County Calls for Urgent Push to Get Health Care Funds : Finances: With Oct. 1 deadline for cuts looming, chief administrator urges supervisors to lobby state officials.

With just 19 days remaining until a massive dismantling of their health care system begins, Los Angeles County officials said Monday that urgent lobbying efforts are needed this week to pry loose hundreds of millions of dollars in state and federal bailout money jeopardized by last-minute logistic delays and political squabbles.

But because most of that money already has been patched into the county’s precariously built $12-billion budget--including $178 million in federal health care funding--preventing even further collapse of the health care safety net is the best that can be hoped for at this late date, officials say. Already, all six comprehensive health centers and 28 of 39 health clinics are slated to close Oct. 1.

“I’m worried,” Chief Administrative Officer Sally Reed said at a weekly press briefing. “It’s starting to get very late.”

On Monday, Reed sent an “urgent” missive to county supervisors, asking them to personally call state officials who are considering helping the county with up to $433.9 million in health care funds.

“Please make the calls today,” Reed wrote, underlining those words to underscore that the money is “critically needed to help the county stabilize its health care delivery system.”

Of particular concern, Reed reminded the supervisors, is a meeting today of the California Medical Assistance Commission, a little-known independent state agency that would play a critical role in freeing up much of the federal health care funds for the county, along with state legislators and Gov. Pete Wilson.

County officials said they will begin closing some of the six county hospitals if any of the necessary approvals fall through. Under extraordinarily complex funding mechanisms, however, significant pieces of the bailout need to be approved by the medical assistance commission, while other parts rely on state and federal health officials and state legislators.

How to secure all those approvals in a matter of days will present the county with its most challenging task yet, after months of scrambling for desperately needed help, county officials said.

“We are right down to the wire,” said health czar Burt Margolin, who added that his staff and county officials will try to compress several months of work into a few short days. “There is no margin for error. We cannot afford to have any piece of this funding fall through.”

For instance, a top-level county delegation, including Margolin and Department of Health Services Director Robert C. Gates, was planning to go to Sacramento to plead the county’s case to the commission. At the last minute, Margolin said late Monday, he decided to stay home to woo a group of federal officials who have promised to come to town today after weeks of delay, to discuss the federal health care money.

One bottleneck is that the medical assistance panel cannot even consider granting approval until the federal officials do so, making the federal delays all the more nerve-racking, state and county officials said.

“It’s been on again, off again, on again, off again,” said commission Executive Director Byron Chell. “Meanwhile, Oct. 1 approaches.”

“I’m frustrated, just like everybody else associated with this,” Chell said. “But until we get resolution [from federal officials], this commission will not be in a position to act on the L.A. County request.”

Because approval by federal officials will not be in place by today’s meeting, the commission will meet at least once more before committing its approval. And since its next meeting is Sept. 28, Chell said, he is considering convening a special meeting.

Failure of the commission and state and federal officials to act “in a timely manner,” Margolin said, “could cause the collapse of a major health care system in the state.”

“We are . . . asking every level of government to collaborate under a time schedule they would normally dismiss as impossible,” Margolin said. He added that the delay by federal officials was only because of their furious efforts to get the appropriate permissions and establish complicated funding mechanisms.

Still, Margolin and Reed said, the federal money may not come in time to avert catastrophic health care cuts.

“It’s the age-old problem that we have in budgeting money that isn’t certain,” Reed said. “At what point do you write it off and deal with the problem. It is a very difficult, difficult issue.”

Meanwhile, Reed said she and other county officials were watching with concern the “very fluid” situation in Sacramento. State lawmakers are considering measures that could give the county $140 million--or end up shifting even more costs to the county. But with some lawmakers holding out for aid to Los Angeles County while others insist on more aid to bankrupt Orange County and other special interests, Reed said she fears that no compromise will be reached before lawmakers finish the legislative session by midnight Friday.

In fact, so much bad blood has arisen between warring factions in Sacramento, county officials said, that the whole bailout package may go down.

But some state and county officials grumbled that the five county supervisors’ failure to agree last week on how much transit funding to seek has not helped the county’s case. And neither has a squabble between board Chairwoman Gloria Molina and a state senator from Los Angeles who is trying to secure more funds for the county.

Sen. Richard G. Polanco (D-Los Angeles) had scheduled a meeting Monday of the Latino Legislative Caucus to discuss ways to protect the county’s interests in the waning days of the budget battle. But Molina--a political adversary of Polanco--told the senator she planned to crash the meeting because she hadn’t been invited. The meeting was abruptly canceled.