County Health Officials Warn of Deukmejian Budget ‘Disaster’

Los Angeles County health officials said Thursday that Gov. George Deukmejian’s proposed state budget, which would slash nearly $100 million from the county’s troubled public health care system, would force them to reduce services to thousands of poor and elderly people.

“This spells disaster for us,” said Irv Cohen, director of administration and finance for the county Department of Health Services. “We’re a big department but we can’t absorb cuts like that” without severely cutting back on services, he said.

The crippled trauma system likely will be among the areas hardest hit by the cuts because the county is trying to lure back several private hospitals. Ten hospitals have dropped out of the emergency care network in recent years and county health officials have been looking for funds to bring them back.

“Every time the county system takes a cut it cascades in a ripple effect into the private hospitals,” said Virginia Price-Hastings, director of the county’s trauma care network. When clinics close, the poor eventually end up at a county or private hospital emergency room, she said.

“Private hospitals get frightened away (from joining) because they know that every time the county budget gets cut that they’ll have to pick up the slack and that costs them money,” Price-Hastings said.

Assemblyman Burt Margolin (D-Los Angeles), who vowed to fight the cuts, said the governor’s proposals would “create havoc in a county system already in disarray and just hanging on by its fingernails. . . . It’s a disastrous budget for the county of Los Angeles.”

Despite the gloomy predictions, however, county health officials acknowledged that the budget would be revised sharply in the coming months and said they were treating the proposed cuts as preliminary.

Statewide, the governor proposed cutting health and welfare expenditures by more than $1 billion. Those changes include reducing hospital grants, AIDS care and in-home supportive services and eliminating cost-of-living increases in Medi-Cal payments for the 1990-91 fiscal year. The governor also cut programs for heroin detoxification and child welfare services.

The cuts followed an upbeat State of the State Address delivered by Deukmejian one day earlier.

“I liked what I heard in his (State of the State) speech, but the cuts behind his rhetoric will be very destabilizing to this county,” said Los Angeles County Supervisor Ed Edelman.

Most of the reductions would require special legislation and Democratic legislative leaders are already lining up to block them. “These cuts are too drastic,” said Senate President Pro Tem David A. Roberti (D-Los Angeles). “We’re going to restore those.”

If the austere budget is ultimately adopted, Cohen said, the first cuts would be made in administration. “But we’ve been cutting there for 10 years,” he said. So, entire health care programs may have to be eliminated, he said.

But that could cause even larger problems for the county and private hospitals.

County health officials said cuts in medical programs tend to lead to higher overall medical costs.

“It’s a vicious cycle,” said David Langness, a spokesman for the Hospital Council of Southern California.

Some public resources also are becoming overloaded as the poor become desperate for medical care.

“Some people believe there is a direct correlation” between recent cuts and the rise in medical calls to the county’s 911 emergency number, Price-Hastings said. “People know 911 is a direct ride to the doctor.”

In the same way, Langness said, cuts in drug treatment programs lead to more expensive medical problems for the county. “If people keep taking drugs (because there are no treatment programs) we’ll see them as patients sooner or later.”

Robert C. Gates, county health department chief, said he was worried about the potential impact on obstetric services, which he earlier termed “critically overloaded.” Gates has told state Medi-Cal officials that so many women are having babies at county facilities some may have to be turned away. County officials expect 46,000 babies to be delivered at hospitals this year, severely overtaxing a system with a capacity of about 35,000.

“We consider obstetrics a top priority, but a cut like this could be devastating,” Gates said Thursday. “It looks like one more year of not very good news.”