauma hospital serves.
Huntington Memorial announced in late February that it would withdraw from the network on May 1 due to financial losses incurred from treating trauma patients, some of whom carry no health insurance.
But Huntington's board of directors reversed its decision after the county agreed to significantly increase funds from Proposition 99, the tobacco tax initiative that went into effect Jan. 1.
Similar offers have been extended to St. Joseph Medical Center in Burbank, Daniel Freeman Memorial Hospital in Inglewood, Presbyterian Intercommunity Hospital in Whittier and Queen of the Valley Hospital in West Covina, said Virginia Price-Hastings, chief of the county's paramedic and trauma-hospital program.
If those four hospitals can be persuaded to rejoin the system, the county could fulfill its goal of transporting critically ill patients to a trauma center within 20 minutes, Price-Hastings said.
"It's such a shot in the arm. We're ecstatic," Price-Hastings said of Huntington's announcement. "I'm hopeful that it heralds the beginning of a turnaround for the system. We feel if we can get those four back in we will have rebuilt the system."
Mounting financial losses have eroded the trauma network from 23 members in 1983 to 13 now. The withdrawal by Huntington, one of the largest private hospitals in the trauma system, would have left 1 million residents in the San Gabriel Valley and eastern San Fernando Valley without access to a nearby trauma center.
But until more hospitals can be brought back into the system, large gaps in trauma care will remain throughout the county.
Huntington said it lost $3.7 million in 1989 while treating 666 trauma patients. Under its agreement with the county, Huntington will receive $920,000 in Proposition 99 funds for hospital services and an additional $920,000 for physicians' charges.
The county had originally offered $639,000 to the hospital and a matching amount to physicians. But a recent fiscal-year-end review of Proposition 99 funds revealed a surplus and allowed the county to increase its offer, Price-Hastings said.
"When we announced our withdrawal we . . . could not in good conscience continue to drain our resources away from our other services," said Dr. Allen W. Mathies, president and chief executive officer of Huntington Memorial Hospital. Mathies said the infusion of funds and restrictions on the service area could limit its losses to $1.5 million to provide trauma care this year.
"Although we will still lose money, our loss will be manageable and this enables us to stay in the network," Mathies said.
One drawback to the county's plan, however, is the expiration of Proposition 99 funds in June, 1991.
But health officials said Friday that they are seeking an additional source of state revenue to keep the trauma system operational after the Proposition 99 funds expire.
Some hospital officials said they fear that the offer of Proposition 99 funds might be just a quick fix for a system that needs a drastic overhaul.
Officials at St. Joseph Medical Center in Burbank are negotiating with the county but are concerned that funding will be temporary, said Daniel Fahey, chief operating officer of St. Joseph.
"Our main concern is how long they can continue," Fahey said. "There is only legislation to keep them going to June of '91. After that there would have to be new legislation."
Price-Hastings said her office will continue its efforts to make trauma-care funding a priority. The county will also consider a change in strategy to reduce the load of trauma patients to any one hospital, she said.
Shortly after Huntington announced that it would withdraw from the system, the county ordered paramedic crews and hospitals not to transport critically ill patients to trauma centers if they are injured outside the service area of the hospital, called its catchment area.
The decision was intended to ease the load on the county's remaining trauma centers but meant that patients in areas not served by a trauma center are transported to hospitals poorly equipped to provide trauma care.
But, Price-Hastings said, the county will stick to its agreement to adhere to service areas.
"The biggest problem that (Huntington) had was the ever-growing numbers of patients," Price-Hastings said. "We had been been hopeful if we can manage the volume of patients, we might induce them to rejoin the system. And if we get those four hospitals back, everyone will be covered by our 20-minute transport standard."
CENTERS STILL OPEN 1. Westlake Community Hospital, Westlake Village 2. Henry Mayo Newhall Memorial Hospital, Valencia 4. Northridge Hospital Medical Center 5. Holy Cross Hospital, Mission Hills 8. UCLA Medical Center 9. Cedars-Sinai Medical Center, Los Angeles 12. Childrens Hospital of Los Angeles 13. Huntington Memorial Hospital, Pasadena 15. County-USC Medical Center, Los Angeles 17. County-Harbor UCLA Medical Center, Torrance 18. County-Martin Luther King/Drew Medical Center 22. St. Mary Medical Center, Long Beach 23. Memorial Medical Center of Long Beach CENTERS CLOSED 3. Antelope Valley Medical Center, Lancaster 6. St. Joseph Medical Center, Burbank* 7. Santa Monica Hospital Medical Center 10. Hollywood Presbyterian Medical Center 11. California Medical Center, Los Angeles 14. Daniel Freeman Memorial Hospital, Inglewood* 16. Methodist Hospital of Southern California, Arcadia 19. Presbyterian Intercommunity Hospital, Whittier* 20. Queen of the Valley Hospital, West Covina* 21. Pomona Valley Community Hospital * Four other hospitals are negotiating with the county to rejoin the trauma system.