Panel Unveils Plan to Spare Big County Hospitals

The Los Angeles County Health Crisis Task Force unveiled a plan Saturday that would keep open major hospitals, including County-USC Medical Center, by closing at least 30 walk-in health centers and clinics.

Other key elements of the plan, which will be released publicly Monday and presented to the Board of Supervisors on Tuesday, are a proposal to sell Rancho Los Amigos Medical Center, a nationally acclaimed rehabilitative hospital, and reduce the number of county health administrators by half. The plan also would end all inpatient services at High Desert Hospital in the Antelope Valley, leaving the facility open for walk-in treatment only.

About 3 million patient visits --representing everything from treatment for sore throats to broken bones to vital prenatal checkups--would be lost under the proposal, according to preliminary estimates.

The task force is trying to close a health budget gap that is conservatively estimated at $655 million but could go as high as $745 million.

“Our plan would keep the major hospitals open, but with devastating service cuts,” said Burt Margolin, a former legislator who heads the five-member task force. “You are going to be denying needed preventive care to hundreds of thousands of people. This goes in the exact opposite direction of where health care is going.”

Margolin conceded that the plan is “undesirable” and said that if the Board of Supervisors approves it, “there will be an overload of emergency rooms in this county the likes of which you have never seen before.”

And concerns were raised that closing the health centers would threaten programs that operate out of those facilities to control and treat tuberculosis, and AIDS and other sexually transmitted diseases.

But Margolin and other task force members believe that closing the clinics and health centers would have a less drastic impact on the public health system than shuttering County-USC, which handles one-quarter of the county’s 911 trauma calls, or one or more of the other large public hospitals--Harbor-UCLA Medical Center, Martin Luther King Jr./Drew Medical Center and Olive View-UCLA Medical Center.

County officials have said that only Olive View meets earthquake safety standards and that closing any of the other hospitals would mean they probably would never reopen because of prohibitively expensive repairs needed to meet retrofitting requirements.

The task force worked Saturday under a tight deadline that requires it to submit a budget plan for health services to the Board of Supervisors by Tuesday.

Task force members believe there is a possibility that hundreds of millions of dollars in federal or state money may be available later this year to relieve the budget problem. If such funds materialize, they believe, it would be easier to reopen the clinics and health centers than it would be to reopen one of the major hospitals.

They also hope that private health care organizations would take over some of the clinics or health centers. Talks are under way between the county and California Medical Center, a large private hospital owned by UniHealth America in Downtown Los Angeles, to take over one or more comprehensive health centers in South-Central Los Angeles.

“We’re hoping others will step up,” Margolin said.

The plan to close the health centers ran into immediate opposition from public health officials. Dr. Shirley Fannin, director of the county’s disease control programs, said closing the clinics, along with a proposed 20% cut in all public health programs, would badly damage the county’s war on communicable diseases. “We not only have a 20% cut, but we have no place to function in. We have no buildings, we have no offices,” she said.

The original proposal had called for closing all 45 health centers and clinics. But to address the concerns, Margolin and county officials proposed a compromise that would make 15 clinics, health centers or other sites available for public health programs on a limited-use basis.

It was suggested that public health programs could operate in county facilities such as fire stations and parks.

The plan to sell Rancho Los Amigos in Downey is a testament to the hospital’s excellence. Ranked among the top 10 rehabilitative hospitals in the United States in a survey published annually by U.S. News & World Report, it is regarded by experts as the county’s most marketable property.

Selling or privatizing the hospital would save the county $100 million annually.

Rancho Los Amigos administrators have proposed privatizing the hospital within five years, allowing the facility to remain a public hospital but be run by a private board of directors.

The task force members want to speed up the timetable to two years.

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