LOS ANGELES COUNTY: Medicaid Waiver Negotiations Reach Impasse
The Los Angeles County Board of Supervisors announced Tuesday that it will halt expansion of all outpatient programs, after negotiations with state and federal government officials over health care funding broke down, the Los Angeles Times reports. County officials plan to freeze up to $30 million in expenditures "to lessen the [potential] catastrophic meltdown" in public health services if a $1 billion Medicaid waiver is not renewed. County, state and federal officials have yet to determine how to split the bill for public health services; each branch of government thinks the others should pay more. But time is running out, as the current waiver is set to expire June 30. For its part, the county proposed spending half of its annual $120 million tobacco settlement on health care for the poor. Gov. Gray Davis (D) also included some additional health care money in his revised budget, but the exact amount earmarked for the county remains "unclear." At the federal level, HHS Secretary Donna Shalala unofficially guaranteed that the waiver will be granted, but HCFA "is driving a harder bargain now than five years ago."
Officials argue that the decision to freeze health care funds for outpatient care "jeopardizes the financial future of more than 100 not-for-profit clinics" throughout the county. Most officials anticipate a resolution to the current funding crisis, but some worry that the approval may simply provide a "Band-Aid" solution that would only temporarily halt deficits, which could reach $700 million in several years. As county clinics face increasing patients loads on limited budgets, "the unravelling [of the county's public health system] has already begun," Beth Osthimer, a lawyer for San Fernando Valley Neighborhood Services, said (Riccardi, 5/24).