Los Angeles County Supervisors Unanimously Approve Deep Cuts to Health System, Including Closure of 11 Public Clinics

The Los Angeles County Board of Supervisors on June 26 approved "the deepest cuts ever" to the county's health system, voting unanimously to close 11 of the county's 18 public health clinics, end inpatient services at High Desert Hospital and lay off 5,000 health workers, the Los Angeles Times reports. When fully implemented, the plan would save about $150 million. The vote came during final negotiations over the county budget, with supervisors stating that the county does not have enough money to sustain the current system. Since 1995, the county health department has relied on two five-year, $1 billion "bailouts" from the federal government. The bailout funds begin to decrease next year and run out completely by 2005. As part of the agreement resulting in the bailouts, supervisors had promised to streamline the health system, a condition had not met until the vote June 26. "We have to do what we probably should have been doing five years ago," Supervisor Yvonne Burke said. The supervisors added that the health department should "prepare for far more severe" funding cuts in October if they fail to convince the federal government to give the health system an additional $350 million. Those cuts could reduce or eliminate emergency room and inpatient services at two hospitals, possibly Olive View and Harbor UCLA Medical Center. Supervisors also voted to spend $4 million in surplus funds to maintain a program for low-income mental health patients.

Not Over Yet
The plan approved June 26 still must be debated at public hearings this summer, after which time supervisors will vote on the plan again. If they approve it, the clinics would close by October. Labor unions and health care advocates have pledged to "fight" to keep the clinics open, possibly through legal action. The county health care system cares for 800,000 people each year, most of whom are uninsured and "have nowhere else to go," the Times reports. Mandy Johnson, who represents private clinics that will undergo a 25% funding cut, said, "Billions of dollars were found to fight terrorism ... [and] save airlines. How do you tell people with no health insurance ... that there is no appointment available for their sick child, their diabetic mother or father with bronchitis?" Labor leaders and health advocates said that the supervisors have "enough money on hand" to maintain full funding for the health department for another year, adding that supervisors are "moving too fast." The health department has $160 million in reserves for next year, and the county has nearly $500 million. Some supervisors directed the county health department to consider proposals that would maintain inpatient services at High Desert Hospital and explore options to reconfigure the health care system (Riccardi et al., Los Angeles Times, 6/27).