Wednesday, June 28, 2000, Los Angeles Daily News
DEAL TO MAINTAIN COUNTY HEALTH SERVICES
By Troy Anderson, Staff Writer
Narrowly averting bankruptcy of Los Angeles County's public hospitals and clinics, federal, state and county officials agreed Tuesday to a $1.2 billion bailout, with penalties for failing to cut inpatient care.
Breaking an impasse in negotiations, Supervisor Zev Yaroslavsky said federal, state and county officials in Washington, D.C., reached an 11th- hour accord designed to wean the health care system off outside money over the next five years.
"Almost immediately, the county will have to seriously begin to position itself for restructuring. There is some real pain associated with this waiver," Yaroslavsky said.
Supervisor Michael D. Antonovich said he is concerned about whether the county's health-care system can become self-sufficient after five years, calling the pact potentially a "five-year meltdown."
The state has agreed to contribute $300 million, while the federal government will contribute $900 million. The county will spend $80 million a year -- $60 million in tobacco revenues - for a total of $400 million in the next five years, Yaroslavsky said.
The contributions -- in the form of a waiver from Medicaid rules -- are modeled after a deal the county won five years ago to save the sprawling health care system from financial collapse.
The difference this time is the county is on its own come 2005, and it must log 3 million patients a year at its 170 outpatient clinics or face large fines. About $96 million in state and federal money could be withheld if the county fails to keep those numbers up, officials said.
"While preserving health care treatment for low-income residents, this agreement institutes tough new accountability measures to assist Los Angeles in moving away from emergency room care and toward community health clinics," Gov. Gray Davis said.
Projections for the year ending June 30 show the county is meeting the 3 million mark, said John Wallace, spokesman for the county Department of Health Services. "The county is committed to maintaining those numbers."
For the uninsured people and clinic and hospital workers, news of the agreement brought happiness and relief.
"Hallelujah!" exclaimed Gretchen McGinley, who oversees eight Valley Care Health Centers. "The closer we came to July 1 the higher everyone's anxiety level was."
Dr. Ricardo Puertas, a physician at El Proyecto del Barrio Family Health Care Clinic in Pacoima, said the agreement eases worries for many patients.
"This last week we had patients who didn't know what they were going to do. Some of them planned to rely on their families to pay for their medications," he said.
Under the proposed agreement, which must be ratified by the federal government, the Governor's Office and county supervisors, Wallace said the health department does not expect any cuts in services.
"The bottom line is we'll be able to keep the service level that currently exists," Wallace said.
The agreement also commits up to $40 million in state and county funds to train or retrain workers affected by the county's efforts to restructure its health care system.
"We have some difficult times ahead of us," Supervisor Don Knabe said. "For us to become self-sustaining is going to be very difficult."
Yaroslavsky said he had conversations with U.S. Sen. Dianne Feinstein, D-Calif., and President Clinton over the weekend about the waiver.
"I laid out an idea on how we could break the logjam, which she (Feinstein) endorsed and today we have a deal," Yaroslavsky said. "The president heard our plea. We were so close for so many weeks to a deal that it made no sense for this to go on."
================COMMENT================
Yaroslavsky didn't take into consideration that in another five years, if the illegal alien explosion continues at the same rate, there will be a need to serve 6 million patients -- not 3 million.
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