Judge Bars County Cuts in Indigent Health Care

Lawyers for two Los Angeles County indigents won a court order Thursday temporarily blocking the planned shutdown of dozens of special health-care clinics and services for the poor, closures that a Superior Court judge said would cause “irreparable harm” if allowed.

Faced with the need to cut $6.8 million from their health services budget, Los Angeles County officials had intended to start eliminating dental services, specialty clinics, surgical services and other programs for the indigent at various county-run hospitals starting Sunday.

But Superior Court Judge Ricardo A. Torres issued a temporary restraining order preventing the county from implementing the plan for at least 20 days.

“I am convinced there is irreparable harm if these cuts are made Sunday,” said Torres in granting a temporary victory in a lawsuit filed by Gilbert Sanchez and Virginia Vargas. Both plaintiffs, in their 50s, subsist partly on public assistance and rely on county hospitals for treatment for a variety of illnesses including diabetes. They were assisted in their lawsuit by public interest attorneys.

Irving H. Cohen, assistant director of health services, said county officials were disappointed with the court order. “What this is going to do is just add chaos and confusion,” he said.

However, Bruce G. Iwasaki, a Legal Aid Foundation attorney who represented Sanchez, said his client and other indigents who rely on county hospitals will be relieved at the judge’s decision.

The cuts had been approved earlier by the Board of Supervisors, and among the affected hospitals is County-USC Medical Center, where reductions in the cardiac and prosthetic valve services for the poor had been planned. Elimination of the pediatric neuro-ophthalmology services in the County-USC eye clinic was scheduled, as well as elimination of the dermatology and tuberculosis treatment services in the center’s pediatric hospital.

Other Planned Cuts

Also earmarked for elimination was the gynecology clinic at Women’s Hospital and surgery services at the El Monte Comprehensive Health Center.

In Central Los Angeles, the H. Claude Hudson Comprehensive Health Center was scheduled to close its surgery services for the poor, as well as the entire gynecology clinic, where indigent women sought detection and treatment of cervical and breast cancers.

The Martin Luther King Jr./Drew Medical Center in South-Central Los Angeles was also set to close its cardiology, dermatology, gastroenterology, chest clinic and dental clinics for the poor.

In all, 87,000 patient visits would be eliminated under the county plan, with patients encouraged to use other county facilities--a proposal that Iwasaki found unacceptable.

“It’s a giant shell game,” he said of the proposed changes, adding that he and lawyers from the Western Center on Law and Poverty and other legal services group will seek a permanent injunction next month against the shutdowns.

Cohen, meanwhile, said the county already spends about $1.3 billion on health services, and officials are confident they will eventually prevail.

He added that notices have already been posted on clinics and about 25 permanent and temporary employees were told that they would be laid off next week. Those orders will now be rescinded.

“We definitely did not want the cuts,” he said. “We just don’t have the money.” County officials said they sought to fully fund health services by allocating money from other programs and using state funds, but still came up short by $6.8 million.

The court action came only hours after a special Assembly Committee on Medi-Cal Oversight concluded a public hearing on the county health system that was replete with grim statistics and horror stories about long delays, nurse and doctor shortages and soaring costs at county hospitals.

Denounce Level of Care

In four hours of testimony, the committee heard health care professionals and advocates for the poor denounce the level of health care in the county as inadequate, blaming county budget cuts and dwindling financial help from the Administration of Gov. George Deukmejian.

Assemblyman Burt Margolin (D-Los Angeles), the committee chairman, said the hearing showed that the county health system is “in shambles” and needs more money from the state.

“What this hearing overall did was reinforce the sense of urgency that many of us have that the State of California take a leadership role in saving the county health care system,” said Margolin.