A nurses' sickout triggered by Los Angeles County's fiscal crisis led to an ambulance diversion from LAC-University of Southern California Medical Center and apparently contributed to a gunshot victim's death.
At the end of a week from hell for healthcare facilities-including another sickout by nurses at County-USC's outpatient clinic-county supervisors were considering another proposal by County Administrator Sally Reed to close that hospital. The nation's largest public hospital was thought to have been spared by the scheduled closing of most county outpatient clinics Oct. 1.
Meanwhile, at press time there were reports that President Clinton was working on a bailout plan. A White House official traveling with Clinton in Los Angeles said the federal government and Los Angeles County were "close to a deal to bail out the Los Angeles County health system." The official declined to confirm a report in the Los Angeles Times that the federal contribution would total $364 million.
The county is facing a $1.2 billion budget deficit-more than $650 million of it in healthcare services.
"The situation to us is absolutely bleak," said Jim Barber, president of the Healthcare Association of Southern California, "and the hope that keeps emerging on different issues keeps getting beat down because.....the money isn't there."
The County-USC nurses were protesting the layoff of some 300 emergency-care staffers countywide as part of the layoff or demotion of 5,200 healthcare workers. County supervisors quickly ordered the emergency-room personnel rehired.
The gunshot victim died after he was turned away from County-USC during the sickout. Doctors said the unidentified man might have lived had he received speedy treatment at a trauma center.
The county was awaiting word on its request for a $178 million Medicaid demonstration waiver to permit a restructuring of the delivery system to outpatient-based care.
The state Legislature approved the transfer of $150 million from transportation funds to the county, $100 million of which would be a loan.
But supervisors fear putting the county deeper in debt.
Among the hospitals proposed for possible closure by Burt Margolin, county health chief, are 173-bed LAC-High Desert Hospital, Lancaster; 377-bed Olive View Medical Center, Sylmar; and 553-bed LAC-Harbor-UCLA Medical Center, Torrance. County-USC would remain open under his proposal.