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LA County Safety Net

An Ailing System. Since the early 1990s, LA County has been forestalling an imminent healthcare crisis. A federal 5-year waiver kept the county from major closures in 1995 and was extended in 2000. The Waiver expired in June 30, 2005, once again threatening the county public healthcare system's viability.

Fiscal Truth. LA County faces a significant budget deficit that threatens the safety net.

Fiscal Year             Annual Surplus/         Cumulative Surplus/
                                       (Deficit)                         (Deficit)   
FY 2005-06                $ 7.9 million               $154.2 million
FY 2006-07              ($351.9 million)            ($197.7 million)
FY 2007-08             ($367.3 million)             ($565.0 million)
FY 2008-09             ($389.7 million)             ($954.7 million)

Dr. Thomas Garthwaite, LACDHS Director, cited in Sick System: A 10-Year Look at the Los Angeles Health Care System and Its Current State of Health. LA Health Action Policy Brief. August 2005.

State of LA County Public Hospitals. Los Angeles County DHS Workload is as follows.

Type                               LAC-DHS                   Countywide
# Hospitals                        5                              84
Hospital Discharges       101,571                      888,000
Staffed Beds**          3,257/2,260                     19,600
Occupancy**                  72%                           75%
ER Visits                      304,779                   2,218,000

Jonathan Freedman, Los Angeles County Chief Administrative Office, presented to Assembly Select Committee on the Los Angeles County Health Care Crisis.

Changing Payer Mix. Funding sources for admissions to LAC-DHS hospitals have changed in the past decade as follows.

                      Medi-Cal          Uninsured
1990-91                69%                21%
2002-03                54%                32%
   
DHS' Contingency Plans for Hospitals.

  • Privatization

  • Outpatient MAAC

  • Closure

  • Independent Health Authority.

    • What has been done?

  • Passage of SCHIP program and establishment of children health coverage programs at the local level

  • Submission of 1115 waiver for additional funding to safety net

  • Passage of Prop B funding for emergency rooms

  • Pending legislation and ballot initiatives.

    • What needs to be done?

  • Increased public investment in healthcare through national health insurance

  • Increased public policy for oversight and public accountability

  • Redistribution and commitment of resources to achieve racial and ethnic parity.





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