County to Ask State to Speed Its Payments : Finances: Health care revenue totaling $1 billion is sought to avert cash-flow crisis. Officials also release list of clinics that will close Oct. 1.

Seeking to avert a cash-flow crisis, Los Angeles County will ask the state to accelerate as much as $1 billion in health care payments, Chief Administrative Officer Sally Reed said Monday, as officials released a list of clinics that will close Oct. 1.

Although six major hospitals--including the massive County-USC Medical Center--were spared for now, the county’s six comprehensive health centers will close, as will 28 of 39 walk-in health centers, according to Department of Health Services cuts mandated under the budget adopted last week by the Board of Supervisors.

Centers that remain open will be able to provide only the most basic public health services, treating tuberculosis, sexually transmitted disease and acute communicable disease, providing immunizations and testing for HIV, the virus that causes AIDS, health officials said. The decisions on which health centers to keep open were based on population, location and capacity, they said.

County officials still hold out hope that private firms may be brought in to save some of the clinics; there were widespread predictions of dire consequences if the closures take effect as scheduled.

“People are going to fall through the cracks,” said Rina Levi Shroyer, a clinical social worker at the Mid-Valley Comprehensive Health Center in Van Nuys. “How can that be absorbed in the community? I have no idea. To me, this is a very dangerous precedent.”

She said the comprehensive center, one of six in the county, provides nutrition, health education, referral services and social work, “the sorts of things private doctors don’t have time to provide.”

Meanwhile, at a wide-ranging session with reporters Monday on the crisis status of the county’s finances, Reed promoted her proposal to hire an outside cash-flow adviser to ease the mounting financial strains.

Reed said such an adviser, who appeared Monday to have the support of a majority of the Board of Supervisors, would be important in helping project exactly how much money the county has in its coffers. He or she also would monitor incoming and outgoing revenue to ensure that the county does not write checks it can’t cover until state and federal revenues become available.

One reason such an outside expert is needed, Reed said, is because the county is taking a huge risk by spending more than it can afford at the beginning of the fiscal year to keep the health system afloat for two months while other sources of state and federal revenue are found. If that effort fails, she said, the county’s cash reserves could be perilously low, necessitating further cuts in the health care system to ensure that the county does not go broke.

“We have got to do everything we can to make sure our cash flow can sustain our strategy for attempting to preserve our health system,” Reed said. Hiring an adviser for about $50,000 to $70,000, she said, “is a small amount of money to spend to make sure we are completely on top of our cash flow. . . . We are in a crisis situation.”

The idea of hiring an adviser, to be taken up by the supervisors today, is just one part of an overall strategy aimed at maximizing the county’s cash flow--allowing it to squeeze every penny. Reed said the county’s cash-flow predicament is unprecedented this year because the newly passed budget relies so much on $300 million in unguaranteed funds and revenues that may not be available for months to come, if at all.

Because the county is operating so close to the margin, Reed said, efforts already are under way to put off as much spending as possible, while ensuring that the county immediately recovers every dollar coming in from the state and federal government.

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The centerpiece of that effort will be an appeal to the state to reconfigure its complicated matching fund arrangement with the county. Typically, the county has to pony up hundreds of millions of dollars a year in health care money, she said, so it can be matched with about the same amount in state and federal money and then distributed back to the county later in the year.

Reed said the county will propose sending monthly payments instead of a large lump sum up front and will seek to recover as much of the final revenues as quickly as possible.

“We expect to ask the state to modify procedures . . . so we can rely upon the turnaround of those deposits in an orderly fashion to maintain solid cash flow throughout the year,” Reed said. “It is simply sound practice, given the fact that we will be relying on such a major change in our cash-flow practices in order to balance the budget.”

The county is asking the state for help because, unlike in previous years, it cannot afford to wait for those funds, Reed and other county officials said.

“We are in a precarious situation,” Reed said. “I think anyone would admit that. But it is a well-recognized situation . . . and one we are working to manage as best as we can.”

To help ease the county’s financial strain, its top officials plan to meet with state and federal administrators today in Los Angeles and Wednesday in Sacramento. The various officials also will discuss ways to help the county obtain another $178 million in health care funds that it has already included in its budget, but which it may not receive until next year, if it receives them at all, Reed said.

In other county developments, Assessor Kenneth P. Hahn announced that the county’s 1995-96 assessment roll plummeted by $10.2 billion. Although the drop could affect county finances, Reed said the projected loss of $32 million in revenue was included in her budget proposal, which set the county’s budget deficit at a record $1.2 billion.

Times staff writers Timothy Williams and Susan Moffat contributed to this story.

(BEGIN TEXT OF INFOBOX / INFOGRAPHIC)

Prescribed Shutdowns

Los Angeles County announced that six comprehensive health centers and 28 walk-in health facilities will close as of Oct. 1. Other facilities will remain in operation.

CENTERS TO BE CLOSED

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San Fernando Valley

* Mid-Valley CHC, Van Nuys

* Canoga Park Health Center

* Burbank Health Center

* North Hollywood Health Center

* Tujunga Health Center

* San Fernando Valley Health Center

* Valencia Health Center

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Northeast

* Edward R. Roybal CHC, Los Angeles

* Northeast Health Center, Los Angeles

* Pico Rivera Health Center

* H. Claude Hudson CHC, Los Angeles

* Ruth Temple Health Center, Los Angeles

* Yvonne Burke Health Center, Santa Monica

* Venice Health Center

* El Monte CHC

* La Puente Health Center

* Azusa Health Center

* Alhambra Health Center

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Coastal

* Long Beach CHC

* Harbor Health Center, San Pedro

* Torrance Health Center

* Avalon Subcenter, Santa Catalina Island

* Bellflower Health Center

* Norwalk Health Center

* Hawaiian Gardens Health Center

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Southwest

* Hubert H. Humphrey CHC, Los Angeles

* Compton Health Center

* Dollarhide Health Center, Compton

* Paramount Health Center

* Florence / Firestone Health Center, Los Angeles

* San Antonio Health Center, Huntington Park

* Bell Gardens Health Center

* Lawndale Health Center

* Imperial Heights Health Center, Los Angeles

FACILITIES TO REMAIN OPEN

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Antelope Valley

* High Desert Hospital, Lancaster

* Antelope Valley Health Center, Lancaster

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San Fernando Valley

* Olive View Medical Center, Sylmar

* Glendale Health Center*

* Pacoima Health Center*

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Northeast

* County-USC Medical Center, Los Angeles

* Whittier Health Center*

* Central Health Center, Los Angeles*

* Hollywood / Wilshire Health Center*

* Pomona Health Center*

* Monrovia Health Center*

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Southwest

* Harbor-UCLA Medical Center, Torrance

* Wilmington Health Center*

* King / Drew Medical Center, Compton

* South Health Center, Los Angeles*

* Curtis Tucker Health Center, Inglewood*

* Rancho Los Amigos Medical Center, Downey * Health centers offering limited public health services