SPENDING STANDOFF BOARD SPLIT ON BAILING OUT HEALTH SYSTEM.

Byline: Troy Anderson Staff Writer

With Los Angeles County's public health care system facing a meltdown, county supervisors are fighting over whether to try to save it or spend available funds on pet projects - including a new $200 million headquarters for themselves.

Supervisor Zev Yaroslavsky last week refused to approve the $18.5 billion 2005-06 budget, saying he couldn't in good conscience pass a spending plan that shortchanges hospitals and clinics while providing hundreds of millions of dollars in additional spending in other areas.

``I get very nervous when I see a budget that increases every supervisor's pet projects and postpones what, today, would not be a very difficult decision to set aside funds to prevent the collapse of the health system,'' Yaroslavsky said.

``The library budget is going up 30 percent. The parks budget is going up 19 percent. There are double-digit budget increases in more than several departments.''

When the Board of Supervisors deadlocked 2-2 last week over the proposed $18.5 billion spending plan, longtime observers could not remember such an impasse over any previous budget.

Many say the standoff underscores the bleak financial situation facing the nation's biggest county as it struggles to meet competing demands for a broad range of public services. The most serious need is its giant health care system, which according to a state audit issued in March has failed to be reformed to prevent a looming fiscal crisis after a federal bailout ends this year.

Supervisor Michael D. Antonovich, who has voted against the budget each year for nearly a decade, questioned a proposal to spend $20 million to design a new Hall of Administration building, a project expected to ultimately cost $200 million. He joined Yaroslavsky in opposing the budget for the fiscal year beginning in July.

Supervisors Don Knabe and Yvonne Brathwaite Burke voted in favor of the budget, which is 3 percent larger than the current year's plan.

Board Chairwoman Gloria Molina, who was traveling on the East Coast and did not vote, is expected to break the standoff when she returns Tuesday. Molina was unavailable for comment, but her spokeswoman said she is likely to vote for the budget.

At stake, Yaroslavsky and health experts say, is the future of the county's public and private health care systems.

Since 1995, federal waivers have injected more than $2 billion into the county's health system, but that funding expires June 30 and the health department is expected to have a $435 million shortfall in 15 months - growing to $1.4 billion to $2.5 billion by July 2008.

State officials are seeking additional funding from the federal government. Meanwhile, health officials are expected in June to present to the supervisors proposals to cut services, which may include hospital and clinic closures.

Health experts say if additional county hospitals are closed, it could trigger the collapse of the entire trauma-care system - even though county voters approved a new parcel tax in 2002 to raise $168 million a year to preserve trauma centers and emergency rooms.

``There is little doubt in my mind that the county Department of Health Services funding stream is heading into extremely turbulent waters,'' said Dr. Steven Asch, a research physician at the Veterans Affairs Greater Los Angeles Healthcare System and a senior health policy analyst at Rand, a Santa Monica-based think tank.

``There is already evidence that emergency room waiting times are increasing and even people with insurance are having a difficult time getting the care they need.''

The supervisors agree that the health system has to be a top priority. But Burke, Molina and Antonovich said the safety net must be balanced with the competing needs to repair infrastructure and provide high-quality parks, libraries, beaches and other facilities the public expects.

Officials estimate the county needs to spend an extra $786 million to fix all the facilities in need of repair.

``The Department of Health Services has had two waivers to right-size the department,'' said Antonovich spokesman Tony Bell. ``And it failed to enact the reforms. Instead, it made empty promises to the state and federal government and is no closer to solving or to addressing the looming $2.5 billion deficit.''

The budget proposes $710 million in appropriations for construction and major improvements and renovations of facilities - collectively known as capital projects.

Molina would get the most for her district, $291 million, followed by Knabe at $102 million and Burke at $80 million. Antonovich would get $75 million and Yaroslavsky the least, $39 million.

Those totals include a number of projects the supervisors have taken extra steps to support in their own districts by providing money from special accounts.

They include projects like the $70 million Mexican-American cultural center known as La Plaza de Cultura y Arte near Olvera Street, which Molina is helping to pay for out of her discretionary funds.

For the last nine years, Molina has set aside money the county gives each supervisor to pay for community projects. Each supervisor receives $1 million annually in discretionary funds.

That amount is expected to rise as the supervisors' total budgets go from $3.2 million to $3.4 million in the new year.

Molina spokeswoman Roxane Marquez said it's going to take action on the part of the state and federal governments to solve the county's health crisis.

``For residents in the 1st District, things like libraries and parks are not pet projects,'' Marquez said. ``The Sorensen Library (in Whittier) is a good example of a facility the community has asked the supervisor to renovate for many years and the biggest reason why she hasn't is because she's been prudent fiscally, especially when it comes to the health department.''

In addition to the discretionary fund, an additional $344 million in capital project and extraordinary maintenance funds carried over from the prior year are also available for projects in the supervisors' districts. Some of that money has already been allocated.

``In the last several years, as one-time funding became available, some money was allocated to capital projects,'' said John Edmisten, a division chief in the Chief Administrative Office. ``I guess that's where this notion of a 'pet project' is coming from. The supervisors always have long lists for me.''

Chief Administrative Officer David Janssen said using these ``one-time funds'' to save the health system would ``be a last resort and something we would start looking at seriously next year.''

Burke, who is putting some of her capital project funds into a seismic retrofit at the Museum of Natural History, said without additional federal help the county is never going to have enough money to meet the health care needs of its large uninsured population.

``I have parks in disrepair,'' Burke said. ``I have libraries that need upgrades. The reality is we have a responsibility to put money into the unincorporated areas.''

Troy Anderson, [phone]

troy.anderson(at)dailynews.com

CAPTION(S):

5 photos, box

Photo:

(1) Gloria Molina

(2) Yvonne Brathwaite Burke

(3) Zev Yaroslavsky

(4) Michael Antonovich

(5) Don Knabe

Box:

PET PROJECTS

SOURCE: Los Angeles County 2005-06 proposed budget

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