High Desert Hospital Aims to Escape Ax

In the weeks since the Los Angeles County Board of Supervisors approved deep cuts to the county’s health-care system, a home-grown crusade to save High Desert Hospital has sprung to life on the county’s northeastern edge.

The High Desert Hospital Advisory Council has lobbied county officials, drummed up community support and crafted a new business plan that includes innovative moneymaking ventures.

Their labors now come to this: a two-hour bus ride from the Antelope Valley to downtown Los Angeles to attend today’s public hearings on the planned cuts. The 21 members of the hospital council hope for a last chance to make their case and persuade supervisors to spare their facility.

Before the financially strapped county can move forward with plans to close 11 clinics and end inpatient services at High Desert, it must hold public hearings mandated by the state.

Thousands of people countywide would be affected by the cuts, including emergency room patients, health-care workers and the “medically indigent,” who lack insurance and depend on county facilities for health care.

No one knows how many will show today to plead with the county to find a way to avoid the cuts.

But the hearings will undoubtedly highlight the painful choices the county faces in reducing health-care costs.

“The people across the table from us are mostly bookkeepers, accountants, finance guys,” said Tom Craft, a retired Navy captain and member of High Desert’s advisory council. “They’re looking at numbers. We’re looking at lives.”

County officials reply that the cuts aren’t a matter of valuing dollars over lives but an attempt to bring balance to an overextended health-care system.

“The county has a proud tradition of providing a very high level of service to a very wide population,” said John Wallace, a spokesman for the county’s Department of Health Services. “Unfortunately, sources of funding that have been available in the past are either declining or capped.”

Though county officials and health-care advocates acknowledge the need for changes in the sprawling county health system, their visions diverge widely on what those changes should be.

The county envisions a health system that relies heavily on a network of outpatient clinics to funnel the most medically needy patients to the system’s largest hospitals, County-USC Medical Center in Boyle Heights and King-Drew Medical Center in Watts.

But High Desert Hospital is 75 miles from County-USC, and 87 miles from King-Drew, distances that Craft says could doom severely ill patients forced to travel that far for a hospital bed.

“They’ll die on the way,” Craft said at a meeting last week.

A few miles off Highway 14 and hidden by the barbed-wire fences of Mira Loma Detention Center, High Desert Hospital provides some unique services.

The nondescript one-story building houses the only ward in the state equipped to house the most contagious tuberculosis patients and the only skilled-nursing program in the county system.

High Desert, the county’s sole public hospital north of the San Gabriel Mountains, is also the one hospital targeted by the county in the first of three possible rounds of health-care cuts.

The county voted in June to trim $57 million from next year’s health budget, $10 million through service reductions at High Desert. Under the county plan, High Desert would be converted to an outpatient clinic.

Mel Grusing, former CEO at High Desert, says that rather than scaling back inpatient services at the 42-year-old hospital, the better solution is to increase them.

Though licensed to provide 170 beds, High Desert has the budget for 72. With only two other hospitals in the Antelope Valley, Grusing and other members of the advisory council say eliminating beds at High Desert is folly.

A plan submitted by Grusing and the other members of the hospital’s advisory council to the Department of Health Services projects that the hospital could raise more than $10 million a year by contracting out unused beds.

After reviewing the plan, the Department of Health Services is still urging cuts at High Desert but is now advising the county to “conduct further evaluation and negotiations” about using the hospital’s skilled-nursing capacity.

There is no guarantee that the High Desert’s advisory council will get to address the supervisors this morning, no guarantee that the supervisors will change their minds about the hospital.

But the council members are still making the trip, armed with charts, arguments and their plan.

“They’re a tenacious bunch,” Wallace said.