County’s 1987-88 Budget Restores Most Health Cuts

In a partial but significant victory for patient-care advocates, the Los Angeles County Board of Supervisors on Wednesday adopted a $7.6-billion budget that restored most of $27 million in health service programs that had been targeted for elimination.

The county’s spending program also restored most of $11 million in mental health programs that had been slated to be cut. And it provided money for a number of pet projects within the individual supervisorial districts.

The 1987-88 budget also, once again, beefed up the criminal justice programs that have rested atop the priority list of the board’s conservative majority since 1981.

Some Services Face Cut

Not funded in the record county budget was $8 million in health services that will be eliminated Oct. 1 unless the Legislature and the governor agree to provide additional money to the county. Threatened are outpatient programs at three county hospitals as well as detoxification, surgical and dental services at smaller health facilities.

The board also did not provide any money to help bail out the local trauma network providing emergency medical care. In the last year, three private hospitals have pulled out of the trauma program because of a lack of funding and an inability to transfer stabilized indigent trauma patients to county hospital beds.

Also absent from the approved budget is any money for employee raises once union contracts for an estimated 70,000 workers expire Sept. 30.

But there was some good news for county employees as the board largely rejected recommendations by Chief Administrative Officer Richard B. Dixon to eliminate about 1,800 jobs.

The new county budget, covering the fiscal year that began July 1, was adopted two days after the supervisors heard scores of witnesses urge them to avoid health care cuts by either cutting other programs or by imposing some type of new tax. The supervisors were not expected to decide until Aug. 11 whether they would slash $27 million in programs, but Wednesday they moved to restore nearly $19 million of that total.

Discretionary Funds

Using about $30 million in so-called discretionary funds set aside by the state for the county, the supervisors reduced the $27-million health shortfall to $16.4 million. The board found about $8.4 million more for health services by dipping into other county department budgets as well as into a skimpy reserve fund that will now total $3 million.

For the first time since the account was set up five years ago, the board dipped into a $10-million fund established to eventually restore 25-year-old facilities at the county-owned Marina del Rey community. County officials said about $1.6 million remains in the account.

Health Director Robert C. Gates said that the impending reductions could mean as many as 400 layoffs at the affected health facilities. Specifically, the following cuts, totaling $8 million will be made:

- Outpatient clinics at County-USC Medical Center, Martin Luther King Jr./Drew Medical Center and High Desert Hospital.

- Surgical services at Claude L. Hudson and El Monte Comprehensive health centers. Also adult dental services at all county comprehensive health centers.

- Drug detoxification programs at Rancho Los Amigos Rehabilitation Center as well as about $500,000 in various heroin detoxification programs under contract with the county.

Supervisor Ed Edelman, who fought all day to save all of the threatened health care programs, won support for increased prenatal care and to spare several ambulatory clinics that had been slated to close without new funding. Joined by his colleagues, Edelman also successfully pushed for restoration of several neighborhood clinics that offer specialized treatment for a host of ailments.

Not Totally Satisfied

Although voting for the final budget, Edelman expressed concern that the board needed to spare health programs at the expense of other county services. Some cuts were made in virtually every county department except those involving criminal justice--probation, district attorney, sheriff’s--or fire protection in order to find extra money for health services.

“(It) is not a good solution; it is not a great solution and it’s not a very acceptable solution,” Edelman said. “But we have to do something.”

For the second time this week, Edelman, a Democrat, also attacked Gov. George Deukmejian for vetoing money that would have kept county programs funded at least at last year’s levels. The three Republicans on the board--Mike Antonovich, Deane Dana and Pete Schabarum--did not criticize the GOP governor, but they called for greater efforts in Sacramento to secure more money for county health programs, including the trauma network.

In other budget actions, the board:

- Delayed consideration for several months of a Dixon plan to launch a new public defender program to handle certain indigent cases involving multiple defendants. Although Dixon said such a plan could save the county up to $3 million, the board said it wanted the input of private attorneys before such an ambitious program were adopted.

- Restored $8 million to the county’s Mental Health Department that Dixon had recommended be cut. Director Roberto Quiroz said that the department will still realize a $3-million shortage, but that virtually all mental health clinics once targeted for elimination will remain open, although at reduced levels.