Fighting for the disease-fighters

Out there on the front lines of the war on contagious disease in Los Angeles, the 14 centers run by the county’s Department of Public Health have seen it all—from hepatitis A to tuberculosis.

Now the centers—which log about 280,000 visits a year—need some medicine of their own.

The new proposed county budget calls for a sweeping “regionalization plan” that would improve the bottom line for the deficit-plagued public health department, but would also lead to the consolidation or even elimination of services in many centers.

Seeking to buy some time—and perhaps ease the pain of budget-driven service cuts—the Board of Supervisors on Tuesday approved two motions seeking funding relief for the department as the county’s budget process moves forward.

Supervisors Zev Yaroslavsky and Don Knabe noted that the proposed budget submitted by Chief Executive Officer William T Fujioka already sets aside $3 million in reserve funds for use by the department, whose deficit is expected to hit $21.2 million in the coming fiscal year. But in their motion the supervisors said that $1.7 million more may be needed to preserve jobs and allow DPH a year to come up with an efficiency plan that does not jeopardize its mission to protect the public health. The motion directs the CEO and department to closely monitor this year’s DPH budget and to allow the $1.7 million carryover from any funds remaining when the new budget is finalized.

In a related motion, Supervisor Mark Ridley-Thomas asked the department and the CEO to provide before-and-after maps showing the “volume and accessibility” of public health services now and what they would be after the proposed cutbacks. He also asked the CEO to explore whether other outside funding sources could be found to help maintain service levels.

As things stand now, the department is looking at as many as 75 layoffs—out of an estimated 131 countywide. It also is facing cutbacks under the budget-driven plan to consolidate services at some centers while eliminating a number of key clinical functions altogether at its Hollywood/Wilshire and Torrance health centers.

The centers’ mission is to provide treatment and testing for TB and sexually-transmitted diseases as well as care in the broad category of “communicable disease triage.” They also offer immunizations. In addition, the centers are the launching point for the county’s public health field staff, which takes the fight against contagious disease out onto the streets and into restaurants and other workplaces—anywhere an infected person may have come into contact with others.
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After the board meeting, Jonathan E. Freedman, chief deputy director of the Department of Public Health, said he was cautiously optimistic about the coming year but noted there was little financial wiggle room, given the challenging budget picture.

“We have a delicately balanced budget here with very little revenue-generating possibility,” Freedman said.

The supervisors’ public health motions were among 10 offered Tuesday, asking the CEO to report back to the board on a variety of topics as budget deliberations get underway. Public hearings on the $22.7 billion budget are set to begin May 12, with budget deliberations set to start June 7.

Posted 4-20-10

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