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Help May Be on the Way for Health System

Finance: Although no commitments are made, state and federal officials say they may be able to help close Los Angeles County's funding gap.


Los Angeles County officials received encouragement from state and federal officials Wednesday that aid may be coming for their ailing health system but got no financial commitments to patch a massive projected deficit.

They also were urged to delay a vote on closing hospitals and making other cutbacks until after the November elections.

The county Department of Health Services faces a deficit projected to reach between $500 million and $750 million in three years.

The county's top officers met in Washington with federal health financing officials to present a multiyear $1.4-billion bailout proposal that a key Bush administration official had dismissed last week. Though federal officials were noncommittal, they said they did not want to see hospitals closed and urged that supervisors delay any major decisions.

Meanwhile, Gov. Gray Davis, amid a campaign for reelection, huddled in Los Angeles with Supervisors Gloria Molina and Zev Yaroslavsky. He had earlier been chastised by fellow Democrat Molina for not being attentive enough to the woes of the nation's second-largest public health system.

After the meeting, Davis said that he was open to calling a special legislative session in January to address the Los Angeles County health-care crisis and that he hopes to put together some aid for the county by mid-November.

"Our goal is to keep the public system together, viable and serving the people of L.A. County," Davis said during a telephone news conference.

Later, however, a spokesman clarified that the governor had not committed to holding a special session.

"He's open to it if he sees a need for it," Davis spokesman Steve Maviglio said. "If there's a way to avoid it, I think he will. Much of it depends on what the feds do between now and then."

Despite requests to delay further cutbacks, county officials said late Wednesday that they were not ready to call off their scheduled Oct. 29 vote on closing Harbor-UCLA and Olive View-UCLA Medical Centers.

County health analysts say that in order to realize savings from shutting hospitals, the lengthy process of closing them must start this month.

"A vote on Oct. 29 is reversible," Yaroslavsky said, if state or federal aid comes through. "A delay of two or three months is not reversible" if aid is not forthcoming.

The county may also get political benefits from moving forward with cuts, though Yaroslavsky denied that was a motive. It may be in a better position to pry funds out of Washington and Sacramento, and voters may be more likely to approve a $168-million parcel tax that supervisors placed on the November ballot to fund emergency and trauma care.

Yaroslavsky called Wednesday's meetings incremental progress, saying that much work remains to be done. "This is all part of a mosaic that we have to piece together," he said. "To save the Los Angeles County health system, there are federal, state and local components."

The immense deficit results from the cost of providing medical care to 600,000 uninsured patients annually and delays in reforms over the years.

Immediate cuts approved in June, including closure of 11 clinics, brought the projected deficit down by about $50 million, to $750 million in three years.

Other cuts expected to take effect over time could pare it to about $500 million.

County health planners had expected Wednesday's meetings to be key in determining whether supervisors should proceed with another round of far more dire cuts. But after a 2 1/2-hour meeting in Washington with federal health financing officials, they said it is too soon to tell.

"We think it went reasonably well, and we don't have any commitments," said county health Director Dr. Thomas Garthwaite after the meeting. "We do have a commitment to work further, dig into the data and explore any alternatives."

David Janssen, the county's chief administrative officer, said that a week of follow-up meetings is needed. "You can't imagine how complicated all of this stuff is and how many moving parts, between the state, the county and the feds," he said.

County officials went to Washington with trepidation. Tom Scully, administrator of the Centers for Medicare and Medicaid Services, last week ruled out a significant bailout. But the county said the meeting was not decisive. "No doors were closed," county health spokesman John Wallace said.

Scully has indicated that he would rather see Los Angeles County get its money from the state, but California is wrestling with a projected $15-billion budget deficit next year.

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