L.A. County may close most of its clinics

Los Angeles County healthcare officials unveiled a draft cost-cutting plan Wednesday that calls for closing all but one of the county's dozen clinics and reduces services at its six comprehensive outpatient health centers.

Officials said a $195-million deficit make the cuts necessary even under a "best-case scenario" for the badly strapped public healthcare system. The county faces the threat of more reductions in state and federal aid in the next few months. Health department officials have privately floated the possibility of deeper cuts if the projected deficit grows.

The current proposal, if approved by the Board of Supervisors, would dramatically retreat from the county's longtime role in providing primary care to the indigent. The clinics and comprehensive centers get about 400,000 primary care visits a year, nearly two-thirds from uninsured patients.

Officials said they plan for private, nonprofit clinics to step into the gap and provide care to most of the displaced patients for a lower cost than the public system. The county currently has contracts with private clinics, and those would be expanded.

But several healthcare advocates questioned the proposal."On paper, it looks like they're trying to achieve savings without cuts in services, but the numbers leave more questions unanswered," said Yolanda Vera, director of LA Health Action, which advocates for improved community healthcare for the poor.

Lark Galloway-Gilliam, executive director of the advocacy group Community Health Councils, said the county had failed to make good on promises to expand specialty healthcare in South L.A. after closing Martin Luther King Jr.-Harbor Hospital last year. The area, she said, already lacks enough private clinics.

"In South L.A., there is a heavy reliance on county clinics," she said. "It's very scary."

County officials said the plan would allow them to focus on protecting the most crucial parts of the region's safety net: trauma, hospital and specialty care services. The state and federal governments reimburse the county for much of that care.

"What we're trying to do is keep the safety net intact," said John F. Schunhoff, chief deputy director of the county Department of Health Services. "If we're successful . . . we're going to be preserving patient care. We're just shifting who's providing it."

But closing the clinics could shift many patients into the already overburdened hospitals.