DECISION MAY IMPERIL HEALTH CARE; 600-BED HOSPITAL WINS OK.

Byline: Troy Anderson Staff Writer

In a move that could jeopardize state help in rescuing Los Angeles County's failing health care system, county supervisors rejected a request Tuesday to expand plans for County/USC Medical Center.

The supervisors voted 4-1 to approve an environmental impact report for the 600-bed hospital, rejecting a request by Assembly Speaker Robert M. Hertzberg, D-Van Nuys, for a 750-bed facility.

Supervisor Gloria Molina, who voted against the 600-bed facility, said the board vote could endanger efforts to win state and federal help in bailing out the financially collapsing health care system.

``We are asking the Legislature to help us obtain the waiver from the federal government,'' said Molina, who has a long political relationship with Hertzberg.

``There has to be a spirit of cooperation. We received a letter from Speaker Hertzberg asking for a spirit of cooperation and a willingness to discuss the issue. That was flatly rejected. It could create some complications.''

Yet Supervisor Zev Yaroslavsky said he'd be surprised if anyone in the Legislature would hold the ``health of their constituents hostage to a debate over 150 beds.''

Hertzberg's staff declined to say whether the state's help is tied to supervisors' approval of the 750-bed hospital.

``Basically, from his perspective, it's very disheartening to hear our request for a delay was refused,'' said Paul Hefner, spokesman for Hertzberg. ``The speaker believes the health care system in Los Angeles County is clearly at a crossroads.

``We think a successful resolution to the current crisis is only possible if there is cooperation between the county, state and federal government.''

Last year, a coalition of Latino lawmakers demanded that the supervisors reverse their plans to downsize the hospital or face opposition to the county's efforts to renew a $1 billion Medicaid waiver that saved the county from bankruptcy in 1995.

County health officials met with federal and state officials Monday in Washington, D.C., to get the waiver renewed before the June 30 deadline. The county has offered to spend part of its tobacco settlement, but the state has been silent on whether it's willing to give up part of its $13 billion surplus to help the county, stalling the negotiations.

``It was a very productive meeting and we have another one scheduled for Monday,'' said Mark Finucane, director of the county Department of Health Services. ``All three parties have a lot of work to do between now and then.''

Without the waiver, the county may be forced to close down dozens of its health clinics, lay off doctors and nurses and scale back services to the county's nearly 3 million uninsured residents.

In his letter, Hertzberg said he appointed Assemblywoman Gloria Romero, D-Los Angeles, to chair a newly created Select Committee on Health Care Access in Los Angeles County.

``I believe the Los Angeles County delegation is very strongly interested in averting a crisis,'' the speaker wrote. ``Toward that end, we are interested in seeing what monies we can bring forward.''