Decrepit county health care system receives first $100 million in relief.

The Los Angeles County Board of Supervisors is expected this week or next week to approve the first three major contracts, worth an aggregate $100 million, for what is planned to ultimately be a $2.3 billion overhaul of the county's outdated and overburdened public health care system.

The three contracts scheduled for final approval are for architectural and engineering services on three major new public hospitals that the county hopes to build in Boyle Heights, Lancaster and the City of Industry.

Some public officials insisted last week that the health-care system overhaul has taken on even greater importance in light of the recent rioting, while others conceded that other public services -- such as police and fire protection -- now have temporarily eclipsed the urgent need for a public health care system overhaul.

One thing is certain, the overhaul program would provide a tremendous boost to the local economy, if financing can be secured.

"Studies indicate this capital program would create 64,000 new jobs and provide $4 billion worth of business output," said Sandra Anderson, director of governmental and community relations at the Los Angeles County Department of Health Services. "That's exactly the kind of thing we need to bolster this economy."

Finding public funds to pay for the massive health-care overhaul remains highly doubtful, especially now that riot-related rebuilding programs are competing for scarce public funds, some sources confirmed.

But at least a few public officials argued that the recent riots may actually help encourage voters to approve a $2.3 billion bond measure to fund the health-care overhaul.

"I think the riots strengthened in peoples' minds the need for hospitals with up-to-date trauma and emergency services," asserted Jerry Buckingham, executive director of County USC Medical Center.

Francis Dowling, project director of the county's health-care overhaul, agreed with Buckingham's assessment.

"Even before the riots, there was talk of getting some federal public-works money," Dowling explained. "Perhaps this (rioting) will enlarge those efforts. Perhaps now there will be some additional public-assistance dollars available to us that otherwise wouldn't have been available."

The three contracts expected to be approved at the supervisors' meeting on either May 12 or May 19 involve architectural and engineering services for the new hospital planned to replace the 60-year-old County USC Medical Center in Boyle Heights; architectural/engineering services for the new High Desert Medical Center, tentatively slated for Lancaster; and architectural/engineering services for the new East Valley Medical Center, tentatively slated for the City of Industry.

A public-private advisory panel headed by health-care consultant Romigh Roger Rusk has already selected the three architectural/engineering teams it will recommend for those $100 million in contracts. The Los Angeles County Internal Services Department has already concluded contract talks with all three selected teams, sources confirmed last week.

A two-firm team will be recommended as architect/engineer for the $1.2 billion County USC Medical Center replacement hospital. That team is comprised of Hellmuth Obata & Kassabaum Inc. and Lee Burkhart Liu. That team's contract will be worth about $60 million, sources estimated.

A three-firm team will be recommended as architect/engineer for the $378.7 million East Valley Medical Center, sources confirmed. That team is comprised of Daniel Mann Johnson & Mendenhall, Ellerbe Becket, and the HMC Group. That team's architecture/engineering contract will be worth about $25 million.

A four-firm team will be recommended as architect/engineer for the $214 million High Desert Hospital. That team is comprised of Anshen & Allen, Stone Marraccini & Patterson, Langdon Wilson Architecture Planning, and Villanueva Arnoni. That team's contract will be worth about $15 million, sources estimated.

Project director Dowling stressed that any or all of the three contracts could be cancelled at any time, with a 10-day notice, which would protect the county from getting stuck with the entire $100 million contract obligation if voters don't approve bond financing.

The county hopes to pay for the bulk of its $2.3 billion health care system overhaul by issuing tax-exempt general obligation bonds. But such a bond issuance currently requires a two-thirds approval from voters. And some county officials are becoming increasingly pessimistic that such a vote could be garnered in riot-and-recession-ravaged Los Angeles County.

L.A. County lobbyists in Sacramento have been working diligently to push a state constitutional amendment through that would reduce the amount of votes needed to approve local health-care bond measures from the current two-thirds requirement to a simple majority vote.

So far those efforts have proved fruitless. But one prominent county lobbyist in Sacramento revealed last week that the county is preparing for another round of lobbying that has "about a 50-50 chance" of pushing a state constitutional amendment through the state Legislature.

County lobbyists are focusing their efforts on two constitutional amendment proposals currently pending before the California Assembly. One measure is ACA (Assembly Constitutional Amendment) 6, introduced by Jack O'Connell, D-Carpinteria. The other measure is ACA 12, introduced by Bruce Bronzan, D-Fresno.

Constitutional amendments require a two-thirds approval vote from both legislative houses, and then need a simple majority approval vote from the state's electorate.

In other words, constitutional amendments must be approved by at least 54 of the 80 state assembly representatives, and at least 27 of the 40 state senators before it can be put on the state ballot.

Neither ACA 6 nor ACA 12 qualified for the June 2 ballot. But county officials remain hopeful that at least one of the measures will qualify for the Nov. 3 ballot.

County lobbyists refused to provide any details about their Sacramento game plan.

"I'm not about to explain in your paper what our (lobbying) strategy is going to be, that's confidential," one prominent county lobbyist said. "But I will say part of our strategy will be new, and part of it will be a continuation of what we've been doing all along."

Another county official revealed that the new round of lobbying will not commence until after the June 2 primary because several state legislators are up for re-election. Hence, they are preoccupied with getting re-elected, and health-care lobbying efforts would likely fall on deaf ears.

The official cut-off date for getting measures approved for the November ballot is June 25. Although that date can likely be extended until some time in August, L.A. County lobbyists definitely have their work cut out for them this summer, after the June 2 primary.

If no constitutional amendment qualifies for the November ballot, L.A. County would have to wait until the next statewide elections in 1994 to try again. Or, the county could opt to put a health-care bond measure before local voters, and hope for a two-thirds approval.

Any further delays in securing funding, however, would also result in the loss of crucial state and federal matching funds, sources pointed out.

All construction documents for the 33 separate projects in the overhaul program must be submitted to the Office of Statewide Health Planning & Development in Sacramento by June 30, 1994 to qualify for state and federal matching funds.

Those state and federal funds could pay for as much as 40 percent of the program's total $2.3 billion cost, sources said.

To meet that deadline, a very strict timetable must be adhered to. Yet, the overhaul program has already slipped five months behind schedule, sources confirmed last week.

The three contracts set to come before the county Board of Supervisors this week or next week were originally slated to be considered by the board last November.

"The whole project is taking more time to get approved than we anticipated; it's a very complex process," conceded Bonnie Zogby of Romigh Roger Rusk, the consulting firm hired by the county to oversee its overhaul program. "We need to get going on this."