Feud Over Funds May Put Crimp in Health Care

Los Angeles County’s system of public hospitals, clinics and other health facilities, facing more than $80 million in cuts in the next fiscal year, is confronted with another, more immediate problem: $10.2 million in budgeted funds needed for current services may not be available.

The latest bad news is the result of a continuing failure by Gov. George Deukmejian and the Legislature to resolve a long-running 1986 dispute over how to finance that year’s health appropriation. The dispute has lingered on, unsettled, even while the governor prepared his $39-billion budget--released Thursday--for the fiscal year that begins July 1.

County officials said that unless at least some part of the $10.2 million is restored soon, they could be forced to reduce the number of beds at major hospitals and the hours that neighborhood clinics are open. The clinics provide medical services ranging from prenatal care to treatment for serious illnesses to about 6,000 low-income patients each month.

Officials said that the loss of the $10.2 million could force curtailment of services at one clinic that treats drug addicts at Rancho Los Amigos Medical Center in Downey and at two comprehensive health centers--the H. Claude Hudson Center in South-Central Los Angeles and the El Monte facility--which provide such services as abortions and vasectomies.

Officials said the largest reductions would be at various general, medical and specialty clinics at County-USC Medical Center and outpatient clinics that treat about 400 heart patients and diabetics a month at Martin Luther King Jr.-Drew Medical Center. Harbor-UCLA Medical Center in Torrance could lose 29 surgery beds serving about 90 patients a month and one or more of the major hospitals could shut down orthopedic surgery services, consolidating them with other facilities, officials said.

“To the best of our ability, we would curtail services as opposed to completely cutting them out,� said Carl Williams, assistant county health director.

Williams said the Board of Supervisors must decide in the next few weeks what course to take, but he predicted that whatever happens, longer waits at local hospitals and clinics will result. The board could make a special appeal to the Legislature for the funding or dip into county general funds to keep the threatened services going. The state had provided six months of interim funding for those services, but that money technically ran out Dec. 31.

The crises of county health funds stems from a dispute between Deukmejian and the Legislature. Last summer, the governor vetoed about $50 million in state health funds, contending that the money for the programs should come from the state Public Employees Retirement Fund. Democratic lawmakers, however, objected and argued that the health money should come from a state budget surplus, believed generally at the time to be about $1 billion.

Surplus Funds Drained

But state officials disclosed recently that lower revenues and higher Medi-Cal expenses have drained much of the surplus.

At first, Los Angeles County’s portion of the health funding shortfall was about $29 million. Later, interim state legislation reduced it to $10.2 million.

One county lobbyist, who asked not to be named, said Friday there is still hope that the state funding will be found, but he was not very optimistic.

“The same problem exists today as existed all along,� the lobbyist said, referring to the disagreement between Deukmejian and the Legislature.

Williams, citing the governor’s just-released spending priorities, also said the cuts are likely to be made.

“We’re not very optimistic from what we hear that money would be passed along (to the county),� Williams said.

An Administration spokeswoman in Sacramento agreed that there is no apparent agreement on the immediate horizon.

“There is no other money as far as we’re concerned,� said Lois Wallace of the Department of Finance.

Next week, state Sen. Alan Robbins (D-Van Nuys) is expected to propose legislation to restore the balance of the vetoed cuts, a Robbins spokeswoman said. But what is not included in the appropriations bill, which Robbins will sponsor at the county’s request, is the funding source.