Speakers Plead to Save Hospitals

Dozens of hospital workers, patients and elected officials argued at a hearing Thursday that Los Angeles County’s emergency and trauma system would collapse if two public hospitals are closed as proposed.

Many of the speakers, appearing before the county’s Emergency Medical Services Commission, said the county needs to spend more money on emergency care, rather than cut back. The commission, an advisory body to the Board of Supervisors, is exploring the effects of efforts to close a deficit that is projected to reach nearly $800 million within three years.

“I find it unimaginable that, one day after Sept. 11, we’re arguing about closing another trauma center,” said Dr. Mauricio Heilbron Jr., a trauma surgeon at St. Mary Medical Center in Long Beach. “I not only urge you not to close these, but let’s consider making more.”

Barring a federal bailout or another cash infusion, county supervisors soon will consider reducing 211-bed Olive View-UCLA Medical Center in Sylmar and 377-bed Harbor-UCLA Medical Center near Torrance to outpatient clinics. Both now operate emergency rooms; Harbor is one of the county’s 13 trauma centers.

The supervisors have already approved plans to close 11 community health clinics and four school-based clinics by the end of this month. The board also approved converting High Desert Hospital in the Antelope Valley into an outpatient center next May.

Doctors and hospital executives argued that, if the county further cuts its medical services, the action would have a domino effect on the hospitals that remain. Private hospitals don’t have the capacity to treat the influx of new patients, they said. Also, many of the county’s patients lack health insurance, and the private sector says it cannot absorb that added cost.

“The entire system here is on the brink,” said Dr. Franklin D. Pratt, medical director of the Los Angeles County Fire Department. He compared the current emergency network to a “rubber band pulled as tightly as it can be pulled before it breaks.”

Kerry Carmody, administrator of Providence Holy Cross Medical Center in Mission Hills, said private hospitals, too, may be forced to close their emergency rooms.

“Ultimately, at the hospital level, you move beyond emotion and you move beyond the passion for providing the services,” he said. “It will become a dollars and cents decision.”

Pasadena Fire Chief Ernest Mitchell said he knows firsthand the ripple effect an emergency room closing can have. Earlier this year, Tenet Healthcare Corp. shut St. Luke Medical Center, leaving Huntington Memorial Hospital with the city’s only emergency room.

As a result, the fire department has driven far more patients to hospitals outside the city. To keep response times from spiking, Mitchell said, he has been forced to add another ambulance that he is hard pressed to pay for.

Some of the pressure on the emergency system could be alleviated by a tax proposal, if voters approve it in November.

After the public testimony on Thursday, the Emergency Medical Services Commission unanimously voted to support the $168-million parcel tax, which also would be used to improve the county’s bioterrorism preparedness. Under the proposal, the county would levy a tax on developed properties of 3 cents per square foot. Two-thirds of voters must approve the increase for it to pass.

In addition, the EMS Commission urged county supervisors to give the public six months’ notice before scaling back or closing hospitals. The commission also recommended that the supervisors wait until after the November election before cutting any more hospital services.

“These issues are life and death,” said John Edelston, the commission’s chairman.

Several commission members and supervisors said residents must be educated about how they would be affected if the emergency and trauma system collapses.

“If the emergency rooms start to shut down in this county ... the ripple effect doesn’t just affect the uninsured and the poor,” said Supervisor Zev Yaroslavsky. “It affects everyone else who has insurance.”

State Sen. Debra Bowen (D-Marina del Rey) criticized the county saying it had failed to adequately restructure the health department after receiving its first federal bailout in 1995 and a second bailout two years ago. She said the county’s attempt to secure a third bailout, coupled with the tax increase on the November ballot, comes a bit late.

“We’re now in a position of having to buy homeowners insurance while our house is on fire,” she said.