County Hikes Taxes, Weighs Hospitals’ Fate

While blaming state lawmakers and the governor for Los Angeles County’s fiscal woes, the Board of Supervisors on Tuesday approved $27 million a year in new taxes and were told they must face tough decisions about closing hospitals, possibly including County-USC Medical Center.

With the county’s health care system on the brink of unraveling, Chief Administrative Officer Sally Reed renewed her suggestion in a memo to the supervisors that they consider closing the landmark Eastside hospital if a financial bailout does not arrive from Washington.

“However your board chooses to define health services in this county,” Reed said, “I cannot stress strongly enough that judgments must be made quickly and decisively to bring county spending under control.”

Without federal help, Reed said, the supervisors will have no choice but to close a number of other hospitals or County-USC. She said again that the massive facility has suffered earthquake damage, would cost $1 billion to replace and has high operating costs that make it fiscally unsound in the long run.

“It is an agonizing choice for the supervisors to make,” she said. “It does provide very important services, but it is living on borrowed time.”

Accusing Reed of being “out to get” County-USC, board Chairwoman Gloria Molina reacted strongly to the CAO’s renewed suggestion that the nation’s biggest public hospital--which is in her district--be closed. “She’s politicized this,” Molina said. “She continues to look for the three [supervisor] votes to kill County-USC. She has from day one.”

At least one supervisor, Mike Antonovich, said he was willing to consider Reed’s suggestion. “It’s very unlikely the federal government will come through with those funds” to replace County-USC, said Antonovich, who may see two hospitals in his district close if the board makes further cuts. “Closing down those other hospitals . . . makes no sense,” he said.

After a long day of discussions, a divided board approved increases in fire protection fees, hotel taxes and dumping fees at landfills and agreed to impose a new tax on tickets to Universal Studios and Six Flags Magic Mountain theme parks. The fire protection tax, coupled with a new tax for libraries approved last week, will cost homeowners in unincorporated county areas at least $41 a year.

The $19.41 increase in fire protection fees approved by Supervisors Zev Yaroslavsky, Deane Dana and Yvonne Brathwaite Burke, with Molina and Antonovich abstaining, will avert threatened closures of fire stations in Malibu and other areas.

But the supervisors made no progress addressing the health crisis that will force closure of all six county health centers and most of its community clinics on Oct. 1 unless the Clinton Administration provides a last-minute reprieve of at least $178 million.

And on Tuesday, supervisors played a contentious game of brinkmanship with state lawmakers and union leaders, saying they will reject $100 million in critically needed bailout money from the Metropolitan Transportation Authority because it is a loan and not an outright gift.

Yaroslavsky criticized lawmakers and the governor for taking $1 billion in property taxes from the county to solve the state’s budget problems and then encouraging the supervisors to continue borrowing when that practice has aggravated the county’s bleak financial condition.

‘We are like a drug addict in a rehab center and you are going to give us another shot,” Yaroslavsky told state Sen. Tom Hayden (D-Santa Monica) and Assemblyman Antonio Villaraigosa (D-Los Angeles).

“We are on the brink now of fiscal insolvency and it doesn’t take much to push us over the edge,” he said. “We have got to get off that narcotic called borrowing and start spending within our means.”

But the Rev. Jesse Jackson joined the liberal legislators and union leaders in urging the supervisors to take the $100-million, five-year, no-interest loan. “Even addicts choose one more shot over embalming fluid,” Jackson said.

As Montgomery, Birmingham and Selma were cornerstones of the civil rights movement of the 1960s, Jackson said, Los Angeles is now in the forefront of the collapse of the nation’s public health care system.

Jackson urged the governor, state lawmakers and the Republican leaders of Congress to address the crisis here before it becomes a prelude to similar breakdowns in other major cities.

“The eyes of the nation truly are on L.A.,” Jackson said.

Hayden said the county must accept the $100-million loan before any further legislative action can be taken to address the county’s pressing needs.

The supervisors Monday publicly demanded that Gov. Pete Wilson call the Legislature back into special session to revive the Los Angeles aid bills that died in the pre-dawn hours Saturday.

