THE COUNTY BUDGET CRISIS : Health Crisis Chronology

The health care crisis in Los Angeles County was a long time in the making. It resulted from decreased revenues due to a stubborn recession, cuts in state and federal funding, a huge shift of property taxes from local governments to the state, increased scrutiny of county fiscal practices by financial institutions, and the county’s inability to adapt to changes in patient population and health care delivery systems. Here is a brief chronology of key events:

* September, 1992Gov. Pete Wilson signs $57.4-billion state budget, including a shift of $1.3 billion in property tax revenues away from local governments, reflecting a 45% decrease in the state’s contribution to county coffers.

* July, 1993State budget of $52.1 billion passed; $2.6 billion shifted from local governments to the state.

* May 24, 1995Robert C. Gates, head of the county Department of Health Services, announces his resignation, to become effective Nov. 1.

* June 15As part of a county budget balancing plan, Chief Administrative Officer Sally Reed recommends closing County-USC Medical Center.

* June 26Five-member Health Crisis Task Force, appointed by the Board of Supervisors, meets for first time to address the looming health care crisis.

* July 14Gates reveals that the department’s deficit is $90 million worse than the $655 million previously estimated.

* July 24Health Crisis Task Force calls for appointment of health czar and urges closing 34 of 45 clinics in lieu of closing county hospitals.

* July 25Health Crisis Task Force issues report warning that entire county health system is in danger of collapse.

* Aug. 1Board of Supervisors adopts $12-billion budget calling for sweeping health care cuts. Burt Margolin, a former state lawmaker who is an expert in health care issues and chairman of the Health Crisis Task Force, is named “health czar” by supervisors.

* Sept. 1Official deadline for county facilities to stop accepting new patients. Patient traffic in private hospital emergency rooms climbs 11% the week ending Sept. 2.

* Sept. 15Layoff notices are delivered to 4,166 county health care workers. Demotion notices given to 1,034; 1,500 notified they will be transferred when closures begin Oct. 1.

* Sept. 16State legislators approve an unprecedented shift of $150 million from the Metropolitan Transportation Authority to the county treasury to help avert worse cuts in the health care network than already planned. But the Legislature fails to adopt $135 million in additional aid that the county had been counting on.

* Sept. 18Emergency room nurses at County-USC Medical Center stage a sickout to protest pending layoffs, briefly forcing the closure of the emergency room and trauma unit at the nation’s largest public hospital.

* Sept. 22President Clinton announces a $364-million rescue package to bail out the county’s crippled health care system for the present and requires local officials to implement much needed reforms.

Source: Times files