LAC+USC MEDICAL CENTER
RESTRUCTURE AND CONSOLIDATION PROJECT
II. LAC+USC MEDICAL CENTER FACTS AND FIGURES
IV. ADDRESSES OF OFFICIALS TO WHOM TO WRITE
1. Why do we need this hospital?
"The LAC+USC Medical Center is the largest safety net provider in a densely populated region. It provides care for the uninsured, particularly high acuity specialty services not sufficiently available in the community. It also serves as the County's primary emergency and trauma care hospital, providing almost thirty percent of the County's trauma care. Today it is one of the thirteen remaining trauma centers serving nine million residents."
2. Why do we need to replace it?
"Built in 1932, the facility has become obsolete, inefficient, and expensive to operate. It is in violation of numerous federal and State building, safety, and seismic codes. The federal Health Care Financing Agency (HCFA) and the State's Office of Statewide Hospital Planning and Development (OSHPD) require that various life/safety problems be fixed or the facility replaced in order to continue operating and receiving reimbursement. It also suffered enough damage during the Northridge earthquake that the Federal Emergency Management Agency (FEMA) has authorized over $462 million that may be used for its replacement."
3. Is there still a need for the hospital?
"Through our studies and a number of outside reviews, we have determined that there is a strong need for a replacement public hospital to handle trauma, emergency, specialty services, and general acute care to the medically indigent. For example, the updated Los Angeles Model, developed by the Lewin Group, predicts a severe shortage of emergency room capacity by the year 2005. Completing all County-planned projects, including rebuilding LAC+USC Medical Center, would reduce the projected emergency room capacity shortage by half."
4. Why don't we just contract out the services to the surrounding hospitals?
"We are surveying private sector hospitals for their interest in providing overflow services from a reduced LAC+USC Medical Center. Although current studies, including the Los Angeles Model and Department of Water and Power report, indicate an abundance of available beds, the available private sector services don't always match the County's patient needs. Also, the private hospitals will not accept additional indigent patients without compensation. The availability of such funds are unknown in the future."
5. How is a new hospital part of the County's changing health care system?
"The County's health care system is rapidly evolving. The new facility will be smaller than present and will emphasize high acuity services least available in the private sector. LAC+USC Medical Center is also working with non-hospital based outpatient providers to increase ambulatory care. This is in line with the 1115 Waiver and principles of managed care, which requires increasing lower cost primary outpatient care by fifty percent and reducing expensive inpatient capacities by a third. The Department-recommended new hospital will be smaller -- 750 licensed beds as opposed to the present 1,779 licensed beds. It will have a daily inpatient census of 638 patients, as compared to today's 850 to 900 inpatients per day."
6. Will the other County hospitals also be reduced?
"In accordance with the precepts of managed care and the federal 1115 Waiver goals of reducing inpatient services and increasing community-based out patient services, each hospital is being evaluated for its services and capacities. The objective is bed reduction and services realignment. The Board is also considering public/private partnerships for High Desert Hospital and Rancho Los Amigos Medical Center. Finally, the Department has inaugurated a reengineering process to cut inefficiencies and reduce operating costs while generating better service."
7. Can we afford to build a new hospital?
"The total price may be high, but it is reduced considerably by State and federal programs. First, FEMA (Federal Emergency Management Agency) has authorized $462.7 million in reimbursement for earthquake damage. Consider that our down payment. Then, under the SB 1732 program, the State will reimburse up to half the debt service. That equates to up to half the mortgage payment paid by the State. The remaining payments are about one percent of the Department's operating budget. The operating costs for this smaller facility will be lower. Current operational savings estimates range from $142-$151 million per year."
8. Why can't we just fix the old one?
"Fixing the old hospital is impractical and costly. First, the FEMA grant would have to be renegotiated, and there would be no SB 1732 reimbursements. Second, there are risks of complications, delay, and hidden cost increases because of building deterioration. Third, keeping the renovation to life/safety and seismic repairs would result in a code compliant but inefficient 65-year old hospital. Finally, estimates for seismic upgrade, State code compliance, federal and minimal life/safety corrections, and facility modernization range up to $800 million"
9. How long will it take to design and build a replacement facility?
"Depending on the option approved by the Board of Supervisors, it will take between seven and ten years to complete. The shorter term options -- seven years -- will use the basic design already under review by the State. The longer terms will require additional years for design development and State approval."
10. Why is the Department recommending a 750-bed replacement facility?
"It is the best balance between needed services and costs. A downsized 750-bed hospital goes furthest in meeting projected demand while minimizing costs. It allows sufficient capacity for trauma, emergency and indigent services, while maintaining beds for specialties -- 24 jail beds, 20 burn beds, 48 neonatal intensive care beds, and 48 psychiatric beds. Department of Health Services analysis indicates that 677 beds are needed to just support the emergency function. Also, its operating costs are reduced and would be eligible for SB 1732 reimbursements."
11. What comes next?
"The Department, along with the CAO and Department of Public Works, will return to the Board with a request to proceed on the development of a specific replacement hospital. When that is approved, the Department of Public Works will initiate a contracting process that will take the project through the final design and all construction phases."
12. What actions are taking place now?
"The Department, in cooperation with the Healthcare Association of Southern California, is performing two surveys. The first is to inquire about private sector provider interest in contracting for overflow inpatients from a downsized LAC+USC Medical Center. The second survey is being sent to all Los Angeles private providers seeking their interest, available services, and costs for inpatient medically indigent. Finally, the APM health care consulting firm just completed a review of potential operating costs for the various size replacement options. Their results confirmed Department estimates and noted that further cost savings were achievable through reengineering."
13. What has been the public response to replacing the hospital or to the recommended 750-bed facility?
"The Los Angeles County Medical Association and the California Hispanic American Medical Association have endorsed a 750-bed replacement facility. The Healthcare Association of Southern California endorsed a 675-750 bed replacement facility. All endorsements stressed the need to ensure availability of the EMS/trauma services through the County and ensure continued access to inpatient medical services for indigents in the region.
"The SEIU Local 660 has endorsed a 750-bed replacement facility.
"Numerous Congressional Representatives and State Senate and Assembly members have agreed that a replacement facility of up to 750 beds is needed. These include ..."
II. LAC+USC MEDICAL CENTER FACTS AND FIGURES
1. Beds
2. Workload (95/96)
3. Specialty Services
4. Service Area Population
This sample letter may be used to encourage your elected officials to support a downsized replacement of the LAC+USC Medical Center. Although this letter is simplified, it will register your interest. For greater impact or focus, use the facts and figures in Sections I. and II. For the names of your County and State representatives click here.
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Your Name
Return Address
Date
Representatives Name
Address
Dear Senator (Representative, Supervisor),
I urge you to support the immediate replacement of the aging and damaged Los Angeles County + University of Southern California Medical Center (LAC+USC). The LAC+USC Medical Center, badly damaged during the 1995 Northridge Earthquake, is the largest single provider of Emergency Medical Services and trauma care to the residents of Los Angeles County, as well as the region's largest health care provider to the medically indigent. The downsized replacement of this facility, at the County Department of Health Services-recommended level of 750 beds, will insure continued and high quality health care services to the indigent and the ability to meet the projected regional shortfall of emergency room capacities. Thank you for your concern for the residents of Los Angeles County.
Sincerely,
Above information provided by Mindy Halls.
Posted July 17, 1997