Los Angeles County Officials Approve 25% Reduction in Subsidies for Private Clinics

Los Angeles County officials on Sept. 24 approved a 25%, or $12.5 million, reduction in funding for the county's "public-private partnership" program, which provides subsidies to private clinics, signifying a "further fraying of a 'safety-net' health system that is supposed to serve the poor and uninsured," the Los Angeles Times reports. The cuts, "effectively made in June" and finalized this week by the county Board of Supervisors, come after the county already approved closures for several public clinics (Cardenas/Briscoe, Los Angeles Times, 9/25). As part of a plan to help reduce a Los Angeles County health system budget deficit expected to reach $710 million in three years, the Board of Supervisors on Aug. 21 voted to close 11 of the county's 18 public health clinics and four school-based health centers, as well as end inpatient services at High Desert Hospital in Lancaster, Calif. The plan will also reduce funds for childhood immunizations, tests for sexually transmitted diseases and examinations for communicable diseases. In addition, the county will lay off 4,230 health care workers by 2006 (Kaiser Daily Health Policy Report, 8/22). The cuts in funding for private clinics seem to "undermine the health care model adopted in 1996" by the county, which "relied heavily on public-private partnerships" to provide care for the poor and uninsured, the Times reports. More than 150 private clinics have been cut from the program, and of the 98 clinics that will continue to receive funding, half will receive less money from the county than they did last year. County officials took into account federal accreditation, diversified funding sources, offered services and location to determine which clinics it would continue to fund. Some of the clinics that will not be receiving county funding this year are applying for grants and considering charging indigent patients for care, the Times reports. For the clinics that will remain open, some are cutting operating hours, seeing fewer new patients and eliminating staff members. Linda Dacon, executive director of Clinica Para Las Americas in Los Angeles, said, "We expected to get cut but not eliminated. How do I pick and choose who gets an appointment? That's what wakes me up at three in the morning" (Los Angeles Times, 9/25).