The Northern Virginia Health Systems Agency board voted last night to recommend that the state health commissioner deny a national health-care chain permission to build a 200-bed hospital in Reston.

Humana Inc., a Louisville-based firm that operates 90 hospitals around the country, had proposed building a $34 million facility near the Dulles Access Road, but since the commissioner usually follows board's recommendation, last night's 17-2 vote appears to have effectively killed the project.

The decision came just a week after Fairfax residents had registered strong support for the Humana hospital. At a hearing at South Lakes High School in Reston, citizen testimony ran 3 to 1 in favor of the firm's plan, and two members of the county board of supervisors, Democrat Martha Pennino and Republican Nancy Falck, also spoke in favor of it.

Following last night's vote, Karl J. Ingebritsen, leader of a Reston citizens group supporting the hospital, accused the powerful Fairfax Hospital Association of derailing the Humana proposal. The association, which operates Fairfax Hospital, Commonwealth Hospital, Mount Vernon Hospital and the Ambulatory Care Center Emergency Services System in Reston, has long opposed competition in the county and is currently studying the possibility of opening another hospital that would serve the Reston area.

Board members said last night, however, that they were more influenced in their decision by slow population growth in the area than by any other factor. The health systems agency staff had issued a report saying that the current 2,100 medical-surgical beds in Northern Virginia are "more than adequate to meet regional needs for at least the next five years."