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Davis seeks federal help to aid ailing LA County health system

Wednesday November 27, 2002

By ALEXA H. BLUTH
Associated Press Writer

SACRAMENTO (AP) Gov. Gray Davis and Los Angeles County officials are asking for waivers of federal rules to help ease a fiscal crisis that forced the closure of 11 clinics in the nation's second-largest public health system.

Davis and county leaders submitted a plan to the Bush administration Wednesday that health officials said would preserve emergency and inpatient services at two major hospitals and could stabilize Los Angeles County's beleaguered health care system for five years.

The state-county plan asks the federal government to ease regulations that penalize hospitals for using less-costly outpatient care, and urges the renewal of a federal waiver that allows the state to accept competitive bids to serve patients on Medi-Cal, the state's version of Medicaid.

The plan submitted Wednesday does not ask the federal government for more money, but rather would ``allow us to use the moneys already allocated in a creative fashion that solves problems up and down the state,'' Davis said.

``There is no solution to this problem in Los Angeles or throughout the state without the federal government continuing to play the role as a senior partner,'' Davis said.

The Los Angeles County Department of Health Services faces a major deficit, even with voter approval earlier this month of a property tax measure that will generate some $168 million annually for emergency rooms, trauma centers and bioterrorism preparedness.

Around the state, county health departments faced with budget problems are slowing or cutting spending, blaming the state budget crisis, a rise in uninsured patients, reduced medical reimbursements and reduced state and federal spending.

Before the passage of Measure B, the health care deficit was projected to reach $1.4 billion over five years, threatening to force the county into bankruptcy. The tax measure is expected to provide a total $6 to $7 million and the proposed federal waivers would provide another estimated a total of $7 to $8 million over the next five years, said Tom Garthwaite, director of Los Angeles County Health Services Department.

County supervisors voted in August to shutter 11 of 18 public health clinics and cut $56.8 million from its health care budget. Proposals are on the table to close emergency rooms and inpatient services at Harbor UCLA and Olive View medical centers, in addition to scrapping a programs that gives money to privately run health clinics.

The new proposal could mean ``we can probably take those draconian cuts off the table,'' said Jim Lott, executive vice president of the Health Care Association of Southern California, a hospital trade group. ``We can stop looking at wholesale cuts to the health care system in Los Angeles for at least three years; that's a positive thing.''

The county previously asked for a $1.4 billion bailout from the federal government, but federal officials indicated they were opposed. Now, officials are asking the federal government to:

Change financial incentives for hospitals to hospitalize Medi-Cal patients instead of promoting treatment in more efficient outpatient settings.

Renew a waiver for the state's Selective Provider Contracting Program, in which hospitals bid for the state's inpatient Medi-Cal business leading to lower rates for Medi-Cal. The state distributes some of the saved money to about 80 safety-net hospitals and it is used mainly for trauma care. California has encountered resistance from the Bush administration in its latest request to renew the waiver.

Davis said state and county officials will meet next month to discuss the plan.

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On the Net: http://www.lacounty.info

(Copyright 2002 by The Associated Press. All Rights Reserved.)

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