County Budget of $9 Billion Leans Heavily on ‘Iffy’ Funds

Los Angeles County supervisors on Thursday approved a $9.03-billion budget that would shore up the county’s faltering emergency medical services--but the whole spending package relies heavily on state funds that have yet to materialize.

The board, amid a flurry of last-minute maneuvering and political horse trading, adopted the record budget after approving $157.9 million to be spent on the county’s emergency and trauma-care network, which health and hospital officials have warned is in danger of collapse.

At the same time, the supervisors failed Thursday to come up with enough money to avert the threatened closure of outpatient programs at seven mental health clinics. Dipping into their reserve fund, board members used nearly $2 million to delay the closing of outpatient programs at four other mental health clinics.

The Department of Mental Health, which absorbed nearly $16 million in cuts, was the hardest-hit county agency in a budget that turned out to be more than $856 million--or about 10%--larger than last year’s.

Banking on State Revenues

In voting unanimously for the spending plan, however, the supervisors acknowledged that they are banking on state revenues that may or may not be forthcoming.

“It’s a very iffy (budget),” board Chairman Deane Dana said. “We’ve got to convince the governor and the Legislature that we have serious problems and need additional funds, otherwise we will be back in the fall with major, major cuts in county services.”

“We’re on very thin ice,” Supervisor Ed Edelman added. “We are basing (our budget) on some pretty risky assumptions.”

Those expectations include the county receiving $135.3 million from the state to finance the operation of trial courts. Gov. George Deukmejian has proposed state funds for only six months of trial court financing, but county officials are hopeful that state legislators will restore the full trial court financing in the state budget when they return next month from their summer recess.

Local officials are also assuming that a statewide initiative aimed at increasing the tax on tobacco products will pass in November, allowing Los Angeles County to spend its $36.3-million share on county health programs, including emergency and trauma care.

Although Chief Administrative Officer Richard B. Dixon told board members that he was “reasonably optimistic” about obtaining sufficient state funds, the supervisors voted to retain a freeze on most hiring and non-essential spending and told Dixon to prepare a doomsday budget that would call for drastic cuts if necessary.

“This is better than Las Vegas, isn’t it?” Supervisor Pete Schabarum asked sardonically at one point.

But despite those misgivings, the board still approved a budget that includes additional money for law enforcement, anti-gang programs, various drug prevention projects and the Probation Department.

The supervisors also voted Thursday to restore $3.1 million to operate the MacLaren Children’s Center, funds that had been eliminated by the state. They also earmarked $1 million as seed money for low-interest loans to encourage entrepreneurs to build foster care facilities for difficult-to-place children.

To help beef up the county’s emergency and trauma-care system, the board agreed to add $36.2 million to bring the figure to the $157.9 million total needed to increase the number of surgical and medical intensive care beds at county-run hospitals and to expand the emergency walk-in hours at those facilities. However, the added amount depends in part on passage of the tobacco tax initiative.

The additional dollars also would be used to purchase new equipment, add urgent care centers at county clinics and help private hospitals maintain their emergency services “with savings from the program,” according to Robert Gates, county health director.

AIDS Treatment Program

Part of the new money for emergency care--$2 million--was taken from a planned increase in the AIDS treatment program, but officials said that even with that adjustment, the county’s AIDS budget will increase by $13.9 million this year.

Although mental health programs overall took the worst beating, the supervisors voted to add $800,000 to help alleviate overcrowding in psychiatric emergency rooms at Olive View, County/USC Medical Center and other medical centers.

The board did find money to fund three health-care programs--Telecare LaCasa, Hillview and San Antonio--for the next three months. And Supervisor Kenneth Hahn also persuaded his colleagues to vote $400,000 for full-year financing for the Kedren Mental Health Center, a clinic in his district.

But a number of other clinics, facing partial closures or the full loss of their programs, failed to receive additional dollars.

COUNTY BUDGET HIGHLIGHTS

Allows county to spend $9.03 billion, up $856 million from 1987-88. Most county services to remain at or above this year’s level.

Budget will be reopened to cut spending unless Legislature approves $135.3 million for trial court costs and voters pass tobacco-tax initiative in November. Initiative would provide $36.3 million to county.

Provides extra $36.2 million to upgrade county-run trauma centers and emergency rooms, which have been hit with more patients as private hospitals cut back. In all, the county will spend $157.9 million on emergency and trauma care.

Delays closure of outpatient programs at four mental health clinics and earmarks money that may come from Legislature for seven other clinics still scheduled to close.

Freeze remains in force on county hiring and non-essential spending.