Governor’s Vetoes of Health Funds Stun L.A. County

Gov. George Deukmejian’s vetoes sent Los Angeles County’s health system reeling Wednesday with grave predictions that the budget slashes could further jeopardize a shrinking trauma care network and lead to deep cuts in many other vital health services.

County officials, including Supervisor Deane Dana, one of Deukmejian’s strongest allies and a personal friend, also expressed bewilderment that the governor would blue-pencil health appropriations at a time when the state enjoys a comfortable surplus.

“I’m a little shocked and startled,” Dana said. “I don’t know where the governor is coming from.”

Dana wrote to Deukmejian last week urging approval of funds for various county programs, including about $27 million for health services. A copy of Dana’s letter, supplied to The Times by Dana’s office, showed that the supervisor did not specifically mention health funding, pushing instead for a $1-million beach renovation in his coastal district. Deukmejian approved the beach money.

“I frankly didn’t think there was a problem (with the health funding),” Dana said. “I’m absolutely flabbergasted that he vetoed it.”

The governor’s veto of nearly $30 million for state trauma programs, about $13.9 million of which would have gone to Los Angeles County, may also have given new weight to recent grim predictions, renewed Wednesday, that the once highly touted local trauma network will crumble.

“We believe that the consequences (of the governor’s vetoes) will be that the Los Angeles County trauma system will collapse,” said David Langness, vice president of the Hospital Council of Southern California.

“What will be left will be only a spotty system consisting mainly of the three county hospitals now in the (trauma) system. The 16 private hospitals now in the system have been waiting to see what would happen with the budget. They have told us that most will leave if no funding is available,” Langness said.

Supervisor Kenneth Hahn assailed the trauma care veto, saying, “It is unconscionable that this life-saving system, which took so many years and so much energy and expertise to create, would be allowed to disintegrate when the funds to keep it functioning are readily available.”

The vetoes, unless overridden by the Democratic-controlled Legislature, will also threaten a host of county health programs that the Board of Supervisors will consider trimming or eliminating after a state-mandated hearing scheduled to begin Monday. Those cuts could deny care to 25,000 people a month at county hospitals and neighborhood clinics.

Targeted for possible cuts are more than 1,100 patient beds at seven county health facilities and services provided at neighborhood and hospital clinics to 28,225 people a month. As much as $27 million in reductions could result.

Next week’s hearing has taken on added political significance and will probably be used to send a message to Deukmejian that his vetoes were ill-advised, officials said. The hearing will also put pressure on state lawmakers, but local officials voiced pessimism that the Legislature can muster the necessary two-thirds majority in both houses to override the governor’s vetoes. Since Deukmejian took office in 1983, the Legislature has not overruled one of his vetoes.

‘Widespread Harm’

Until the governor signed a $40.5-billion state spending program Tuesday that included at least $240 million in health care vetoes statewide, most health programs had not been considered endangered.

“There had been widespread acknowledgement by medical professionals, by the counties, by senior citizens’ groups, by advocates for children that there would be widespread harm if these cuts were made,” said attorney Bruce Iwasaki of the Legal Aid Foundation of Los Angeles. The foundation recently issued a highly critical report charging that the quality of the county’s health services programs is substandard because of insufficient funding.

Many county and hospital industry officials said Wednesday that the governor’s trauma care vetoes were particularly surprising because the highly specialized emergency care could potentially affect patients of all walks of life.

The trauma system was established in 1983 to provide severely injured or wounded people a maximum 20-minute ambulance ride to a specially equipped and staffed emergency room.

Since it opened, however, four private hospitals have pulled out, citing financial losses, two of them this year--Daniel Freeman Memorial and Hollywood Presbyterian. A fifth, Santa Monica Hospital, has announced that it will leave next month.

Trauma network officials said that although many of the remaining private hospitals are re-evaluating their participation, none has yet threatened to pull out as a result of the governor’s vetoes.

The primary complaint of the private trauma hospitals is that the county has been unable to accept enough stabilized indigent trauma patients, those severely injured in accidents or crimes, at public hospitals. If indigent patients, who are unable to pay for long-term care or who are uninsured, are not transferred, the private hospital must absorb the losses.

“I honestly thought this funding would go through . . . and make it more difficult for hospitals to drop out,” said James Haden, president of Queen of the Valley Hospital in West Covina. “This (governor’s veto) puts a darker cloud over the situation.”

One possible silver lining is an $88-million pot of money Deukmejian set aside for the counties to do with as they please. The governor and the Legislature must decide first how that money will be divided.

County Chief Administrative Officer Richard B. Dixon said the county would be eligible for about $30 million, some of which could be used to offset health cuts. Dixon added, however, that given Deukmejian’s vetoes, Dixon would most likely recommend that the discretionary funds go toward other programs, specifically fire prevention and to fight jail overcrowding.

Reacting to other Deukmejian vetoes, Dr. Caleb Finch, co-director of the Alzheimer’s Disease Center of Southern California, said the governor’s cutting of $19 million to help fight that affliction is unfortunate.

“The funding for Alzheimer’s is minuscule compared to a disease like cancer, but the scale of the disease is such that there should be at least 10 times as many dollars as we now have. That’s why the $19 million that was vetoed had such promise. It could be wisely used if funded,” Finch said.

The 1987-88 funding for Alzheimer’s disease is $6.5 million, an increase of $2 million over last year.