Budget Deficit Raises Possibility of Closing L.A. County Health Clinics

Only one county-run health clinic would remain open under a plan Los Angeles County health officials put forward on Wednesday as part of an effort to address a projected $195 million budget deficit for the county health department, the Los Angeles Times reports.

The plan calls for the county to expand contracts with private, not-for-profit clinics to provide medical services to uninsured patients. Medi-Cal beneficiaries and patients with limited insurance who currently use county clinics would have to find other sources of care.

The county health department would shift its focus to maintaining trauma, hospital and specialty care services.

If approved, the plan would not close 14 centers run by the county Department of Public Health, nor would it close the county's clinic in the South Antelope Valley because county officials could not identify a private clinic to provide similar services in the area.

Similarly, county Chief Executive William Fujioka said that if the plan were approved, clinics would not be closed until the county ensures that a private clinic would take over the services.

County health officials say closing the clinics would save the county about $73 million, with some savings being used to fund other services. For example, $10 million would be used to cover the cost of specialty services, while the county would channel another $25 million to private clinics to treat uninsured patients.

The county also is using savings from previous years to help address the budget deficit.

Privately, county health department officials have floated the idea of closing comprehensive health centers administered by the county, according to the Times.

Los Angeles County health officials could face a budget deficit of $1.6 billion within four years, while more cuts to state and federal funding for health care programs are possible (Leonard/Vara-Orta, Los Angeles Times, 2/14).

On Tuesday, the Los Angeles County Board of Supervisors met to discuss the future of Harbor-UCLA Medical Center, which recently failed an inspection and is expected to be penalized by federal regulators, the Times reports.

Bruce Chernof, county health services director, told the supervisors last week that federal officials will be citing Harbor-UCLA for placing its emergency department patients in immediate jeopardy because of overcrowding and delays.

Harbor-UCLA is the third county-owned hospital in recent months to be cited for violating federal patient care standards for deaths in the ED. The citation also comes six months after the county closed the ED at Martin Luther King Jr.-Harbor Hospital in Willowbrook after it failed several federal inspections and lost funding.

During Tuesday's meeting, supervisors criticized Chernof for not determining how waiting times at Harbor-UCLA's ED had changed since the closure of King-Harbor. Chernof also could not tell the board how the waiting times at Harbor-UCLA compared to private hospitals nearby and noted that he was working with private hospitals to determine how to measure wait times, according to the Times (Engel, Los Angeles Times, 2/13).

KCRW's "Which Way, L.A.?" on Wednesday included a discussion about the future of Harbor-UCLA. Guests on the program included:

• Michael Cousineau, professor of research at the Keck School of Medicine at the University of Southern California; and
  
• Jim Lott, executive vice president of the Hospital Association of Southern California (Olney, "Which Way, L.A.?," KCRW, 2/13).