County’s Health System May Face Cut of $80 Million

Gov. George Deukmejian’s budget could force Los Angeles County’s public health system to slash more than $80 million in services next year, officials said Thursday.

Among those cuts, they warned, would be first-ever reductions in emergency services. One possible casualty of the budget tightening is the trauma center program begun just a few years ago at the county’s major hospitals to provide sophisticated emergency treatment to victims of life-threatening injuries from such things as auto accidents and gunfights.

Officials said Thursday that specific program cuts are now being identified and final decisions will be reached early next month. They said that the health services department, as the county’s largest, would be hit hardest.

The possible health service cuts--representing 6.5% of the health department’s $1.2-billion budget--came to light Thursday after Deukmejian released details of his proposed 1987-88 spending plan. Officials had been hoping for weeks that the governor’s budget would not require major cuts in services in Los Angeles County, but Thursday their hopes were largely dashed.

Two weeks ago, Chief Administrative Officer James C. Hankla warned all departments that unless more money was found, the county would have a $153.2-million deficit on July 1. Last year, Hankla had predicted a $135.7-million shortfall by the end of the current fiscal year, but that deficit forecast was boosted by increased costs in state-mandated programs and salary hikes won by employee unions in 1985.

On Thursday, Hankla and his budget staff began a line-by-line analysis of the Deukmejian budget plan. They said their first impression was that the governor’s plan offers the county little hope for immediate relief.

At the same time, county officials were quick to point out that regardless of the governor’s spending proposals or how the Legislature may amend them, future massive cuts in county health programs had for months been a distinct possibility.

However, Hankla said there had been a ray of hope that the state, which is approaching a legal spending limit imposed by voters in 1979, would stay under the limit by diverting revenues to Los Angeles County and other local governments. Hankla added that the county also had hoped that the state would finally assume the costs of running the Municipal and Superior courts, freeing up $163 million for other local programs.

Both hopes were largely doused by Deukmejian’s budget, however. Although the governor proposes shifting about $477 million now earmarked for certain health programs to local governments without any legal strings attached, it was not immediately clear whether such a shift would benefit Los Angeles County’s health programs.

For Los Angeles County, such a responsibility shift would mean that about $174 million in state funds now earmarked for county health programs could be used at the discretion of the Board of Supervisors. The board members could choose to spend that money to restore any health reductions or divert the funds to other non-health programs.

Although there would be pressure on the conservative-dominated board to simply return those funds to the original health programs, the supervisors may be tempted to divert some former health money to law enforcement, for instance, which they have always made a top priority. For years, liberal state lawmakers have said the Los Angeles County board’s majority cannot be trusted to spend state money on health and welfare programs unless required to.

It is this attitude, primarily from the Assembly, that led many local government officials Thursday to doubt that the Democratic-controlled Legislature will look kindly on Deukmejian’s scheme to allow local control of state health funds.

As far as state funding of the courts is concerned, Deukmejian Administration officials said Thursday that the governor may be willing in 1988 to back such a move, but only if the Legislature acts aggressively to enact a number of reforms in the court system. The Legislature first authorized the state court funding two years ago, but Deukmejian, a former state attorney general, has refused to carry out the mandate unless the reforms are implemented.

Hankla said the $163 million that the county could have realized this year from the court-funding shift would have erased the looming budget deficit. Deukmejian’s decision to wait at least another year leaves the county little choice but to step up its efforts to identify possible service cuts, he said.