Budget Used to Pressure Supervisors on Hospital

Lawmakers from the Eastside of Los Angeles are threatening to use the state budget to withhold $6 million in health care money for Los Angeles County unless supervisors reverse themselves and agree to build a larger replacement for County-USC Medical Center.

The Board of Supervisors voted 4 to 1 last year to approve a smaller and less costly 600-bed replacement for the earthquake-damaged public hospital. But Supervisor Gloria Molina wants the facility to be 750 beds, and enlisted the support of Latino Democrats in the Legislature.

In budget negotiations that ended last week, state lawmakers quietly inserted language into the proposed spending plan that would deny $6 million to the county unless the supervisors agree to a 750-bed facility.

Molina has accused other supervisors of delivering a “slap in the face” to the heavily Latino Eastside by opting for a smaller facility. She contends that the larger hospital is needed because residents of her district lack adequate health care.

Sen. Richard Polanco (D-Los Angeles), who helped orchestrate the move, characterized it as a matter of “getting their attention,” adding that the state lawmakers are trying to gain some leverage over the county supervisors. He called the proposed hospital a regional facility that would serve millions, thereby justifying the Legislature’s involvement.

County supervisors are doing the wrong thing by insisting on a 600-bed facility, Polanco said Monday. “It doesn’t make sense. Something is fundamentally wrong with that stubbornness.”

The $6 million at issue comes from a fund to reimburse hospitals that care for disproportionately large numbers of poor people who lack health insurance.

The budget language says the $6 million will be withheld for a year, or until the county agrees to build a 750-bed hospital. If the county fails to agree to the larger hospital by next June, Los Angeles County would lose the money for good. After a year, the money would “revert to the general fund, and become available for other purposes.”

The Legislature is set to vote on the $80-billion state budget as early as today. The fight over the Los Angeles County hospital is not likely to hold up the budget.

Although Latino legislators are a powerful bloc in Sacramento, their budget ploy did not sit well with some Los Angeles-area lawmakers, who were caught unaware that the action had occurred.

“It’s going to be a tough sell,” Assemblyman Roderick Wright (D-Los Angeles) said Monday, speculating that Republicans might be willing to try to block the effort. “It begins to set precedents.”

Wright, convinced that a larger hospital would cost more to operate, suggested it could drain money needed elsewhere in the county. “When it comes time to pay to operate it, that won’t come from here [in Sacramento]. It’ll be done there,” he said.

In the wake of the Friday maneuver, a delegation of legislators led by Polanco met in Los Angeles with Board of Supervisors Chairman Don Knabe to discuss the situation. Assembly Speaker Antonio Villaraigosa (D-Los Angeles) also was involved, speaking with Knabe by phone.

At the meeting, Polanco said he and other lawmakers offered the county $100 million spread over five years to help with construction costs, if only the board would agree to build the larger hospital.

“The board appears willing to jeopardize $100 million by refusing to support this proposal,” Polanco said.

By the account of one legislator who was at the meeting, lawmakers told Knabe the board could reverse its earlier stand by simply telling the public that the county has concluded that it is cheaper to operate a larger hospital, and “your representatives in Sacramento have given you another incentive”--the threat of blocking the $6-million payment to the county.

Knabe did not return calls Monday seeking comment.

Earlier this month, Knabe sent a letter to state lawmakers urging that they refrain from such action.

“Adoption of language which sets a specific level of hospital beds in a county is an extraordinary intrusion into local government operations and sets a terrible precedent for all local government in California,” Knabe wrote. “Such mandates penalize citizens by limiting the ability of local government to best determine and meet the needs of our communities.”

Joel Bellman, a spokesman for Supervisor Zev Yaroslavsky, scoffed at the legislators’ budget threat.

“The fact of the matter is, in a billion-dollar project, $6 million is . . . lunch money,” Bellman said.

On Monday, a Los Angeles County lobbyist was at the Capitol trying to persuade aides to Gov. Gray Davis that the governor should use his line-item veto authority to block the budget move.

Davis administration officials gave no indication of what the Democratic governor might do. “The intrigue continues,” a Davis administration official familiar with the hospital saga said Monday.

The board supported the 600-bed facility, citing the higher cost of building a larger hospital and the additional cost of operating a 750-bed facility--although there have been varying projections about the operation costs.

To carry her message, Molina dispatched an aide, Jerry Hertzberg, to Sacramento last week as the Senate-Assembly budget conference committee completed work on the 1999-2000 budget. Hertzberg’s brother, Bob Hertzberg (D-Sherman Oaks), also supports the expanded hospital.

An aide to Molina lauded the move, saying that it got the sides talking.

“Hopefully, it will result in constructive dialogue,” said Molina aide Miguel Santana.

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Morain reported from Sacramento, Daunt from Los Angeles.