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A detail of the exterior of the LAC + USC Medical Center on April 29, 2009 in the Boyle Heights section of Los Angeles, California.
The Board of Supervisors today directed staff to develop a contingency plan to relieve overcrowding in county hospitals, including County-USC Medical Center, in the event that health care reforms don't solve the problem.
Supervisors Gloria Molina and Mark Ridley-Thomas specifically asked the county's chief executive officer to consider adding 150 beds at County-USC in an attempt to ease emergency room delays and patient transfers to other hospitals.
The request also called for projections on the number of indigent patients likely to obtain insurance as a result of health care reforms and the effect on the demand for beds at all county hospitals.
County-USC's emergency room has been overcrowded 80 percent of the time since the new hospital opened, and conditions were ``severe or dangerous'' for half of June, according to the supervisors.
Molina said she was willing to consider the possibility that health care reform would serve to decrease demand at the busy emergency room, but said the county should prepare for the possibility that it does not.
"Health reform ... right now it's a basket that has so many expectations ... There's no doubt that we have to wait and see ... but the biggest mistake we could make is not planning,'' Molina said.
Health care reform could cut admissions as the newly insured access primary and specialty care physicians for non-emergency treatment. But it might also increase admissions as those with insurance schedule surgeries or other procedures as inpatients.
Molina said the continual deficit of available inpatient beds showed that County-USC was sized too small when it was built. She had originally fought to built the hospital with 750 beds, but was voted down by her board colleagues in 1997 (Yvonne Burke held Ridley-Thomas' Second District seat at the time).
The new facility was sized to 600 beds with the hope that technology and efficient management could compensate for the smaller size.
The unanticipated closure of Martin Luther King Jr. Medical Center and private emergency rooms increased the demand for beds.
Supervisor Michael Antonovich closely questioned county CEO William Fujioka about how the county could afford to pay for an expansion of its health care facilities, if the study recommended such action, and ultimately voted against the proposal.
Based on the 4-1 vote, staffers will develop a construction plan to add the medical-surgical beds at County-USC -- including cost estimates, funding sources and a timeline -- and return to the board in 90 days.
Based on a request by Supervisor Don Knabe, the contingency planning will also consider needs at all county hospitals.
KPCC wire services contributed to this report