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LA County Supervisor Molina finally gets the hospital she asked for

A detail of the exterior of the LAC + USC Medical Center on April 29, 2009 in the Boyle Heights section of Los Angeles, California.
A detail of the exterior of the LAC + USC Medical Center on April 29, 2009 in the Boyle Heights section of Los Angeles, California.
Robyn Beck/Getty Images
A detail of the exterior of the LAC + USC Medical Center on April 29, 2009 in the Boyle Heights section of Los Angeles, California.
Archival postcard of Los Angeles County General Hospital.
Tichnor Brothers Collection at Boston Public Library via Flickr Creative Commons

The County of Los Angeles just announced, rather triumphantly, that it was authorizing the construction of facilities containing 150 new hospital beds in its central County-USC Medical center. But the county left out an interesting back story.

Officials say that the center has been overcrowded since its new facility opened in 2008 — running around 95% capacity. Built at only 600 beds, the facility replaced the 1,100 bed Art-Deco landmark General Hospital.  

“With the 150-bed addition, the LAC+USC Medical Center finally will get the 750 beds it always needed,” County Supervisor Gloria Molina, whose First District contains the hospital, said in her official statement.  But in an interview later, she told me, “I should feel vindicated, but it’s been bitter, harsh and painful.” She’d sought these same 150 extra hospital beds over 15 years ago. And lost.

Back in the 1990s, when the replacement medical center was planned, Molina fought hard for all 750 beds proposed for the biggest hospital in her district. The rest of the board members voted her down. “I guess I should say that it’s water under the bridge,” she said Thursday. “That it is good that we are finally getting what we originally asked for.”

Back in the 1990s, when the issue was discussed and voted on, the county in general and its health services in particular were suffering intense financial hardships in a national budgetary crisis.  As a result, many of the county’s clinical facilities were either closed down or their management partnered to private, non-profit health entities.  As a part of this cutback, those proposed additional 150 rooms in the county’s prime medical center were eliminated on the basis of an expectation that the indigent hospital population of Los Angeles County would somehow subside in years to come. Even so, the new County-USC hospital complex reportedly cost over $1 billion.

Molina, for one, never expected the number of county health inpatients would decline. “Our studies forecast that we’d need those extra facilities. And they were correct.” For years now, she said, some surplus County-USC patients have been sent to certain private Eastside hospitals with county contracts, but the largest number have been transported to the county’s Rancho Los Amigos facility in Downey. The problem with this latter arrangement, Molina said, is that Rancho is a rehabilitation hospital, not generally suitable to serious in-patient care.

Besides, the distant emergency transport is hard on the patients, “and also on the families of the patients, for many of whom (USC) is a lot closer to where they live.”

Molina said the just-authorized additional beds will also help the county health system better accommodate the additional demands of the Affordable Care Act — so called “Obamacare.” She noted that after Massachusetts passed its own healthcare law, demand for low-income health care rose considerably. That’s certain to happen here, she added.

But the inflation over the passing years since the extra beds were first planned mean they are going to cost the county a lot more. Molina said, “What’s certain is that if we had built the facility as (originally planned), the extra beds would have cost a whole lot less. That was a bad decision.”