Little Opposition Voiced to New County Health Clinics

In contrast to the emotional testimony that greeted the Los Angeles County Board of Supervisors last week over impending layoffs, a public hearing Tuesday on the expansion of the county clinic network attracted only a handful of people--most of them proponents of the plan.

As part of an effort to steer its health care system away from inpatient hospitalization and toward less expensive outpatient care at community clinics, the county is seeking to more than double the number of its health centers--from 39 to 83--by the end of the year.

Most of the new centers are likely to be jointly operated by the county and private health providers.

On Tuesday, the Board of Supervisors held a hearing to elicit comment on the first phase of the clinic expansion, which will increase the services offered at 18 existing county health centers, including two centers that will be contracted out to a private health provider.

Because the health department has already agreed to give laid-off county health workers priority in getting jobs in the health centers--as well as whatever training is necessary--the plan encountered little opposition from the three speakers who signed up to comment.

“We are positive about the expansion,” Kathy Ochoa, a representative of Local 660 of the Service Employees Industrial Union, told the board.

Mark Finucane, director of the county’s Department of Health Services, said the expansion will open up 186 jobs in the clinics.

But memories of last year’s budget crisis--which forced the county to reduce services at its clinics and form public-private partnerships in six of its health centers--led to some skepticism about the relative rosiness of the health department’s plan.

Lynn Kersey, executive director of the Maternal and Health Access Project, told supervisors she was opposed to privatization and that the public knows too little about the privatized clinics.

“We need to know what kind of services are going to be offered,” she said. “We need to know more than the number of visits they will handle and the hours they will be open.”

After the meeting, Finucane said additional details will be available when the contracts are finalized and presented to the board for approval next Tuesday.

Finucane also said that next week the county will issue the results of a survey on customer satisfaction regarding the care and services provided at the clinics privatized last year.

Overall, Finucane said, the privatized clinics have performed well, although the number of privatizations in the next two or three months could lead to abrupt transitions for patients.

“It is an incremental change for both us and the people who work for us,” Finucane said. “It’s going to take growing pains, which are better than shrinking pains--which we’ve had enough of.”

Last week, the board voted to lay off more than 500 county employees at Rancho Los Amigos Medical Center in Downey, County-USC Hospital and Olive View/UCLA Medical Center in Sylmar.

To pay for the mammoth reorganization, the county is using a $364-million bailout from the federal government received last year when the system was on the verge of collapse.