Officials Hope Bill Can Avert County Health Facility Closings : Legislation: A temporary suspension of state matching fund requirements could free $72.8 million earmarked for the county.

State and local health officials said Tuesday they are optimistic that they can win legislative approval to keep open 20 clinics and four comprehensive health centers that are targeted for closure by the Board of Supervisors.

The officials, who are familiar with the Los Angeles County health care financing crisis, are pinning their hopes on legislation that would temporarily suspend state matching fund requirements on health dollars, thus freeing $72.8 million already earmarked for the county.

The Legislature will not return from its summer recess until next week, but county officials have been meeting regularly with interest groups and lawmakers to line up support.

Donald C. Petite, controller for the county Department of Health Services, said, “We are fairly sure that one way or the other we’ll get something. Nothing is for sure in this world, but we think we have a reasonable chance.”

“This is not a slam dunk. There will be problems. But I think we can work it out,” echoed a Sacramento-based lobbyist who spoke on the condition that he not be identified.

A provision of the tobacco tax initiative, Proposition 99, that passed in 1988, allocated money from a tax increase to local health programs but only on the condition that the money supplement local revenues, not replace them.

The county had no trouble adhering to the provision until this year. The Board of Supervisors, faced with a recession-related decline in tax revenues and dwindling state support for local programs, put together a bare-bones budget that left its health programs more than $100 million below the legal amount required to qualify for the money.

Faced with the possible forfeiture of the $72.8 million, the supervisors passed a health services budget last week calling for the closure of the 24 health facilities, with a deadline of Sept. 1. But they left open the possibility that the clinics would stay open if the legislation suspending matching fund requirements is passed.

County Health Director Robert C. Gates affirmed that Tuesday. “We’ve made the commitment that we’ll keep them open” if the legislation is passed, he said.

Closure of the clinics would wipe out more than 1 million patient visits a year, forcing the poor and uninsured who use the health centers to either find new clinics or go without health care, and lead to the layoffs of more than 1,500 health care workers.

One of the county’s biggest problems in getting the legislation passed is overcoming ardent support among health care officials, doctor groups, hospital associations and others for maintaining the matching fund requirements.

They fear that once the legal requirements are loosened, the county will be tempted to move more and more money out of health services, relying on state or federal dollars to close the gap. They predict that if this happens, there will be a net reduction in funding for health programs.

Susan Fogel, an attorney for the Legal Aid Foundation of Los Angeles, was among the strongest foes to any changes in the so-called “maintenance of effort” requirements.

But the attorney indicated a softening Tuesday, saying that in light of what she called the county’s need for “a desperate fix,” she might support a one-year suspension of the requirements as long as “the relief (is) very narrow and very controlled.”

At an extraordinary gathering downtown Tuesday, acting Chief Administrative Officer Harry Hufford, Gates and other county officials met with several dozen health care executives to plead for support for the lobbying effort they plan to mount, beginning next week.

Sen. Art Torres (D-Los Angeles), said he would support the county’s legislation, but added that local officials would have to overcome resentment in the Legislature over past actions by the Board of Supervisors. He recalled that last year, only months after agreeing to a pension increase package of $265 million for top county administrators, the board threatened to close 16 health centers for lack of funds.

“It’s awfully hard to defend them when they come up here asking for money and continue with pension spiking,” he said.