Molina Splits With Board Colleagues on County-USC

What began this week as a routine budgetary discussion among the Los Angeles County supervisors has laid bare an increasingly rancorous back-room struggle between most of the board and one of its members, Gloria Molina, who has obtained the backing of a newly assertive group of powerful Latino legislators.

At stake is not only the fate of County-USC Medical Center in Boyle Heights--the linchpin in largely Latino East Los Angeles’ public health system--but also hundreds of millions of dollars in state and federal aid the county must secure to prevent the collapse of its entire health network.

At Thursday’s budgetary meeting, the board’s chairman, Supervisor Zev Yaroslavsky, who represents the Westside and parts of the San Fernando Valley, labeled the fight being waged by the Latino lawmakers “blackmail”--a charge they angrily rejected.

Their goal, however, does conflict at least in part with what the federal government wants: When President Clinton made a campaign swing through Los Angeles County in 1995 and bailed out its troubled health care system, his $364-million check came with strings attached. The strongest was the caveat that the current system, which relies principally on expensive public hospitals, be supplanted by one based on outpatient care.

County-USC, which has beds for 1,100 patients, was badly damaged in the 1994 Northridge earthquake, and must be replaced. Most of the board, as well as the federal authorities whose emergency assistance is keeping Los Angeles County’s health care system afloat, envision a new, much smaller hospital than the current one. Molina, who represents the Eastside and the heavily Latino San Gabriel Valley, wants at least a 750-bed facility as recommended by County Health Services Director Mark Finucane.

So do her allies in Sacramento, who include at least six members of the state Legislature’s influential Latino Caucus--among them the recently elected Assembly Majority Leader Antonio Villaraigosa (D-Los Angeles), state Sen. Richard Polanco (D-Los Angeles) and Assemblyman Martin Gallegos (D-Baldwin Park), chairman of his chamber’s Health Care Committee. Other Latino legislators who have quietly expressed alarm over the issue include Democratic state Sens. Charles Calderon of Whittier and Hilda Solis of El Monte and Assemblywoman Martha Escutia (D-Bell).

Politics and demographics have made them and the other caucus members a force to be reckoned with. High Latino birth rates and heavy immigration have combined to make Latinos the largest single ethnic group in Los Angeles County, where 3.8 million Latinos constitute about 42% of the population. According to California Department of Finance projections, Latinos will become a majority in Los Angeles County soon after the turn of the century. By 2040, two-thirds of all county residents will be Latinos.

Los Angeles County alone is home to more immigrants--about 3.1 million--than any entire state except California; most of them are Latino, and many of them are served by County-USC.

That fact is foremost in the minds of the Latino legislators, some of whom have feuded with Molina in the past. But according to Molina, the future of County-USC has brought them together to such an extent that eight days ago, she, Villaraigosa and Polanco met privately in Polanco’s Los Angeles office to discuss ways Sacramento might bring additional pressure to bear on the other supervisors. Molina said the lawmakers have set aside personal differences to protect their Eastside Latino constituents against the supervisors’ possible vote to scale back the number of beds at the new hospital.

A former state assemblywoman, Molina criticized Yaroslavsky for alleging blackmail by the Latino coalition, citing his vigorous efforts on behalf of his own constituents.

“I don’t understand how advocacy is blackmail,” she said. “If it is, then meet Mr. Blackmail in capital letters.”

If they choose to exercise it, Molina’s legislative allies have the power to back up their advocacy by stalling legislation critical to the county.

In recent weeks, that prospect has prompted a flurry of back-room meetings and phone calls between the supervisors and other top county officials and Latino lawmakers from Los Angeles. Several supervisors have flown to Sacramento for meetings of their own.

In those meetings, the state lawmakers have made it clear: They want to make sure that there are enough medical services--especially inpatient hospital beds--for their constituents, many of whom are indigent or among the working poor.

What has also been said or implied in these meetings, according to county officials who asked not to be identified, is that these legislators wield enormous influence over hundreds of millions of dollars in health care, criminal justice and transportation funds that the state gives to Los Angeles County each year.

Polanco has bills in the hopper that could provide the county with more than $110 million in funds, as well as a bill to block a judge’s order that the county pay back $50 million in Metropolitan Transportation Authority funds that the Legislature gave it at the height of the county’s fiscal crisis.

The extent of the pressure already applied by the Eastside coalition became clear at Thursday’s budgetary session, when Yaroslavsky snapped:

“The blackmail that is going on is just so fruitless and pointless up there” in Sacramento. “I’ve heard it and I know other members have heard it. It is a road to nowhere. And it is all of our constituencies collectively that will get hurt by that.”

Polanco angrily denies that there has been any attempt to “blackmail” county officials by holding up legislation in Sacramento until the supervisors promise enough hospital beds for East Los Angeles.

But he did confirm that the supervisors have been explicitly warned not to even think about downsizing a new County-USC beyond the 750 beds recommended recently by a task force headed by a Dr. Robert Tranquada of the USC Medical School, a conclusion endorsed by Finucane.

“They were shocked at me drawing the line in the sand on this issue,” said Polanco, head of the Latino Caucus, recalling recent meetings with the supervisors.

“But the community needs these beds and deserves them, and we are going to make sure it happens,” Polanco said. “We are the purse strings; we distribute hundreds of millions of dollars [to the county] and we definitely have a say in how that will be” spent.

Villaraigosa agreed: “We are making it clear that we want to be involved because our constituents will be greatly impacted by what [the supervisors] do.”

Supervisor Mike Antonovich said Friday that he and his colleagues resent such intervention. “What you have is a gang of legislators who are attempting to ask the taxpayers to subsidize an overbuilt hospital,” Antonovich said. “What we need are flexible policies that fit the needs of the people, not the political demands of those in Sacramento.”

“Politics,” Antonovich added, “is what got us into this situation” in which the county’s health care system has a projected a $500-million deficit over the next five years, even with the federal bailout money. “We don’t need to bankrupt Los Angeles County as a result of political power in Sacramento.”

Polanco rejects both that position and Yaroslavsky’s characterization of the legislators’ campaign as blackmail.

“For him to say this is political blackmail is a very serious charge,” Polanco said Friday. “He ought to cool the rhetoric. It is very irresponsible.” Yaroslavsky and the rest of the supervisors, Polanco added, “should not interpret this as hostile. That could engender some hostility in the Latino community, and he should be very careful.”

But Yaroslavsky isn’t the only one who is not thrilled with the pressure from Sacramento.

“We made a commitment to the taxpayers and the federal government that we would be downsizing [the public health care system] as we move the health system into 21st century,” Antonovich said. “Political strong-arm tactics traditionally hurt the taxpayers and those who need the services that are being sought. In this particular case, there is no medical or financial reason to build a 700-bed hospital facility at County-USC Medical Center.”

Supervisor Don Knabe, who also participated in some of the Sacramento meetings, worded his concerns carefully.

During the budget session Thursday where Yaroslavsky made his remark, Knabe said: “We need to get beyond, ‘Well, here’s the bottom line, here’s what I want for this [hospital] replacement project and then I’m willing to discuss your other issues.’ ”

Molina suggested to her colleagues that their efforts to cut health services could unfairly affect her Eastside constituents, Knabe snapped: “Oh, I see. So it becomes territorial.”

“No,” Molina answered, “it becomes clear.”

Times staff writer Patrick Mc Donnell contributed to this story.