UCI Medical Center Plans to Lay Off 104 to Hold Down Deficit

To keep its projected budget deficit under $9 million this year, UCI Medical Center in Orange will lay off nearly 5% of its work force--104 nurses, secretaries, technicians and other employees--effective March 15.

A moratorium also was ordered this week on using 88 nurses who serve on an as-needed basis, much in the way of substitute teachers in school.

UCI Medical Center Director William Gonzalez said the cutbacks will not adversely affect medical care at the hospital, which employs 2,200 people and where 70% of the patients are indigent or on Medicare. The layoffs are the first announced this year, but there have been layoffs at the medical center annually since about 1982, he said.

Effect on Care Unknown

A county health official Wednesday said it is too soon to determine the effect of the staff reductions.

But spokesmen for the two hospital-worker unions expressed concern that the layoffs “will cut into services for the poor” and jeopardize patients by cutting back an already understaffed hospital.

A similar concern was expressed by UC Irvine Medical School Dean Stanley van den Noort, who is in charge of faculty physicians at the teaching hospital and who said he was “somewhat” consulted on the layoff decision.

Van den Noort declined to say whether he supports the decision to make the layoffs.

“In order to sustain an appropriate quality of care, it may be necessary to restrict admissions,” van den Noort said. “I would not know how to do it without turning people away.”

Nevertheless, Gonzalez insisted Wednesday that “we’re not turning anybody away.”

Gonzalez said that changes in eligibility standards are continually reducing the number of patients who receive government-assisted treatment at the medical center and around the nation. About 57% of the hospital’s patients are indigent, and an additional 13% are Medicare recipients, he said.

Longer Waits Possible

“People might have to wait longer and we might have a narrower range of services” because of the layoffs, conceded Gonzalez, who was busy Wednesday briefing employees on the layoffs. “But there will be no effect in terms of quality to patients.”

Two weeks ago, UCI Chancellor Jack Peltason told the UC Board of Regents that the medical center stands to lose up to $9 million this fiscal year, compared to a $3-million loss in 1983-84. The operating deficit will continue indefinitely, he said, unless there is a $30-million modernization of its aging facilities.

But Peltason also promised regents to keep the deficit within $9 million this year, Gonzalez said.

“A variety of cost-cutting methods employed in recent months were not taking effect as fast as hoped,” a medical center spokeswoman said. The economy measures included limiting the rehiring of former employees, restricting supply purchases, tightening supervision of patient tests and reorganizing the nursing staff.

The layoffs constitute “an accelerated process” of cost cutting, the spokesman said.

‘No Promises’

Peltason could not be reached for comment Wednesday. But when he announced an audit of the financially troubled hospital in October, he said, “I can make no promises that we will be successful in turning this situation around.”

The medical center’s central problem, Peltason said, is the very high percentage of poor patients. Government subsidies no longer cover the actual cost of health care for the poor, a difference of more than $200 per day in some cases, hospital officials said.

If fewer government-assisted patients are treated--a trend that UCI Medical Center officials concede has occurred in recent years--the hospital stands to lose less money.

Barbara Himmer, a California Nurses’ Assn. representative, called the layoffs “morally reprehensible.” She challenged the medical center’s ability to meet legally required staffing ratios.

A hospital spokeswoman, however, said all legal mandates and those for nurse staffing will be met.

Nurses on Overtime

Himmer said nurses already were working overtime before the layoff notices. Whatever savings is realized from the layoffs, she said, will be offset by additional overtime needed to fully staff the hospital.

Luis Rodriguez, public affairs spokesman for the American Federation of State, County and Municipal Employees, said it is too early to tell what effect the layoffs will have.

“We’re concerned that if they are going to cut back employees, you’re cutting back services,” Rodriguez said. “We’re concerned for the jobs, of course. There’s already been a two-month freeze on new hires and yet medical care is needed.”

Rodriguez said the technicians and hospital aides represented by his union will meet Friday to discuss the layoffs and perhaps come up with alternative suggestions to deal with the looming deficit.

Fewer Hours Possible

One consideration, Rodriguez said, is to ask union members to voluntarily accept fewer hours of work in order to save the jobs of their colleagues who will be receiving layoff notices.

“At this point,” he said, “we think management is going to be flexible, as well.”

About 40 medical center nurses met Wednesday afternoon at a nearby hotel to discuss the layoffs and moratorium on “per diem” nurses--those who are called on as needed by the hospital. About 88 per diem nurses who work from one to five weekly shifts were notified this week that they no longer will fill in for nurses who miss work for reasons such as illness, a medical center spokeswoman said.

Michael Kaulback, a per diem nurse, said, “Somebody could just die because they suddenly go bad on you and you can’t get over there to see them, you can’t even call the doctor in time.”

Fear for the Poor

Because the medical center treats a large percentage of the county’s indigent patients, Kaulback said, poor people will suffer from the layoffs out of proportion to the general population.

Medical center Director Gonzalez said a reorganization of the nursing staff in recent months effectively reduced the number of supervisory positions and increased the number of workers.

Meanwhile, the layoff notices will be mailed March 1, said hospital spokeswoman Kathy Jones. The actual number of people affected is expected to be fewer than 104 because some of the positions will be eliminated by attrition, she said.

The 104 positions include 40 registered nurses, 19 administrative employees, 10 from finance offices and 35 from the ranks of “professional services,” which include radiologists, patient escort workers and licensed vocational nurses, she said.

Dean’s Concern

UCI Medical Center is one of 32 hospitals that contract with the county to serve indigent adults and one of two or three that serve Medi-Cal patients, she said.