Health Agency Officials Not Cooperating, Yaroslavsky Says

With the county’s vast health system on the verge of unraveling, the Board of Supervisors meeting on Tuesday degenerated into a round of finger-pointing, with Supervisor Zev Yaroslavsky accusing top health department officials of “stonewalling” by not providing critical information to the board.

Yaroslavsky complained that the troubled department has failed to provide any innovative ideas on dealing with the worsening fiscal crisis that threatens to collapse the safety net of county hospitals, health centers and clinics that provide medical care for the poor and uninsured.

“It looks to me like the health department is stonewalling,” Yaroslavsky said. “I think we’re being stalled.”

The department’s chief deputy director, Mary Jung, denied the charge but acknowledged that the health services department had not come up with recommendations for $25 million in additional cuts. “It is not a matter of will,” she said. “It is a matter of time and workload.”

Moments later, the county’s health czar, Burt Margolin, laid blame at the door of the county’s chief administrative officer, Sally Reed, for failing to communicate with him and the health department before recommending even deeper cuts in the health care system.

“There was no consultation with me,” Margolin said, charging that there was no real communication with the department before Reed’s office made its latest recommendation--an assertion disputed by the CAO’s office.

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The public display demonstrated in graphic detail the profound difficulty the county is having in getting a handle on the fiscal crisis that may lead to the closure of comprehensive health centers and most community clinics, as well as sharp curtailments in outpatient treatment at county hospitals and care for the mentally ill.

“This place is going to have to get its act together,” Yaroslavsky said. He demanded that there be “a little more collaborative spirit” among the department, the chief administrative officer, the health czar and the supervisors. “If there isn’t, we’re all going to sink.”

Board Chairwoman Gloria Molina joined in criticizing Reed’s office for failing to consult with the newly named health czar. “Gloria Molina would like Ms. Reed’s office to cooperate,” she declared.

The supervisors were forced to reopen the financially strapped health care budget two weeks to the day after adopting a $12-billion spending plan built in part on money the county does not have and may never receive.

The budget began to break down within hours of its adoption after Gov. Pete Wilson announced he would veto a hastily crafted bill to divert $75 million a year from the Metropolitan Transportation Authority to the county.

Although there have been no solid assurances, the supervisors still hope to receive $50 million from the MTA this year.

Tuesday’s round robin of laying blame began when Assistant Chief Administrative Officer Sandra Davis recommended that the board move to close the remaining $25-million gap by cutting another $17.3 million from the health care. system. The recommendation included temporarily eliminating planning work on hospital projects and making deeper reductions in already slashed public health and mental health programs.

But the Health Services Department objected to all of the cuts on the table Tuesday. The only item of agreement was $7.7 million in hoped-for revenue from the state.

Yaroslavsky sharply criticized the department for failing to provide the information the board needs to make critical decisions. “This is a bad way to do business.”

The board delayed any decisions for a week on further health care cuts. And the supervisors ordered the department to produce a detailed, item-by-item list of potential cuts by Sept. 19.

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It was not the first time that board members have expressed frustration with the massive health department and its outgoing director, Robert Gates, who did not attend Tuesday’s meeting.

As the gravity of the health care crisis has become more evident in recent months, the supervisors have been expressing their dismay at the failure of the department to provide detailed options for dealing with a $655-million deficit in health services.

They named Margolin to chair the county’s Health Crisis Task Force, then appointed him to the new post of health czar to search for alternative ways of dealing with the deficit without closing County-USC Medical Center.

Still looking for additional revenue, the supervisors voted 3 to 0 to support legislation by Assemblyman Leader Willie Brown (D-San Francisco) to boost the state’s cigarette tax by 17 cents a pack to provide additional funding for health care, particularly in Los Angeles and Orange counties.