Most services at six county comprehensive health centers and 22 outpatient clinics slated for closure will be maintained under a plan approved by Los Angeles County supervisors.
The plan also keeps alive some hospital-based outpatient departments within the six county hospitals with the intention of relicensing them as freestanding clinics in the future.
The plan, developed by Burt Margolin, county health crisis manager, was made possible by a $364 million federal relief package in the form of a Medicaid waiver promised last month by President Clinton. The county is counting on the money, although it's still in the process of formally applying for the waiver. The bailout is needed to close a healthcare budget deficit of $750 million.
The funds also will keep all county hospitals open for the remainder of the fiscal year ending June 30, 1996, according to Judy Hammond, a county spokeswoman.
Meanwhile, the county will implement cuts totaling $285.4 million beginning Oct. 15. The cuts include laying off or demoting 3,300 healthcare employees.
The comprehensive health centers will receive 90% of their current funding.
The outpatient clinics will receive 75% of their current funding and remain open while supervisors continue to approve contracts for their privatization. So far, contracts have been awarded to private companies to operate six of the 22 clinics slated for closure.
Service Employees International Union Local 660, which represents most of the healthcare workers, filed suit late last week to halt privatization of the clinics on the grounds that it would violate union contracts with the county.
Margolin said several more weeks of "detailed negotiation" are needed to complete the Medicaid waiver application, which must be approved by HCFA, and to resolve details that "will be enormously important to the county's future restructuring plan."
The waiver is tied to a requirement that the county restructure its health services to focus on outpatient care.
Margolin called on supervisors to "act quickly to appoint a new director of health services" to provide the necessary leadership in restructuring the healthcare system. The current director, Robert Gates, will retire Nov. 1.