The Board of Supervisors Tuesday warned that severe cuts to health care services were likely unless state and federal officials provide needed funds to the county.
Yaroslavsky warned that the state would suffer if the county -- which he estimated manages about a third of the state's healthcare load -- starts shutting down hospitals and reducing services.
The federal healthcare system could not withstand a failure in California, he said.
The Department of Health Services had hoped to erase most its deficit -- about $200 million last year and about $429 million this year -- with federal funds from various sources including federal funds, a hospital provider fee, and a Medicaid waver.
Despite assurances from congressional leaders during a visit by the supervisors to Washington in May and numerous follow-up calls, the prospects for funding now seem dim, based on comments by the supervisors today.
"The FMAP (federal medical assistance percentage) is on life support," said Yaroslavsky, saying that estimates had already been cut by 50 percent and it was still not clear whether the dollars would be available.
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"We're gambling that we're going to get the hospital provider fee and the waiver," said Supervisor Gloria Molina. "I think we're being overly optimistic, because we haven't solved last year's deficit."
To add insult to injury, county Chief Executive Officer William Fujioka said the state still owes the county $172 million in healthcare reimbursement dollars from 2005-06 which officials have said will not be paid out in the next 11 months.
The county is seeking an estimated $115 million in cost savings for all its departments through negotiations with labor unions, but the outcome of those discussions is not yet clear, said Fujioka.