Feeling backed against a wall by petitioners from an AIDS activist group, Los Angeles City Council members agreed Wednesday to place a measure on next year's ballot asking if voters want the city to create an independent health agency. But then they agreed to also file a lawsuit challenging the validity of such a measure.
Council members said they were forced to place the initiative before voters because petition gatherers had successfully qualified it for the ballot. Their only other option was to adopt it immediately, ending five decades of contracted health services provided by county-run clinics, a step the majority said they were reluctant to take.
Placing it for a vote in June 2014 gives them a year to work through legal concerns about several provisions of the ordinance, council members decided. The council did not publicly discuss what those concerns are, recessing in closed session to vote 9 to 1 in favor of litigation.
The petition was organized by the AIDS Healthcare Foundation, a health advocacy group based in Los Angeles. Spokeswoman Miki Jackson said she hoped the ballot measure would spur "wide and deep dialogue" on whether city residents were receiving their fair share of public health services.
"We are not prepared should there be a major public health emergency," Jackson said, citing outbreaks of syphilis and meningitis across Los Angeles. "We have many serious public health issues in this city, and in this county, and in the city we do not feel we are getting enough attention and we're not doing the best we can do."
William T Fujioka, Los Angeles County's executive officer, defended the Public Health Department's record and said shifting to an independently run city system would result in inferior services and, potentially, higher costs for taxpayers. Fujioka said he was "encouraged" by the council's votes.
"The city recognizes that this measure would be detrimental to the overall health system in Los Angeles County," he said.
In a report to the council, City Administrative Officer Miguel Santana estimated that it would cost $4.5 million to hold the vote and roughly $261 million a year to operate an independent agency. Jonathan Fielding, the county's public health officer, said a split could mean the loss of $107 million in fees, grants and other revenue and the potential loss of 970 county jobs.
Initiative supporters pressed their argument that the city is not getting a fair share of public health dollars spent by the county. Contracting for health services has resulted "in a waste of money, as fees paid to Los Angeles County under this arrangement have subsidized the healthcare needs of other areas of the county," the proposed ordinance states.
Under questioning by Councilman Paul Koretz, Fujioka estimated that 46% of visits to county healthcare clinics were made by city residents. The city of Los Angeles makes up about 40% of the county's population of just under 10 million.
Business groups, neighborhood budget hawks and a spokesman for the Hospital Assn. of Southern California spoke against the measure, saying that it would result in a more inefficient public healthcare system and potentially higher taxes.
catherine.saillant@latimes.com
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