Sharp Cuts Foreseen in Health Programs

On top of a worsening crisis over emergency-room care, Los Angeles County officials warned Tuesday that other county health care services could suffer drastic cuts if Gov. George Deukmejian succeeds in pushing through his proposed state budget.

Chief Administrative Officer Richard B. Dixon, delivering a bleak message to the Board of Supervisors, estimated that the county stands to lose between $66 million and $180 million in state aid for health care services under the governor’s spending plan.

In unveiling his recent budget proposal, Deukmejian suggested reduction of general fund dollars for medical assistance to indigent adults. But he also proposed making up for that cut by using revenues from Proposition 99, the voter-approved tobacco tax increase.

Nevertheless, Dixon said, Los Angeles County would come out a loser.

Dixon said that the “best-case scenario would place us in the position that we not only could not substantially support the private emergency room problem, we would have to make severe and very painful cuts in our own core, health services operation.”

Dixon did not specify where such reductions would take place but later said they would involve “across-the-board cuts” during the next fiscal year unless additional revenue is found.

Health Services Director Robert Gates, who had said on Monday that the county could no longer subsidize private hospital emergency rooms under the governor’s budget, agreed with Dixon that a wide array of programs could be jeopardized when the next fiscal year begins in July.

“What you may see is not only private hospitals closing their emergency rooms but also the shrinking of health services at county hospitals,” Gates said.

Since many of the patients treated at county emergency rooms are indigents, Deukmejian’s proposed funding reductions threaten the collapse of an overloaded, underfinanced emergency health care system, Dixon said.

Stephen Gamble, president of the Hospital Council of Southern California, said the present crisis among private hospitals is “much, much worse” than in previous years.

‘Public Safety Crisis’

“We now have an extremely serious public safety crisis,” said Gamble, who added that “people from all walks of life are needlessly dying or being permanently disabled or suffering irreversible damage due to our inability to adequately fund adequate basic emergency services.’

Battalion Chief Jim Sheppard, director of the county’s paramedic services, told the supervisors that last weekend paramedic crews in East Los Angeles, West Hollywood, Carson and Dominguez were turned away from the nearest emergency rooms on 39 occasions, forcing paramedics to take patients to other hospitals.

“He’s making a big mistake on this question,” said Supervisor Kenneth Hahn of Deukmejian’s plans. “What has happened to the conscience of the Legislature and the governor on this situation?”

In an effort to alleviate the crisis, the board voted Tuesday to urge the governor and state legislators to spare the county from cuts in health care funds. Board Chairman Ed Edelman also suggested that the county explore a possible court challenge to force the state to provide the necessary health care dollars.

Matter of Priorities

“The governor might cut some other area but we need to let him know what our priorities are,” said Edelman, who authored the tobacco tax proposal.

But even as he voted to go along with his colleagues, Supervisor Pete Schabarum, who like Deukmejian is a conservative Republican, made it clear that he thought the supervisors’ action was futile. “Big deal,” he told his colleagues after the vote, “We haven’t done diddly.”