Damaged sepulveda va hospital to be razed : health care: washington officials decide against rebuilding. Outpatient clinic will replace the facility.

In a decision that angered many Los Angeles-area veterans, U. S. Secretary of Veterans Affairs Jesse Brown announced Monday that the quake-damaged Sepulveda VA hospital will be demolished

and replaced with a $65-million outpatient care center. The 431-bed federal hospital has been closed since the Jan. 17 temblor wrecked operating rooms, knocked out heat and water supplies

and littered corridors with broken glass, forcing the evacuation of 331 patients. Speaking to reporters in Los Angeles, Brown said he decided not to rebuild Sepulveda because the VA must cut

costs as it enters the era of managed health care, and because there are more than enough beds to absorb evacuated Sepulveda patients at the big West Los Angeles VA hospital. Most of those

evacuated from Sepulveda have been at the West Los Angeles facility, which has 1,157 inpatient beds, since the quake and will stay there, Brown said. He added that even with the Sepulveda

patients, there are nearly 200 empty beds at West Los Angeles. VA officials in Washington had been considering for the past two months whether to rebuild the 39-year-old Sepulveda hospital,

the centerpiece of a sprawling medical complex in North Hills that employs more than 1,700 and features well-regarded programs in geriatric research and medical education. The cost of full

reconstruction was estimated at $188 million. Brown said the VA will spend $50 million to tear down the ruined hospital, known as Building 3, and repair other structures. It will spend $65

million to erect the outpatient center, which is expected to open by February, 1996, and will expand ambulatory care programs at Sepulveda. Brown said a 120-bed nursing home at Sepulveda

will reopen within six to eight weeks. The complex’s psychiatric ward will be closed. Many local veterans reacted angrily to Brown’s announcement, saying it may jeopardize medical care for

people who fought America’s wars and will badly inconvenience their families, especially those from the San Fernando Valley who will be forced to drive an extra 15 miles over congested roads

to reach West Los Angeles. “These people are upset because they’ve taken something away from them again,” said Terry Tracy, a spokesman for the American Legion in Los Angeles. “Sepulveda

was kind of their place to go.” “Down at the grass-roots level, we’re going to have some people hollering like hell,” said Jerry Williams, California service director for the Veterans of

Foreign Wars. “They have this (hospital) close by, and now it’s not there.” But a spokesman for another veterans group said Brown’s plan will benefit veterans by allowing more of them,

especially poor veterans with no service-connected disabilities, to receive care. Under federal law, the VA must give preference to veterans with service-connected problems, regardless of

income. “They’re probably going to take better care of a bunch of new veterans than they would have if they just built another bed tower,” said Dave Gorman, deputy national legislative

director for the Disabled American Veterans in Washington. Last week, 21 members of Congress from the Los Angeles area signed a letter urging Brown to rebuild the hospital, saying that

“because of the large geographic area, distance, travel time and dense urban population, the other VA facilities in Los Angeles do not have the inpatient capacity to adequately serve” local

veterans. Closure of the hospital, the members of Congress said, also could damage Sepulveda’s research programs as well as its academic affiliations with the UCLA School of Medicine and

other medical training institutions. Last year, 364 medical residents and interns trained at Sepulveda. But after hearing details of the outpatient program from Brown in morning telephone

calls Monday, several congressman said they believe the secretary’s proposal makes sense. Rep. Howard P. (Buck) McKeon (R-Santa Clarita), whose district includes the hospital, said he agreed

with Brown that it would be foolish to rebuild the hospital given the number of unoccupied beds at the West Los Angeles facility. The extra travel time for Valley-area families, he said,

does not represent “an undue burden.” Brown said his proposal is “clearly in the best interests of veterans” and will help the VA--which operates 170 hospitals and 300 clinics nationwide--to

continue delivering quality medical care at no cost to veterans. The permanent closure of Sepulveda’s six-story hospital would mark only the second time since 1965 that a VA hospital has

been shuttered anywhere in the United States. Politically powerful veterans groups and their allies in Congress traditionally have been able to pressure the VA not to cut services. Brown

said the VA’s plans to build an outpatient center will not reduce Sepulveda’s ambulatory care, research or medical training programs. VA spokesman Dave Bayard said later that although

blueprints have not been finalized, the Sepulveda outpatient center is likely to resemble the one in Downtown Los Angeles. That clinic features dental services, a pharmacy, an emergency room

and programs to treat veterans with substance abuse problems and post-traumatic stress disorder. Brown acknowledged that demolishing the hospital will place a strain on doctor-patient

relationships at Sepulveda, where more than 3,800 surgeries were performed in the 1992-93 fiscal year. Instead of physicians being able to hospitalize and treat patients in Sepulveda, they

will have to transfer them into the care of others in West Los Angeles, he said. “In terms of quality, we’ll lose nothing,” he said. “But in terms of a close relationship that our physicians

want to maintain with their patients, we’re losing something there.” Brown also said that Sepulveda doctors, nurses and other staffers “did not accept this news very well” when he briefed

them Monday morning. “I think part of it is based upon the way they have been conducting business for many, many years,” Brown said. “They have grown to be very fond of their patients, and

they want to be able to maintain that close, intimate relationship. Obviously, with a change in mission, the way we do business will also have to change.” Brown said that of the medical

center’s 1,700 employees, about 1,000 will be kept in North Hills and 400 to 500 others will be transferred to West Los Angeles. The remainder will be offered jobs at other VA facilities

throughout the country. He said none will be laid off. MORE TO READ