Poor Foresee Health Cuts as Deadly : Poverty: Officials predict dire consequences for children with measles, TB and other diseases if the county system’s budget is slashed.

Hospital officials, medical staff and lawyers working on behalf of the poor said Monday that a $131-million reduction proposed for the Los Angeles County health care budget would have deadly consequences for poor children and raise already high levels of measles, tuberculosis and other infectious diseases.

The Board of Supervisors will hold hearings today on the proposed reductions, a legal requirement to ensure that patients have access to comparable care elsewhere.

“They can’t even demonstrate that now, without the cuts,” scoffed Melinda Bird, staff attorney for the Western Center for Law and Poverty, which has collected 93 affidavits from health care workers testifying to the effect of the funding reductions proposed by the Los Angeles County Department of Health Services.

The department funds six public hospitals in the county and 41 health centers that provide immunizations, prenatal care and treatment of infectious and communicable disease. Thirty-three of the health centers are slated for closure if the Board of Supervisors approves the cuts. The eight remaining would be restricted to sick patients only.

The clinics see 88,000 patients a month.

Bird said medical services for the poor are so burdened by inadequate funds and staff that, if tHe supervisors cut the budget at all, her organization will sue to stop the cuts from being implemented.

The center did that successfully in 1987, blocking $8 million in funding reductions. Last year, $55.7 million in cuts were proposed, a similar hue and cry was raised and none were implemented by the supervisors. The ritual of threatened cutbacks and vehement protest has been repeated annually at least for the last decade, but this year prospects of deflecting the budgetary knife are seen by many as jeopardized by the state’s own fiscal crisis.

Gov. George Deukmejian has projected a $3.6-billion shortfall in the fiscal 1990-91 state budget, and initial proposals in Sacramento to reduce funding to counties are what led the Los Angeles County Department of Health Services to prepare its plan for cutbacks of historic proportions.

Pediatric services would be among the hardest hit. The department’s proposal calls for closure of the children’s hospital--known as the Pediatric Pavilion--at Los Angeles County-USC Medical Center. It also would eliminate all pediatric services at Martin Luther King/Drew Medical Center in South-Central Los Angeles.

Patricia Sheedy, an emergency room nurse in the Pediatric Pavilion, was one of those who spoke at a news conference on the steps of County-USC on Monday. She said the hospital sees an average of 175 children a day, two to three of whom are so close to death that they require resuscitation. In the last months, the emergency room has seen five to 10 children with measles daily, several of whom are so seriously ill that they must be admitted to the hospital.

In a sworn statement that Sheedy provided the Western Center of Law and Poverty, she said the minimum waiting period before a sick child can be seen by a doctor or nurse is now about four hours, as caseloads increase without a corresponding increase in staff.

She also said the chest clinic, specializing in pulmonary illnesses, is so full that she must refer children with positive tests for tuberculosis to the public health centers for follow-up care. But these are so overcrowded, Sheedy said, that many of the children she has referred have gone without treatment.

The Pediatric Pavilion last year cared for 55,000 children, most of them Latino.

“These 55,000 children are going to be in the streets of Los Angeles with communicable illnesses unless this county responds,” said state Sen. Art Torres (D-Los Angeles), who joined those Monday opposing the cuts.

Robert Gates, director of the county Department of Health Services, was out of town Monday and could not be reached for comment, a department spokeswoman said.

But his deputy, Irving H. Cohen, the department’s director of administration and finance, said that the proposed cuts, while exacerbating problems at an already underfunded county health care system, were the department’s response to proposed state funding reductions. As a practical matter, though, Cohen said, he did not think that the county supervisors would approve the degree of cuts proposed.

“We do not believe that the (pediatrics departments) at King and at the medical center are both going to be closed,” Cohen said. But he does expect that services will have to be reduced, with the sickest children given priority.

That does not sit well with those who say that the number of children needing care at these hospitals is on the rise. Nor are they happy with the annual budgetary battle over the medical prospects of children such as Lisbeth Sanchez, a wide-eyed 2-year-old who played with her mother while waiting to see a doctor in the outpatient cardiac clinic at County-USC’s Pediatric Pavilion.

Lisbeth was born with her heart on the right side and depends on medications and bimonthly visits to the clinic to remain healthy, her mother, Letitia Sanchez, explained through a Spanish-language interpreter.

“This annual budget battle has become as familiar to Californians as the swallows returning to Capistrano,” said David Langness, representing the Hospital Council of Southern California in Monday’s protest.

BACKGROUND

Each year for the last decade, advocates for the poor have protested proposed cuts in county health-care funding for the poor, and in many years they have succeeded in getting money restored. Such a protest was held on the steps of Los Angeles County-USC Medical Center on Monday. Today, legally mandated hearings on the proposed cuts are scheduled before the Board of Supervisors. Those seeking the funding cuts must demonstrate that beneficiaries of the program will still receive services comparable to those available to people who are not poor. Representatives of the poor believe they have a strong case that the reduced services won’t meet the test, but they fear the state’s fiscal woes this year will make restoration of full funding more difficult.