Planned County Budget Cuts May Close Some Health Clinics

Los Angeles County health officials Tuesday proposed $55.8 million in budget cuts countywide that could close one neighborhood health clinic in the San Fernando Valley, reduce services at two others and force three more to consolidate.

The cuts proposed by the Department of Health Services drew immediate fire from two county supervisors, including Chairman Mike Antonovich, who vowed that the clinics would be spared.

The plan calls for closing a Burbank clinic and cutting services at centers in North Hollywood and Canoga Park, and raises the prospect of consolidating up to three health clinics--in Van Nuys, San Fernando and Pacoima--at the Olive View Hospital in Van Nuys, which is scheduled to move, or some other site.

The reductions were proposed in response to a projected $170-million county budget deficit for the 1987-1988 fiscal year.

Unsuccessful Motion

At a Board of Supervisor’s meeting Tuesday, Antonovich supported an unsuccessful motion sponsored by Supervisor Deane Dana that would have spared the Valley clinics, along with many others in the county.

The measure failed on a 2-2 vote after Supervisor Ed Edelman asked his colleagues not to begin exempting health facilities prematurely. Edelman said supervisors should present as bleak a fiscal picture as possible to Gov. George Deukmejian and the Legislature, which must decide how much money to allocate to the county for health care.

After the meeting, Antonovich and Dana predicted that the health clinics would be immune from budget slashes.

“I don’t think they will take place,” Antonovich said of the cuts. “I believe we’ll have the support on the board to save those health centers.”

The Board of Supervisors will hold a state-mandated hearing June 5 to assess what effect the cuts would have on health care.

The clinics provide a wide range of services, including prenatal and pediatric checkups, immunizations, screening and treatment for sexually transmitted diseases, dental examinations and walk-in medical care.

Devastating Effect

Physicians who operate the clinics in the Valley said the proposed cuts would have a devastating effect on the poor, the elderly and children.

“If you read all the cuts, it’s dreadful,” said Dr. Dorris Harris, in charge of all the county health clinics in the Valley. “If it comes to pass, we would have to make the best of a rotten situation.”

At the Burbank clinic, devoted exclusively to women, the closing would strain other, already overloaded prenatal clinics in the Valley, where pregnant women typically must wait two or three months for their first appointment, according to health workers. About 1,400 women a month visit for prenatal exams or advice on family planning.

Harris said she is uncertain whether the nearby Glendale clinic could absorb the influx of women if the Burbank staff is laid off. Existing services at the Glendale clinic might have to be scaled back to accommodate the female patients, health officials said.

Frank Binch, deputy health director, said the Burbank clinic was slated to be closed for three reasons: It is close to the North Hollywood and Glendale clinics, the patient count is lower than at general-purpose clinics, and the health department needs to spread the closings evenly throughout the county.

Officials estimate that closing the Burbank clinic as well as six others throughout the county would save $272,000 a month.

The fate of the clinics in Van Nuys, San Fernando and Pacoima is even less certain. County officials said all the clinics, none of them or maybe one or two might be moved to the present Olive View Hospital site or some other place. Health officials said the merger would allow the county to get rid of some of its most crowded and aged health clinics.

‘Terrible Hardship’

But the consolidation would be a “terrible hardship,” Harris said. Some would be too sick or too poor to take a bus to reach another facility or the new Olive View Medical Center in Sylmar, which is scheduled to open this weekend. And health officials concede that consolidations could create longer lines and longer waits for appointments.

In an interview, Health Services Director Robert Gates said the department would not close the clinics in Van Nuys, San Fernando and Pacoima if it is determined that merging services would endanger patient care.

“We wouldn’t do it unless the overall service level would be better than now,” Gates said.

The county has proposed eliminating the ambulatory-care budgets at North Hollywood and Canoga Park, which allow the staffs to see 12,500 patients who walk in each year.

“We have medical care where the people are. They can walk for care--the old and poor. To make them go further would be terrible,” said Dr. Angela Murphy, who is in charge of the North Hollywood clinic.

Patients now using the North Hollywood and Canoga Park clinics might instead have to go to the San Fernando clinic, unless it is closed. In that case, they would be directed to the Olive View site in Van Nuys if the county opens a clinic there.