THE GOVERNOR’S BUDGET PROPOSAL : Budget Calls for Medical Aid Cuts for L.A. County’s Poor

Medical aid to Los Angeles County’s poor would be reduced and cost-of-living aid increases denied to hundreds of thousands of welfare recipients, the elderly and the blind by Gov. George Deukmejian’s proposed budget, officials said Tuesday.

Announcement of the budget set off a long process of fighting and negotiation among local government officials, partisan factions in the Legislature and the governor, with the final settlement not expected until the last days of the legislative session in early summer.

Immediately after the proposed $47.8-billion spending program for the coming fiscal year was released in the Capitol, copies of it were sent by facsimile machine, page by page, to the county Hall of Administration in Los Angeles, where budget specialists in Chief Administrative Officer Richard Dixon’s office awaited the news.

Early Impact Estimate

By early afternoon, they had a preliminary estimate of the impact on the county, which has the responsibility of providing health and welfare benefits to California’s largest population of urban poor--and of maintaining a huge jail and criminal court system.

The governor’s proposal to sharply reduce state medical aid to the working poor would cost Los Angeles County about $100 million, officials said, cutting already limited funding to the overcrowded county hospital and health clinic system. The hospitals include County-USC Medical Center, Harbor General, Olive View and Martin Luther King Jr.

That reduction is part of a series of cuts proposed by Deukmejian to finance additional educational aid mandated by a ballot measure approved by the voters last year, Proposition 98.

Making up for part of that loss in medical assistance would be funds from another 1988 ballot measure that enacted a 25-cent-a-pack increase in cigarette taxes. But county officials said they anticipated just $92 million a year from the cigarette tax, not enough to make up for the reductions.

Further strains on the county’s health care system would come from a proposal to reduce the number of therapeutic drugs financed for welfare recipients by the state’s Medi-Cal program. Anti-inflammation drugs not made from steroids would be among the drugs removed from the list.

County budget analyst Jerry Roos of the chief administrative office said the proposal would result in Medi-Cal recipients seeking their medicine from the pharmacies at the county hospitals.

Under the state Constitution, the county hospitals are the “last resort” providers of medical care, required by law to aid anyone in need. The new rules on prescription would “force patients into our hospitals and contribute to the overcrowding,” Roos said.

In addition, Roos said, Medi-Cal payments from the state for the care of Medi-Cal recipients are an important source of revenue for the county hospital system. “We will be receiving less money,” he said.

Another major part of the Deukmejian package affecting welfare families and other aid recipients is the governor’s decision against seeking cost-of-living increases in aid programs. In Los Angeles County, this feature of the governor’s program would mean denial of cost-of-living increases to 543,823 welfare recipients and 250,000 poor blind, elderly and disabled people, officials of the county Department of Public Social Services said.

Such grants are not large. The average grant to a single welfare mother, for example, is $582 a month, the department said. Cost-of-living increases have ranged from 2% to 5%, and more in years of greater inflation.

In addition, Deukmejian said cost-of-living increases should be denied to those receiving state grants for care in their homes. These are elderly or disabled people who hire helpers with the aid, which allows them to avoid going into nursing homes. The Department of Public Social Services said there are 54,399 such recipients in Los Angeles County.

On the plus side, Los Angeles County would receive about $130 million in the coming year in new state aid for the courts.

That aid was approved by Deukmejian and the Legislature last year to take some of the burden of rising court costs from the counties. Although the courts are a state system, they have traditionally been administered by the counties.

The legislation was designed to free county funds for health care, sheriff’s deputies and other uses.

But balancing that gain against the losses, budget analyst Roos said that “if the budget goes down the way it is proposed, we will see significant cuts in the health and welfare areas.”

However, Roos said he expects the spending debate to follow the pattern of last year, when “nothing was decided until the very end.” And, he said, he expects that there may be a revision of the proposals when new state revenue estimates are announced in May.