County-USC ‘Annex’ Is Put on Hold

As doctors complain about crowding so severe that some patients die waiting for care at Los Angeles County-USC Medical Center, officials have quietly shelved plans to build an 80-bed annex in the San Gabriel Valley intended to ease demand at the main hospital.

The San Gabriel Valley project was suspended, county officials confirmed Wednesday, because of a budget crisis in the health department, which is about to close two other hospitals and cut 100 beds at County-USC beginning this summer.

The change in plans comes to light as doctors at County-USC complain that emergency room patients sometimes wait 16 hours for treatment and up to four days for a bed upstairs. The doctors cite cases in which patients have died while waiting and say the situation will only worsen with the budget cuts.

The decision to build the San Gabriel Valley hospital was the product of a much-heralded political compromise in 2000. It was intended to ease concerns that a 600-bed replacement for County-USC, to be completed in 2007, could not handle the huge number of uninsured patients who need care. The current hospital has 745 beds.

In 2000, Gloria Molina, who represents east Los Angeles County where County-USC stands, was a lonely voice on the Board of Supervisors, arguing with the support of some prominent state legislators that the new hospital would be too small. After a long and bitter debate with county leaders, she and her supporters ultimately agreed to a smaller main hospital if the San Gabriel annex were built as a relief valve.

Now, Molina is resigned to what she calls a “cruel reality”: The county can’t afford it. “We are closing facilities that are already built,” she said Wednesday. “There’s just no way we can look at opening a new facility when we’re closing others.”

Her fellow supervisors were equally pessimistic.

“I would love to feel angry, but I know the reality is what we have taken on is beyond the ability of L.A. County to provide,” said Supervisor Yvonne Brathwaite Burke. “I don’t know anything that we can do. It’s a tremendous sense of frustration that we can’t provide health care for everyone.”

It is unclear whether the county now will be eligible for about $200 million in Medi-Cal funding for construction of the new County-USC, because it has not fulfilled its pledge to build the annex.

The supervisors never formally voted to abandon the project, but in December they told county staff to seek the Medi-Cal dollars for the 600-bed hospital alone. That facility is scheduled to be completed in 2007.

State legislators who embraced the San Gabriel Valley annex as a compromise three years ago expressed disappointment at its apparent demise.

Rep. Hilda L. Solis (D-El Monte), then a state senator, said that “in the back of my mind” she knew the annex was probably a bone tossed to Eastside lawmakers worried that their constituents would not be served.

“It was to appease us,” she said. “We were really fired up.”

Former Assembly member Martin Gallegos argued that the project is sorely needed. Residents in the east San Gabriel Valley now have to travel as far as 30 miles to County-USC.

“I just think it became a victim of the circumstances and the realities of today’s economic situation,” said Gallegos, now chief lobbyist for the state’s hospital industry.

Those realities are frustrating, as well, to doctors at the existing County-USC, who are often deluged with very sick patients. Several doctors have lent their support to legal-aid groups that last month sued to keep the county from making any bed cuts there.

In sworn statements, they have testified about patients who suffered and even died while waiting up to 16 hours for treatment and up to four days for a hospital bed.

The physicians say any reduction in beds will only lead to more deaths -- a prospect that worries some supervisors.

“This just points out the crisis we’re in,” said Supervisor Don Knabe.

“Their own docs are even talking about it. It’s very serious.... This truly is a matter of life or death.”

But Molina said the crisis was nothing new. “For the last six years, we’ve had to close our ER for five to 10 hours daily. That means no ambulances can come in. It’s been overcrowded for well over a decade.”

And Supervisor Zev Yaroslavsky was concerned about the timing of doctors’ complaints.

“If a doctor at County-USC says somebody died because he didn’t have enough beds, I sure hope he told somebody about it. Because if he kept it to himself till now, I think he’s going to have some answering to do.”

All five supervisors interviewed by The Times blamed federal and state governments for the extreme stress on services, the cutbacks and the shelved San Gabriel Valley plans, saying the county is starved for health-care dollars.

“We’re really left with no recourse,” Knabe said. “We’re the safety net by law, not by choice.”

Supervisor Mike Antonovich also blamed illegal immigration for choking the health system.

“There’s no way L.A. County can be an HMO for illegal immigrants without bankrupting the entire county,” Antonovich said.

Health department officials said Wednesday they are looking for immediate ways to treat patients more quickly at County-USC and, if necessary, move them to beds.

Dr. Thomas Garthwaite, director of the county Department of Health Services, said hospital leaders are considering reducing patient transfers from other facilities. They also will try to discharge patients earlier in the day so beds can be freed up faster.

“We’re working as hard as we can to see as many patients as safely and as well as we can,” Garthwaite said.

A state law passed in 2000 calls for the county to complete a study before the new County-USC opens to determine the need for medical services in the community.

If the demand is higher than the 600-bed hospital can handle, the law calls for the county to consider adding beds to its Women’s and Children’s Hospital on the same site.

Even with a smaller County-USC, health department spokesman John Wallace said county hospitals don’t lack space to add beds. What they lack is money to fund nurses and other professionals to staff them.

If more funding becomes available, the county can easily add beds at Harbor-UCLA, Olive View-UCLA and Martin Luther King/Drew medical centers, he said.

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Times staff writer Daren Briscoe contributed to this report.