Motion by Supervisor Zev Yaroslavsky

November 2, 1999

MOTION BY SUPERVISOR ZEV YAROSLAVSKY

It has come to my attention that reductions in State spending for emergency room and trauma services may threaten the future viability of these services in Los Angeles County. In a letter to the Director of Health Services dated October 28, 1999 (attached to this motion), the Chairman of the Emergency Medical Services Commission indicates that "these changes will seriously jeopardize essential emergency departments countywide and potentially devastate the trauma hospital system."

The history of problems associated with financing the County’s emergency and trauma services is well documented. Because of diminishing funding over the years, there has been an exodus of hospitals and physicians from the system. Fortunately, we have been able to preserve an essential level of emergency and trauma service through a carefully developed arrangement involving private sector hospitals, emergency physicians and the County Emergency Medical Service Agency.

Financial support for this emergency care safety net has included distribution of State tobacco (Proposition 99) funds. This funding provides the incentive for participating hospitals and physicians to remain in the system. However, according to the letter from the EMS Commission, current-year funding for participating hospitals has been cut by 45%, and for non-county physicians by 50%, below the levels that were in place prior to fiscal year 1998-99. (Funding was cut by 11% and 14%, respectively, during 1998-99.) These drastic reductions in funding will cause the inevitable withdrawal of medical providers from the emergency service network.

In response to this crisis, the EMS Chairman recommends that the County draw funding from its tobacco settlement revenue to supplant the losses suffered due to the cutback in State support. This recommendation is based on indications from the Governor that tobacco settlement funds are available at County discretion to augment the emergency/trauma program.

In fact, the County has yet to receive any tobacco settlement funds, but we are now in the second year of Prop 99 cutbacks. Furthermore, it would be a major mistake for the Board to accept the financial burden for a program that is clearly a State responsibility. The State’s past support of the County emergency and trauma system reflects the appropriate role of State government in this regard. There is no reason for the State to abandon this responsibility now.

I, THEREFORE, MOVE that the Board sponsor legislation to assure stable and continuing State funding, at the level that existed prior to fiscal year 1998-99, to support the emergency room and trauma service network of Los Angeles County.