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A Booster Shot for County Health Care : * Seemingly Inevitable Cutbacks Are Averted in a Textbook Case of Timely Advocacy

A few weeks ago, the prospect of $700,000 in cuts to three crucial Orange County health-care programs appeared inevitable. Only one thing--a state law requiring public hearings before health programs for the poor can be scaled back--had prevented the cutbacks from being made when the county’s 1991-92 budget was adopted in August. It was expected that at the conclusion of the hearings, originally set to begin last week, the reductions would take effect.

But the hearings have been canceled. County staff, after reviewing the final budget numbers, instead recommended that the Board of Supervisors forgo the cuts. That means that important health programs that may have been severely reduced or eliminated will survive--at least for another year.

While county managers say they simply found that the budget picture was a little brighter than they had anticipated, there were also politics involved. The turn of events provides a vital lesson in advocacy.

The board had planned to close 23 child health clinics serving 3,000 children; only 59 would have remained. It also had planned to reduce staffing for a sexually transmitted disease clinic and eliminate a program helping the county’s 250,000-member Asian community overcome language problems to receive health care.

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These cuts would have been in addition to massive reductions in county programs made to close a $67.7-million gap in the county’s $3.7-billion spending plan for 1991-92.

However, one small program was saved at the last minute, which eventually paved the way for the board’s decision not to make further health cutbacks. The board, charmed by a presentation by young members of 4-H, found $51,000 in the county’s contingency fund to keep 4-H’s animal husbandry and other programs operating.

As a result, the board could no longer say it would not reach into its contingency funds if it believed something was important; it could, and did, when it came to 4-H.

Seeing this, health-advocacy groups geared up for public hearings that would pull out all the stops in portraying the impact of the proposed cutbacks, including, undoubtedly, testimony from some very articulate young people. They knew they could match 4-H, and then some, when it came to emotional appeals.

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Happily, that won’t be necessary after all. More happily still, the cuts that appeared inevitable just a few weeks ago have been avoided.


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