Los Angeles Times Outlines Three Plans to Restructure Los Angeles County Health Department

The Los Angeles Times today examines three options being considered by the Los Angeles County Department of Health Services to cut costs in preparation for a projected $688 million budget deficit by 2005. The scenarios are contingent upon how much financial aid the county will receive from the state and the federal government (Riccardi/Therolf, Los Angeles Times, 5/23). The health department has been financially faltering for 10 years partly because Los Angeles County has nearly three million uninsured residents who rely heavily on county facilities and programs. The county faced bankruptcy in 1995 before receiving a $1 billion federal bailout, which is scheduled to be phased out beginning next year. As part of the agreement resulting in the bailout -- provided in the form of a Medicaid waiver -- the federal government required the county to send uninsured patients to lower-cost clinics rather than hospitals. A report released Jan. 29 by the health department indicated that the shift has not produced expected cost savings (California Healthline, 5/2). Last month, county officials traveled to Washington, D.C., to ask federal officials to provide the county a block grant and additional payments for outpatient care. The following is a description of the three proposed plans that would address the projected budget deficit.

• Under the most "pessimistic" plan, which the Times reports is "unlikely" to happen, the county would close all public hospitals except for County-USC Medical Center in Boyle Heights and Martin Luther King Jr./Drew Medical Center in Willowbrook. In addition, more than 100 county health clinics would close. The plan assumes that the county would make no "financial reforms."
  
• Under the plan that "best reflects the county's present circumstances," the county would convert Harbor-UCLA Medical Center near Torrance and Olive View-UCLA Medical Center in Sylmar into "large-scale" outpatient facilities, change High Desert Hospital in Lancaster to a clinic and force Rancho Los Amigos Medical Center, a rehabilitation facility, to operate independently of the county system. The plan assumes the county will receive no additional money from the state or federal governments.
  
• Under the most "optimistic plan," the county would close only the emergency room at Harbor-UCLA Medical Center, eliminate trauma services at King/Drew Medical Center, reduce the number of beds at Olive View-UCLA Medical Center and change High Desert Hospital to a "beefed-up" outpatient facility. The plan assumes the county would receive additional federal funds.