Proposed County Budget Would Cut Health Services

A $7.2-billion Los Angeles County budget more than doubling the amount spent this year on the local fight against AIDS, but at the same time cutting deeply into other forms of health care, was proposed Friday by Chief Administrative Officer Richard B. Dixon.

His spending blueprint also calls for the elimination or phase-out of about 1,800 county positions--mostly from health and welfare programs--as well as cuts in mental health programs.

The proposed budget offers county employees no wage increases--although union negotiations are still under way--and leaves the Board of Supervisors with a relatively skimpy $10-million emergency fund.

Dixon’s budget, about $225 million more than the current year’s budget, also calls for boosts in spending to relieve jail overcrowding, to fight child abuse and crime and to prepare for an eventual major earthquake, as well as a new workfare program set to begin later this year.

Dixon told reporters that his proposed budget is a “worst-case” scenario based on current projections, and that rosier state surplus estimates could mean that some of the suggested cutbacks could be averted. He was uncertain, however, how much additional state aid may be forthcoming. He added that the county also could benefit if some legislative efforts are successful in granting the county more sales tax money as well as having the state assume the cost of operating the courts.

Generally, Dixon’s proposals reflect the strong law enforcement priorities that have characterized the board’s conservative majority of Mike Antonovich, Deane Dana and Pete Schabarum over the last six years. While caseloads in both welfare and health services have continued to swell, staffing levels have fallen sharply over that period.

A Fivefold Increase

Under Dixon’s plan, spending on AIDS education, prevention and control would rise from the current $14.8 million to $36.8 million. This represents a nearly fivefold increase in spending on AIDS since the 1985-86 fiscal year when the county contributed $7.8 million in state and county funds to the AIDS fight.

The proposed boost in AIDS funding also comes during a period when county officials--particularly the conservative majority of the Board of Supervisors--have come under strong criticism for not being aggressive enough in fighting the epidemic. In recent months, the supervisors have attempted to show a more determined effort by creating a county AIDS commission and ordering that new testing centers be opened.

“The need to arrest the AIDS epidemic is so imperative that it requires the reallocation of funding from traditional county health services, including care of indigents,” Dixon said. Los Angeles County has the third-largest number of AIDS cases in the nation, behind New York and San Francisco, respectively.

Although a significant increase, only about $4.8 million of the $22-million boost in AIDS funding would come from local county money; the balance is expected to come from state and federal sources.

Dixon said the AIDS fight should be financed by cuts or elimination of programs involving Olive View Medical Center, Antelope Valley Rehabilitation Center, drug detoxification centers and a number of health centers and clinics.

Fewer Health Positions

Overall, the Health Services Department--the county’s largest--would take the worst beating under Dixon’s proposal. More than 1,247 health positions would be eliminated from current levels, about a 5% cut.

Dixon said he expected that only a small number of the 1,800 jobs targeted for elimination countywide will involve layoffs. Most of the job cuts, he said, will come from attrition and workers shifting to other assignments. The county’s total work force will drop from 74,187 to 72,372 if Dixon’s plan is approved.

The spending plan will be presented to county supervisors next week in preparation for hearing and deliberations beginning next month. Final adoption, set for mid-July, is expected to be heavily influenced by eventual action on Gov. George Deukmejian’s proposed $39.1-billion state budget.

Dixon said his budget allows for no employee raises, although union contracts for most county workers expire in September. He said each 1% boost in salary would cost the county about $25 million, and that he will propose that any hike be financed by increased productivity--more work done by fewer people.

Additional Problems

The county Welfare Department would continue to suffer from budget shortages despite a growing caseload. Dixon said that despite warnings from Welfare Director Eddy S. Tanaka that the proposed reduction of 630 employees to the lowest level in years could jeopardize federal reimbursements and permit increased fraud, he feels that the county’s performance would not suffer to an intolerable degree.

Other major features of Dixon’s proposal include:

- A boost of more than $50 million in costs and indebtedness to alleviate chronic jail overcrowding that recently has 22,000-plus inmates in a system designed for about 12,000. Dixon called for an addition of 522 jail-related jobs and a total of 1,068 new beds next year at the Central Jail and Peter Pitchess Honor Rancho, at a cost of $50.4 million.

- An increase of 126 new positions to control narcotics trafficking, including 68 new sheriff’s investigators, 22 more deputy district attorneys and 35 more Probation Department supervisors at a cost of $7.5 million.

- Seventy-one more positions in the Children’s Services Department as well as the construction of a new dependency court facility, at a cost of $10.2 million. While overall spending for the Children’s Services Department will increase, Dixon is recommending only about half the amount the department had sought.

- The construction of an emergency operations center for use during the aftermath of a major earthquake, which scientists expect in the next 30 years, at a cost of $11.6 million.