L.A. County Health Cuts May Total $56 Million

Nearly $55.8 million in health service reductions that, if implemented, could deny care to 25,000 people per month at Los Angeles County hospitals and neighborhood clinics were proposed Tuesday as a response to lean state budget proposals.

Health Services Director Robert Gates said the one-year impact could even double to $112 million because of lost revenue now generated by the targeted health programs. Gates added, however, that this was a worst-case scenario and that the actual cuts could be considerably less.

Targeted for possible trims are more than 1,100 patient beds at seven county health facilities, as well as the neighborhood and hospital clinics now providing preventive care to 28,225 people per month. Affected programs would include pediatric, surgical, drug detoxification and dental care.

Consolidation of Services

If implemented, the health budget slashes would result in the consolidation of services at other larger facilities or the total elimination of some services, Gates said. Such cuts also would result in long waits and long lines becoming even longer at facilities that remain open.

The health services scenario, which will be subject to state-mandated hearings June 5, serves two basic purposes. First, it provides specific suggestions to the county supervisors of how to best trim the 1987-88 health services budget, which Chief Administrative Officer Richard B. Dixon is expected to unveil next week. Dixon’s health services recommendation is expected to total $1.28 billion, a $30-million increase over the current year’s program and about 20% of the county’s total spending program.

Secondly, the scenario is aimed at sending a message to Gov. George Deukmejian and the Legislature that the county’s fiscal crunch may cut deeply into programs that the state has mandated, but has not fully reimbursed the county to provide. Gates pointedly noted that if the state abides by a 5-year-old agreement to reimburse the county at 70% of the cost of caring for medically indigent adults, the proposed reductions could be avoided with money to spare.

Shortfall of $45 million

Deukmejian is proposing that the county be reimbursed for indigent care next year at current levels, which amounts to less than 60% of the cost, said Frank Binch, deputy health director. At that level, county health programs would suffer a $45-million shortfall that would have to be funded from cutbacks in other programs, Binch added.

The June 5 hearings will be held before the Legislature acts on Deukmejian’s proposed $39-billion state budget. Pending final action on the state budget, county officials who forecast a total $170 million deficit for all county programs, can only speculate on what actual cuts will have to be produced.

The $55.8-million scenario is $25 million less than what health services officials said earlier this year might have to be trimmed in order to avert a massive shortfall beginning July 1. Former Chief Administrative Officer James C. Hankla had asked Gates and other county department heads in December to trim their 1987-88 programs by 6.5%, which in the case of health services meant reductions of more than $80 million.

Binch said that more specific information on the proposed cutbacks will be provided to county supervisors shortly before the hearings.

Melinda R. Bird, an attorney with the Western Center on Law and Poverty, said that the county has provided inadequate information to the public on what cuts may occur and should have delayed scheduling the hearings until such information was provided. She said the public interest law firm is considering litigation to force the county to provide a detailed breakdown of possible cuts.

Specifically, these health service programs are among those facing reductions:

- Los Angeles County/USC Medical Center: The elimination of Women’s Hospital oncology service and reduction of the hospital’s gynecology, surgical day care, orthopedic and medicine programs could mean reduction of 141 beds serving 794 patients a month. Savings--$627,181 a month.

Also on Gates’ list is the closure of the pediatric pavilion that now treats 400 inpatients and 4,065 outpatients each month. Savings--$881,330 a month.

- Los Angeles County Harbor/UCLA Medical Center: Gates said the reduction of neuro-medical; neuro-surgical; general medical complications services; surgical services for eye, ear, nose and throat; services for tuberculosis and intensive care would affect 328 patients each month. Savings--$396,786 a month.

Suggested also was the reduction of medical outpatient clinics for patients suffering from diabetes, hypertension and who have experienced heart problems. Such programs at Harbor/UCLA serve about 717 patients monthly. Savings--$86,547 a month.

- Martin Luther King Jr./Drew Medical Center: A reduction of a broad range of outpatient clinics that now serve 1,623 patients each month would save about $353,470 a month, Gates said.

Supervisor Deane Dana tried without success to head off consideration of Gates’ proposal to eliminate some clinic services at eight local health centers that he said “are used primarily by the homeless, senior citizens and youngsters.” He also decried the possible closure of seven public health clinics.

“By cutting these services, we will end up treating these patients at county hospitals at a much higher cost to the county,” Dana said. Dana’s motion gained the support of Supervisor Mike Antonovich, but failed to find a third vote.