PRESSURE MOUNTS TO DEAL WITH HEALTH DEFICIT.

Byline: Troy Anderson Staff Writer

With Los Angeles County's public health system expected to hit a $66 million shortfall on July 1, the Board of Supervisors on Tuesday directed the department's new acting director to come up with a deficit management plan by March 21.

The health department's deficit is expected to grow to $1.1 billion by fiscal 2009-10.

``With a pending $1.1 billion dollar shortfall, it is fiscally irresponsible to delay restructuring programs and services within the department,'' Supervisor Michael D. Antonovich said.

``Only through proactive reform can this department prevent having to employ a slash-and-burn approach. The department has struggled with a mounting deficit since 1995, and the 'soft landing' plan touted at that time has turned into a free fall.''

Dr. Bruce Chernof, who took over the Department of Health Services when Dr. Thomas Garthwaite resigned in November, said he needs a few months to develop plans on how to reduce expenses and balance his $5.5 billion budget.

``We are committed to coming forward with a balanced budget,'' Chernof said. ``An important element is to revisit work the department did in 2002, looking at strategic efficiencies, programic consolidations and other programic opportunities to make us more efficient with the resources we have.''

In the next few months, officials plan to review the extensive list of medical procedures the department performs at its various hospitals and determine which ones can be consolidated to reduce costs.

But Antonovich said the department has had years to cut services and is now threatening once again to bankrupt the entire county.

``To put this board in the position of a slash-and-burn approach is not responsible and represents the failure of the department to do its job,'' Antonovich said.

The county's health system nearly pushed the entire county into bankruptcy in 1995 when it faced a similar deficit.

At the time, the federal government stepped in with a $1.2 billion bailout that required the county to shift its focus from inpatient hospital care to a system that emphasized community-based, outpatient primary and preventive care.

As a result, the health department funded a network of more than 100 health clinics. In 2000, the federal government provided an additional $900 million, which ran out June 30.

In 2003, the county proposed closing Rancho Los Amigos National Rehabilitation Center in Downey and cutting 100 beds at County/USC Medical Center, but was blocked by the settlement of two lawsuits.

As a result of pending deficits, health experts say the supervisors will be forced to reduce services or close hospitals and clinics if the deficit cannot be mitigated - actions that would have a ripple effect throughout the private health care system and would significantly compromise care to the uninsured.

Troy Anderson, [phone]

troy.anderson(at)dailynews.com