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$8.9-Billion County Budget to Shore Up Ailing Health Care

May 21, 1988|VICTOR MERINA | Times Staff Writer

A Los Angeles County budget that would commit money for more public health programs and shore up a crumbling trauma-care system until the end of the year was proposed Friday as part of a record $8.9-billion spending plan.

But the proposed budget, released by Chief Administrative Officer Richard B. Dixon, remains reliant on the "precarious nature" of about $87 million in anticipated state revenues to meet the needs of county health-care programs.

"I don't think this office has ever presented to the Board (of Supervisors) a budget that so dramatically represents our dependence on the state," said Dixon in outlining his spending plan.

The proposal, which represents a $770-million increase over the current year's budget, includes $11.2 million in cuts in mental health-care programs and another $1.6 million in cuts in support services in various departments.

No Significant Cutbacks

But in contrast to previous years, Dixon said he is not asking the board to approve any significant cutbacks in either county programs or employees. "This is not a substantial retrenchment or layoff budget," Dixon said.

Instead, the spending plan calls for $128.9 million in funds to relieve jail overcrowding and court congestion and another $35.2 million to beef up law enforcement efforts against gangs, drug trafficking and violent crime.

Those proposals by Dixon generally reflect the law enforcement priorities of a Board of Supervisors that has been dominated over the last seven years by three conservatives: Mike Antonovich, Deane Dana and Pete Schabarum.

But with the supervisors buffeted by criticisms that they have not done enough to deal with health-care problems, they also have moved to funnel more money into health-care programs.

A week ago, the board voted unanimously to spend $2.7 million to intensify efforts to control an outbreak of syphilis as well as other sexually transmitted diseases. And in Dixon's proposal Friday, a similar amount of money was included as part of a package of public health programs.

In addition, $15.9 million was earmarked to expand AIDS treatment and prevention, including money for a hospice program. The additional dollars would raise to $53 million the amount of money the county is spending annually on AIDS, the deadly disease that has already claimed 4,916 victims, according to the latest county health figures.

As part of the health-care proposals, Dixon proposed $2.3 million to recruit and train nurses and another $21.6 million to salvage the county's trauma-care system and help persuade the county's private hospitals to remain in the financially troubled network.

Faced with mounting costs, seven hospitals have already abandoned what was once a 23-member trauma hospital network, and some of the remaining hospitals have promised to remain only until the fall--when county financing was scheduled to end.

Rely on State Funds

But even with a budget that Dixon said is more favorable than past years, he admitted that the county--and particularly the courts and the health services department--must rely on expected state funds or the county could be facing major cuts or "stringent expenditure controls."

Included in the anticipated funds is $135.3 million from the state to pay for trial courts and $87 million in revenue that is needed for health-care programs. Without those state dollars, the county would have to tap other, uncertain sources or cut back in other services.

Despite noting the "precarious nature" of the revenues in his budget and the recent disclosure of a $2-billion shortfall in state revenue this fiscal year and next, Dixon said Friday that he was optimistic that the state dollars would be forthcoming.

"We do believe that they are reasonable projections," Dixon said, "or we would not have included them."

Unlike last year's budget proposal, which had called for the elimination of county jobs, the current proposal projects an increase of 1,497 positions over the 74,403 budgeted positions. And the only department that appears to be facing major cuts is mental health.

Under Dixon's plan, the department will have to make $11.2 million in cuts because there is no state money available to finance the programs. Among the suggested cuts were reductions in outpatient and outreach services provided by county-operated mental health clinics as well as by private mental health providers.

Also, the department is facing another $7.4 million in cuts because it has apparently used up the state money for programs that were funded for only the current year.

Last year, the mental health department was faced with similar reductions until additional state funds were found to rescue the endangered programs. Now with the state encountering financial problems, it is uncertain whether that will happen again.

Richard Van Horn, executive officer of the Mental Health Alliance in Los Angeles County, said his organization and other mental health advocates are rallying in Sacramento on Monday to press for additional money for the county.

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