BUDGET WOES MAY FORCE COUNTY TO CLOSE HIGH DESERT HOSPITAL.

Byline: Karen Maeshiro Staff Writer

LANCASTER - Anticipating an $884 million deficit over the next five years, Los Angeles County health officials are thinking of closing down High Desert Hospital if other cost-cutting measures don't work.

In place of the hospital, the county would expand ambulatory and urgent care services through the Palmdale clinic being built by Antelope Valley Hospital and ``purchase'' patient beds from Antelope Valley Hospital to continue providing inpatient care to the region's indigent.

``It's very preliminary. It's contingent on the department not meeting other goals and not bringing in new money to the system,'' said John Wallace, spokesman for the county health services department.

The proposal was outlined in a Feb. 15 memo from Director of Health Services Mark Finucane to the county Board of Supervisors.

High Desert Hospital is licensed for 180 beds but is budgeted to operate 82. Besides providing inpatient care, the hospital runs a tuberculosis detention unit and treats inmates from the neighboring state prison and Immigration and Naturalization Service detainees housed in the former Mira Loma jail.

Wallace said High Desert - alone of the county's six hospitals - was targeted for closure because it does not have an emergency room, and the area has another public hospital, Antelope Valley Hospital.

``High Desert does not have an emergency department, there is another public hospital, and the resources will be better invested in outpatient care in the Antelope Valley,'' Wallace said.

County-run Rancho Los Amigos Medical Center also lacks an emergency room, but it provides rehabilitation services, Wallace said.

The plan is opposed by Supervisor Michael Antonovich, and Antelope Valley Hospital officials said they were not consulted and don't have any beds available for county use.

``I didn't think we have any beds for sale,'' said Mathew Abraham, Antelope Valley Hospital's administrator. ``We are at premium capacity. On any given day, there are 10 to 20 patients waiting for beds in the emergency room. I don't believe the county is aware of the acute shortage of beds. If they were, they would not make that statement.''

The county health services department is projecting the deficit even with the extension it received last summer of a federal bailout amounting to $900 million over the next five years.

The main drain on health services is providing care to the county's uninsured, Wallace said. A total of 2.5 million people are uninsured, one in four in the county, and the department provides 80 percent of all uncompensated care, Wallace said.

At the direction of supervisors, the department came up with a five-year strategic plan to cover the shortfall. Steps include reducing the work force by 2 percent each year, and cutting back legal fees by 25 percent and travel expenses by 50 percent, Wallace said.

The department also will look at contracting out for emergency room services and consolidating or contracting out for laboratory services, and will seek out new sources of funding at the state and federal levels, Wallace said.

If those measures don't work, then Finucane proposes more cutbacks under a three-phase contingency plan that would save the department another $57 million to $66 million, the memo said.

The first two phases would force cutbacks in services and positions in administration, public health, and clinic and hospital services.

The third phase calls for the closure of High Desert, a move that would save $10 million to $15 million, the memo said.

The department is required to report to supervisors every April and October on the progress it is making in implementing the five-year plan.

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(color) The fact that High Desert Hospital does not have an emergency room makes it more vulnerable to closure, officials said.

Jeff Goldwater/Staff Photographer