HEALTH: The pending downgrade of the county facility means an increased patient load at private South Bay hospitals.

By Lee Peterson DAILY BREEZE

It won’t take a terrorist attack to make this disaster happen.

Sick people lining the hospital halls waiting for help, emergency rooms closing one by one, and health-care workers lured away from Southern California by the hundreds to more hospitable conditions.

The possible demotion of County Harbor-UCLA Medical Center, among the leaders of South Bay and Harbor Area hospitals, to an outpatient clinic conjures up visions of an unprecedented health-care meltdown.

It’s not just a crisis for the uninsured. The county’s plan to solve its health department budget shortfall relies upon shunting patients not only from Harbor-UCLA to other county facilities, but also to such local private hospitals as Little Company of Mary and Torrance Memorial Medical Center in Torrance.

Hospital executives and others met Thursday at Little Company to discuss the potential closure of Harbor-UCLA, a decision the county Board of Supervisors is scheduled to make Oct. 29. County officials will meet with federal health officials Wednesday to seek some sort of bailout, the granting of which appears less and less likely.

Harbor-UCLA, near the Harbor (110) Freeway on Carson Street, handles about 250 emergency room and urgent care visits a day.

“Whether they are coming by ambulance or by car, they are going to be seeking care at a nearby hospital,” said Dr. Gail Anderson Jr., medical director of Harbor-UCLA.

When that happens, it will mean a flood of uninsured patients to the often-busy ERs around the area. First, doctors on call won’t be able to handle all of the unpaid care and will pull out of the system, leaving ERs with no specialists to summon, local hospital executives said.

Long waits at community ERs will stretch into the daylong or nightlong waits that now exist at Harbor-UCLA.

Each year, there are 75,000 visits to Harbor-UCLA’s adult, child and psychiatric ERs. Add another 20,000 to the urgent care clinic. And the hospital has 23,000 hospitalizations a year.

A hospital trade group said it has a watertight legal case that will force the county to postpone closure of Harbor-UCLA’s ER.

“We will stop them,” said Jim Lott, executive vice president of the Healthcare Association of Southern California. “I have a legal analysis that gives a cause of action to stop it from happening if it is so ordered on the 29th.

“But at the end of the day, so what?”

The restraining order would be temporary, Lott said, and the cause of the closure would still be there: a dire lack of funds that figures to be a $404 million shortfall for the county health department in 2005.

County Measure B is a property tax on the Nov. 5 ballot that would generate $168 million a year for emergency and trauma care. It does not guarantee that Harbor-UCLA would stay open as a hospital.

Since the possible closure vote comes six days before the election, some have wondered if supervisors believe it’s better to vote to close Harbor-UCLA to win support for Measure B.

Even if the supervisors vote in favor of closure, any shutdown wouldn’t happen before spring, hospital officials said Thursday.

But the effects already have been showing up.

Harbor-UCLA is a teaching hospital, where doctors in dozens of disciplines are trained in multiyear programs.

Dr. Robert Hockberger, chairman of the Harbor-UCLA Emergency Department, said his department has received only about half the number of applications it normally has by this time of year from aspiring emergency room physicians.

Meanwhile, he spends a lot of time trying to reassure the resident doctors in the midst of their training programs at Harbor-UCLA who wonder if there will be a hospital for them to work at.

Physician faculty also have been eyeing greener pastures.

“We really have a hard time just keeping people from leaving,” Hockberger said. “It’s pretty disturbing.”

In addition to the planned legal attempt to stop the county from closing the hospital, there were other strategies talked about at Thursday’s meeting.

A quarter-cent or half-cent sales tax was mentioned as one way to provide a guaranteed source of income for the county’s vital trauma and emergency care network.

The private takeover of Harbor-UCLA also was offered as one option for saving services, finding a way to make it break even through increased efficiency, for example.

A rally to support Measure B and Harbor-UCLA will be held at 1 p.m. today at Harbor-UCLA.

-- Anonymous, October 04, 2002