Los Angeles Supervisors Approve Closure of Five Clinics; Larger Health Cuts Loom
As expected, the Los Angeles County Board of Supervisors yesterday approved a plan to close five county health clinics and to consolidate some positions within the county's health department, marking the first, small step toward reducing the department's projected $688 million deficit, the Los Angeles Times reports. The plan will reduce the department's $2.5 billion budget by $8.5 million, a "continuation of the agency's 10-year trend of nipping and tucking," the Times reports. Acting health director Fred Leaf said that the plan, which will lead to the closure of "underutilized" facilities in Northeast, Compton, Sepulveda, Paramount and Burbank, "will not result in significant changes, but will set the tone" for future cuts. He added that the changes approved yesterday could eventually save the health system $100 million a year. But Supervisor Zev Yaroslavsky said, "This is nothing. The big bucks are not in health clinics or in public health; they're are in the hospitals" (Larrubia, Los Angeles Times, 1/30). Supervisors are expected in March to choose among long-term options that range from closing all county hospitals and clinics and privatizing the system to leaving open only emergency, trauma and acute care services (Anderson, Los Angeles Daily News, 1/30).
Buoyed by a federal bailout that began in 1995, the health department has enough cash reserves to cover the losses it expects to suffer next year. But after the bailout begins to be phased out next year, the department will face an estimated $364 million deficit in fiscal year 2004 and a $688 million deficit in 2005. The report released yesterday by the department said that the county's attempt to reform the health system by sending uninsured patients to lower-cost clinics rather than hospitals for treatment -- a shift that the federal government required when it approved the bailout in the form of a Medicaid waiver -- has not produced expected cost savings. According to Beth Osthimer of San Fernando Valley Neighborhood Legal Services, the only remedy for the department's financial troubles is more federal help. "You can't cut your way out of a $600 million deficit. It's a closure of the system" (Los Angeles Times, 1/30). But Supervisor Gloria Molina said the chances of receiving help from either federal or state officials are not good. "I don't think George Bush is going to help us. I don't think he should when our own state Legislature is not helping," she said (Los Angeles Daily News, 1/30). Finding long-term solutions to the department's financial troubles will be left to Dr. Thomas Garthwaite, former undersecretary of health for the Department of Veterans Affairs, who will assume control of the health department next week (Los Angeles Times, 1/30).
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