County Gives Dire Report to Private Hospitals : Finances: Officials announce plan to stop accepting most transfer patients Sept. 1. They say that even if U.S. aid comes, it won’t stop crisis.

Even a large infusion of federal dollars would not be enough to stop health center closures, prevent a disruption of emergency services or head off the elimination of neighborhood clinics for hundreds of thousands of patients, top Los Angeles County health officials told private hospital administrators Tuesday.

The development came as the county Department of Health Services announced that as of Sept. 1 it will stop taking transfers of all but a limited number of patients from private hospitals, a sweeping policy change that caught private hospital officials by surprise.

Department officials also circulated drafts of the closure notices that will be posted at county clinics.

The notices, distributed during the meeting with private hospital executives Tuesday, will tell indigent patients that they should “make their own arrangements for care with another provider,” even though experts, both public and private, acknowledge that there are not enough private providers for all of the indigent patients.

In the notices, patients are referred to an 800 number, said to be operated as a physician referral service by the Los Angeles County Medical Assn. But the association said it had no knowledge of the number.

“We have not made any arrangements with the county for them to call us for referrals,” said Bob Holt, the chief medical association executive working with the county. “I have no idea where they got that number.”

A spokeswoman for the county Department of Health Services said the closure notices still had not received final approval and release of them was premature.

But circulation of the notices among providers, along with the other announcements, clearly jolted the private hospital officials.

An hour after the closed-door meeting in the offices of the Healthcare Assn. of Southern California, Sandra M. Chester, the chief executive officer of the Greater El Monte Community Hospital, said she was still stunned.

“I wasn’t expecting the level of catastrophic news I heard today,” said Chester. “I’m . . . completely devastated.”

Jim Lott, policy director for the Healthcare Assn., said hospital administrators were told that even if the county receives at least $200 million in additional health care funding, it will not be enough to head off a massive disruption in health care for hundreds of thousands of patients.

Even though the Board of Supervisors voted Aug. 1 to close 28 of 39 community-based health centers and six regional comprehensive health centers and eliminate most outpatient services at county hospitals, private hospitals had assumed that county hospitals would continue to accept the transfer of indigent patients.

But during the briefing by Walter Gray, the assistant health director who is responsible for the county’s network of clinics, and Virginia Hastings, head of the county’s emergency services system, they learned there would be no transfers after Sept. 1.

In a memo to private hospitals, Health Services Director Robert C. Gates said the transfer restrictions will remain in effect at least until Nov. 1. Transfers will be limited to patients who have suffered traumas, burns or need neurological care.

That means that private hospitals or physicians will be responsible for the continued in-hospital care for patients who normally would transfer to county hospitals because they are without insurance or the ability to pay.

The extent of programs to be hit by budget cuts is also much broader than expected. Emergency services chief Hastings said during an interview that the county plans to eliminate almost half its 30 ambulance crews and place those that remain on limited schedules.

Lott said private hospital administrators are expecting the worst. Estimates are that the private health care system will have to absorb from 1.2 million to 2 million patient visits, a monumental task that all hospital officials say is impossible without a huge infusion of money.

“The patients will be on the streets,” he said. “The only place they will be able to access care will be in the hospital emergency rooms. That is going to cause an overload and a meltdown like no one has ever anticipated in this community.”

Lott said the county officials made it clear that there is little chance of a reprieve from the planned cuts and closures.

* CHOPPER TRIP

Supervisor Mike Antonovich again uses a county helicopter for official business. B10