Los Angeles County health officials want to replace the venerable but decaying Los Angeles County-USC Medical Center with two new hospitals, one on the current site and a second, smaller facility in the San Gabriel Valley.
The formal recommendation, which would cost an estimated $1.8 billion if implemented, is being reviewed by the county's chief administrative officer. It calls for the project to be financed through a series of bond measures beginning in 1992.
The bonds, which would require property tax increases, also would pay for other improvements throughout the county's huge network of hospitals and neighborhood clinics, facilities that primarily serve the poor.
Chief Administrative Officer Richard B. Dixon said he plans to forward the master plan--with his recommendation that it be approved--to the supervisors for a decision within two weeks.
The sprawling County-USC Medical Center, a four-hospital complex whose central facility, the General Hospital, opened in 1932, has a paradoxical reputation for decrepit conditions and quality care. The center's wards, hallways and waiting rooms teem with impoverished patients. Rooms lack air conditioning or other amenities, and the older portions of the facility readily reveal their age in cracks and outdated equipment.
County-USC also has come to be known nationally as a top teaching hospital, having trained thousands of still loyal doctors and nurses. For many of the county's sick poor, especially Latinos, it is the only hospital they know.
"There is a great fondness for this hospital," said Harvey Kern, special assistant to County-USC's executive director. At the same time, he said, medical staff and patients look forward to a state-of-the-art medical facility--with air conditioning.
Replacement of County-USC has been studied for years, but the matter gained urgency after federal officials threatened to cut off funds unless the county corrected fire hazards. Recently, the nation's major hospital review organization put County-USC on conditional accreditation, citing fire hazards.
The master plan was prepared by a team of private consultants.
It maintains that the medical center could operate more efficiently if it were replaced by a 946-bed facility. County-USC has 2,045 licensed beds, but only 1,398 are in use. Under the proposal, the 20-story General Hospital, whose edifice is known to soap opera buffs as the exterior prop for the show "General Hospital," would remain for academic and research use.
The master plan proposes scaling down County-USC to "more evenly distribute medical care throughout the county." Under the plan, the number of beds in the hospital system would remain the same but less at County-USC and more in other regions of the county.
It calls for a 350-bed hospital to be built somewhere in the San Gabriel Valley.
Additionally, the proposal would add 100 beds each at Harbor-UCLA Medical Center in Torrance and Olive View Medical Center in Sylmar.
Dixon said that having projects in each supervisorial district is politically crucial, intended to help secure the support of both supervisors and, eventually, voters.
The bond measure would increase property taxes on a home assessed at $250,000 by $37 in the first year, increasing to $55 in 1996.
The master plan concludes that it would be more economical to build a hospital than repair County-USC to meet fire and earthquake safety standards. "Functional obsolescence of the existing hospitals also lead the consultant team to determine that replacement would yield greater operational efficiencies than remodeling," the study says.
The county is spending $500,000 a year for a 24-hour fire watch in which employees walk the halls of the 20-story main building looking for fires and potentially hazardous conditions.
Because the complex is so spread out, with more than 100 buildings dotting the Lincoln Heights site just east of downtown, patients sometimes have to be transported by ambulance half a block from one medical facility to another.
The proposed site for the new County-USC is east of General Hospital. Plans call for completion of the facility in 1999.
County health director Robert Gates said that building a new hospital would not necessarily reduce crowding or long waits at County-USC. But he said that a new hospital would make visits to County-USC more pleasant. For example, he said, the existing hospital has as many as six patients in a ward. The master plans calls for single-occupancy rooms, although Gates said there could be two patients in each room.
Even without the current proposal, dramatic changes loom for County-USC. A 275-bed hospital is being built near County-USC by the university and National Medical Enterprises Inc. The new teaching hospital, scheduled to open in May, 1991, will primarily serve paying patients, a sharp departure from the medical center's traditional clientele.
The San Gabriel Valley hospital would serve patients who now travel to County-USC. No decision has been made on a site but the region's supervisor, Pete Schabarum, favors Irwindale.
Dixon and Gates said this week they will also recommend that supervisors approve improvements to other county hospitals and neighborhood clinics.
Proposed projects include construction of a larger trauma center at Martin Luther King Jr.-Drew Medical Center in South Central Los Angeles, expansion of the emergency room at Harbor-UCLA, expansion of the perinatal unit at Olive View, construction of a perinatal unit at High Desert Hospital in Lancaster and fire and seismic safety improvements at several hospitals and neighborhood clinics.