In other developments Tuesday:

* Nurses halted a sickout that briefly closed the trauma and emergency units at County-USC to ambulance traffic Monday.

* County health czar Burt Margolin was in Washington on an eleventh-hour mission to revive stalled negotiations with federal officials over at least $178 million in funds the county needs to avoid a health system collapse. In closed-door meetings on Capitol Hill, Margolin presented his case to federal health officials in preparation for full-blown meetings today with federal, state and county health leaders working feverishly to avert deeper health cuts. The county is desperately seeking a waiver of federal regulations that would yield more money if the county switches from treatment of patients in hospitals to less expensive care in clinics and health centers.

* Taking its largest step ever into the county’s budget debacle, the Los Angeles City Council voted unanimously to ask Wilson to immediately convene a special legislative session to address the county’s problems. The council also moved to convene the city’s Emergency Operations Board and Emergency Management committees, and to consider declaring a state of emergency and activating the city’s Emergency Operations Center when the county cuts take effect Oct. 1. “We need to be poised to contend with a crisis that has already begun to descend upon us,” said Councilman Mike Feuer, who sponsored the motion.

* The Service Employees International Union, Local 660, which represents nearly 40,000 county workers, attracted only about 500 to a highly publicized rally outside the Hall of Administration as the Board of Supervisors met.

Nearly 5,200 health workers--from doctors and nurses to lab techs and janitors--received pink slips Friday notifying them that they will be laid off Sept. 30 because of the budget crisis.

Foreshadowing a potential rift in the SEIU local, one union member, Winetka Pleasant, a 16-year county employee, told the board she would be willing to take a pay cut to save the jobs of her fellow workers. Some other union members held aloft signs saying they would do the same.

“I am willing to do it if it saves devastating someone, someone sitting at home contemplating suicide,” Pleasant said as an auditorium packed with union workers erupted into prolonged cheers. “However we have to do it, it’s got to be done.”

Union leader Gilbert Cedillo immediately rejected that idea, saying he still favors a union proposal that he said would save the county more than $30 million through voluntary leave and early retirement programs.

When Cedillo addressed the protesters outside, he was shouted down when he broached the subject of trying to protect union jobs as the county tries to turn over control of its health clinics to private operators.

Cedillo said he was trying to ensure that private operators would retain county workers at their current wages and benefits, but he was drowned out by so many protesters that he had to cut his speech short.

“No privatization,” many rank-and-file members yelled over and over.

As the workers protested the potential loss of jobs, Reed told supervisors in her memo that they should reconsider closing County-USC Medical Center as a long-term solution to the county’s fiscal problems.

In the four-page memo requested by the board, Reed took exception with many of health czar Margolin’s recommendations for handling the crisis.

She said his commitment to maintaining services in communities with the largest number of low-income and poor individuals “results in tremendous hardships for the poor outside of Downtown Los Angeles. . . . This is a choice between a strong service where the need is greatest and no service outside Downtown, or a bare-bones service with some geographical access throughout the county.”

Jonathan Freedman, Margolin’s top aide, said Reed’s proposal “is an alternative point of view. She raises a long-term vision that I don’t think anybody can focus on right now. What Burt presented was a response needed in disaster mode.”

Margolin repeatedly has told the board that County-USC must stay open because its trauma center serves a vast population and cannot be closed without destroying the county’s emergency medical system.

Meanwhile, the Healthcare Assn. of Southern California, which represents private hospitals, physician groups and health systems, urged Wilson to call the special session.

“The Legislature’s failure to provide adequate support to abate further Draconian cuts to the county-operated health care delivery system will result in an increase in avoidable deaths and disability for many Los Angeles County residents,” senior vice president Jim Lott said in a letter to the governor.

The letter cited “adverse outcomes for many of the medically disenfranchised working poor and indigent residents.” The reference to adverse outcomes referred to the shooting victim who died Monday at White Memorial Medical Center after a sickout by nurses at nearby County-USC’s emergency room forced ambulances to take patients elsewhere.

Contributing to this report were Times staff writers Max Vanzi in Sacramento, Faye Fiore in Washington, and Jodi Wilgoren and Douglas P. Shuit in Los Angeles.