Physicians at county health clinics, faced with possible closures or major cuts in the next fiscal year, joined Supervisor Deane Dana last week in warning that the proposed cuts would hurt the county's poorest residents and ultimately could cost more money than they save.
Dana unsuccessfully sought the backing of the Board of Supervisors to remove the 15 health clinics--including one in Pomona and one in Monrovia--from a "hit list" of potential cutbacks that will be considered at the county's budget deliberations in June, when officials grapple with a projected $170-million budget shortage.
Dana's motion was rejected on a 2-2 vote, with Supervisors Ed Edelman and Pete Schabarum opposing Dana and Supervisor Michael D. Antonovich supporting him.
If the cuts are adopted, the county would reduce costs by about $570,000 monthly, eliminating about 15,650 patient visits per month from the clinics. The county would drop services for ambulatory patients at eight health clinics, and seven clinics would be shut down.
Badly Needed Services
Dana said the 15 clinics are in communities where the county's low-cost or free health care is badly needed.
"What we are talking about here are the homeless, elderly people and children--the people who are the very reason why we opened these clinics in the first place," Dana said. "Saving these programs will be a top priority for me."
If the supervisors approve the cuts this summer, ambulatory care would be discontinued at the Pomona Health Center, 750 S. Park Ave., Pomona, and the public health clinic would be closed at the Monrovia Health Center, 330 W. Maple Ave., Monrovia.
Dr. Erica Watson, a district health officer in Whittier, said many patients may seek services at El Monte Comprehensive Health Center if cuts are approved in those areas and in Whittier and Pico Rivera, whose clinics are also under consideration for cutbacks.
"In the outer areas, we have only two clinics--Pomona and Whittier--that have adult ambulatory care," Watson said. If they are shut down, patients will have to wait for long periods to get an appointment in El Monte, which already has a waiting list.
Dr. Michael Langer, district health officer at the Hollywood-Wilshire Health Center, which also faces major cuts, said many poor patients have little transportation available to them, yet would be forced to travel long distances to visit other county facilities.
He predicted that some patients would become discouraged and "would just put it off and let it slide and perhaps end up in an emergency room or the hospital."
Edelman said he did not want to spare the clinics from budget deliberations because he wants to send a message to Sacramento that the county may face a health-care crisis unless the state picks up a larger share of the health-care bill for the poor.
In recent years, the state has shifted more of the burden for caring for the poor to individual counties, and Los Angeles County officials have lobbied for increased state funding.
"I want to get the attention of the governor and the Legislature," Edelman said.
Edelman said he hopes that when state officials see the deep cuts the county is considering, "they will understand what a dire situation we are facing."
Dana said that while he agrees that the county should exert pressure on the state, "if you have 10,000 or so people going to health clinics and then suddenly close them down, people are going to have to go find other county health facilities that will be more difficult to get to and even more crowded. That will cost the county at least the same dollars, or maybe even more."
Dana questioned the wisdom of closing public health clinics, which he said provide "the most basic health services," including prenatal care, immunizations, hypertension screening and children's health care.
"The screening and treatment of sexually transmitted diseases and communicable diseases would be eliminated from these local clinics," Dana told the board. "At a time when we are increasing services for acquired immune deficiency syndrome, it would be counterproductive to eliminate the clinics."
Patients who use the county's health clinics generally pay a fee of $25 per visit. They also can ask to participate in the county's sliding-scale, ability-to-pay program, in which the poorest people are given medical care at no charge and others who qualify are charged a few dollars.