Board Votes for 600-Bed County-USC Hospital

Ending years of indecision and acrimonious bickering, a divided county Board of Supervisors voted 3 to 2 Tuesday to begin building a 600-bed hospital to replace the earthquake-damaged County-USC Medical Center.

But in a compromise aimed at appeasing critics in Los Angeles and Sacramento, the board cobbled together a last-second deal to add a 150-bed annex, if the projected patient load looks like it will be too overwhelming when the hospital opens its doors in about eight years.

The deal, brokered by board Chairwoman Yvonne Brathwaite Burke, also succeeded in heading off what some county officials described Tuesday as a potential political “train wreck”--a plan to build a 500-bed facility--because state lawmakers insisting on a larger hospital have held up $225 million in state construction funds.

“It is not the perfect solution. There is no perfect solution,” said Burke, who got Supervisors Zev Yaroslavsky and Don Knabe to go along with the compromise after several hours of bitter deliberations. “But I hope the Legislature in Sacramento will take this as an earnest attempt to solve this problem.

“What this does, first of all,” Burke added, with visible relief, “is get us off the dime.”

Supervisors Gloria Molina and Mike Antonovich opposed the compromise.

Until Tuesday, the supervisors had refused for years to decide how big the new hospital should be. In November, they voted to build a 600-bed facility, then waffled in July after a coalition of mostly Latino state lawmakers from the Eastside threatened to hold up the $225 million in state construction funds if the county didn’t build a hospital with 750 beds.

Like Molina, the coalition members have said a capacity of 750 beds is the absolute minimum needed in the planned hospital, which provides trauma and emergency room care, much of the county’s advanced AIDS treatment, a burn ward and other specialized services.

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Since July, the county has been proceeding with two sets of plans--one for a 600-bed hospital and another for a 500-bed facility, while the supervisors tried to get the state lawmakers to release the $225 million.

When the lawmakers refused last month, the board pledged to build a 500-bed hospital, which is all a majority of its members said they can afford without the state money.

If the supervisors had waited any longer to launch architectural plans and engineering and environmental studies, it would have cost an extra $3.1 million a month, according to county estimates.

With a projected price tag of about $818 million, the planned complex will sit next to the existing Lincoln Heights medical center, and will replace it as a linchpin in the county’s trauma network and health safety net for a wide swath of East and Central Los Angeles.

The new hospital is supposed to open in about 2006, at which time County-USC will be shuttered and perhaps demolished.

Antonovich said he voted against the measure because he would rather build a 500-bed hospital and use the roughly $90 million in savings to bolster community-based medical care and law enforcement services throughout the county.

In often barbed remarks, Molina assailed her colleagues, charging that the existing hospital with its 850 beds is already too small.

“This board is making an unbelievably bad decision,” Molina said after the vote.

The compromise proposal originally was intended to gain the Eastside lawmaker’s support, but it did not.

And when Molina refused to go along--to the cheers of a Hall of Administration auditorium packed with community activists--Burke grew visibly angry, as did Yaroslavsky and Antonovich.

“You know what? I am just exasperated,” Burke said later. “As hard as you try, there are people who will never have any reasonableness. [Molina] knows better than I do that you have to get three votes to get anything through this board.”

Molina vowed to continue to fight for a 750-bed hospital, and said she would take her case to Washington and Sacramento.

It was also unclear if the compromise would succeed in gaining the support of the coalition of Sacramento lawmakers led by Assembly Speaker Antonio Villaraigosa (D-Los Angeles).

“I think they are moving in the right direction,” Villaraigosa said after Tuesday’s vote. “But I don’t think they’ve come far enough. The fact that they didn’t go to 500 [beds] and have agreed to the possibility of building an annex is good. But we’ll have to look at the fine print to see what if any triggers are involved to make this more than some illusory promise.”

The annex will come into play only if the patient load at the existing County-USC remains above 770 in four years, at which time the county will reassess the situation, according to Burke’s motion.

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Molina had her own proposal, to begin building the annex immediately, and to use it as a comprehensive outpatient health center, if the 600-bed facility is enough to handle the patient load.

Such a step would add as much as $80 million to the hospital’s cost, and Molina’s colleagues said they just don’t have the money to pay for it.

Molina, in turn, insisted that they did, citing the county’s $80-million budget surplus. The board has decided to spend that money to repair courthouses and Sheriff’s Department stations, among other things.

And although Burke said she and her colleagues will continue to press Sacramento for the construction funds, she believes that the county will find a way to pay for the hospital with or without state help.

“We are going to build that 600-bed hospital whether Sacramento gives us one dime or not,” Burke said.