With plans to close a rehabilitation hospital ensnared in court, the director of Los Angeles County's health department said Monday that the next option is to slash services at other public hospitals and clinics.
The first to feel the budget knife would probably be Edward R. Roybal Comprehensive Health Center in East Los Angeles, as well as other clinics sprinkled throughout the county, said Thomas Garthwaite, director of the Department of Health Services.
Closing emergency rooms at Harbor-UCLA or Olive View-UCLA medical centers also remains a possibility, but the health director said he would be reluctant to do so after voters in November approved a property tax to fund trauma and emergency care.
"We're not obligated to keep open Olive View or Harbor, but we're very sensitive to the fact that voters voted to stabilize the trauma network," Garthwaite said.
County Chief Administrative Officer David Janssen, meanwhile, said the county would not divert money from other struggling agencies to the health department.
"That just isn't going to happen. The money isn't there," he said. "It would have to come out of deeper cuts in public safety."
Most of the county's $16.5-billion budget is earmarked for programs mandated by the state and federal governments. Of the $1.3 billion left to the county's discretion, about 38% goes to the sheriff, probation, district attorney and other public safety agencies. Less than 10% goes to the health department.
County leaders have been forced to reconsider the health budget in the wake of a federal court order that temporarily blocked the closure of Rancho Los Amigos National Rehabilitation Center in Downey. The same judge will hear arguments next week in another lawsuit seeking to save Rancho, as well as preserve 100 beds that the county intends to cut at its flagship hospital, County-USC Medical Center.
If the court ultimately rules against the county in both cases, Garthwaite said, the health department will need to squeeze about $75 million per year from other parts of the struggling system.
Also on Monday, Garthwaite dismissed a California Community Foundation plan to convert Rancho to a nonprofit operation. In a six-page report to the Board of Supervisors, he said the plan was too financially risky because it would cost at least $18 million to keep Rancho open for another year with no guarantee that a nonprofit hospital would take it over.
"The assumption that a nonprofit operation can be in place by July 1, 2004, should be viewed with caution," Garthwaite told the board, "since no hospital has expressed explicit interest so far."
Instead, he said, the county should stick to its closure plan.