Handicapped Are Victims of Cost-Cutting : Health: Cuts in outpatient services to the poor are response to a shortfall in state funding.

Carolyn L. Harcar and her mother were shocked when they arrived at Rancho Los Amigos Medical Center last week to find that budget cuts had shut down a job program for the severely handicapped the day before.

Harcar, 47, of Lakewood, suffers from a degenerative condition that has weakened her legs and made her dependent on her mother, a walker or a wheelchair.

She had begun attending the vocational program two days earlier with the hope that it would eventually lead to a job at a nursery school. Now that the county program is closed, the Harcars said they do not know where they will be able to find comparable, affordable services.

“(Carolyn) was disappointed. She cried,” said Caroline Harcar, 76, who fears that her daughter could one day end up in a board-and-care home. “She has to learn to be on her own. I know I’m not going to be around forever.”

Last week, five Los Angeles County hospitals began making 9.5% cuts in outpatient services to the poor. The cuts were ordered earlier this month by the Board of Supervisors in response to a shortfall in state funding.

The cuts will eliminate about 11,000 outpatient visits a month at Rancho Los Amigos, County-USC, Harbor-UCLA, Martin Luther King-Drew and Olive View hospitals. County Health Director Robert Gates said about 100 employees will be laid off.

The cutbacks gutted Rancho’s vocational rehabilitation program. As a result, 409 people will not receive outpatient services, a reduction of 614 monthly visits. Twenty-one employees, ranging from counselors to typists, have been reassigned temporarily and are expected to be laid off next month, spokeswoman Susan Miranda said.

The reductions at Rancho will save the county $389,184 a year.

Susumu Yokoyama, associate executive director at Rancho, said the hospital had few options. Other outpatient services are needed to maintain patients’ physical health, he said.

“Although it does have an impact, it won’t have the serious medical impact if, for example, we had cut the diabetic clinic,” Yokoyama said.

The doors of Rancho’s Vocational Rehabilitation Center were closed the afternoon of Aug. 21.

Among the services eliminated was the hospital’s vocational evaluation workshop, which tests severely disabled people to determine what types of jobs they can perform.

Also eliminated was counseling to train, motivate and help handicapped outpatients find jobs. Such counseling will still be available for inpatients at Rancho.

The hospital’s community resources section was cut as well. It provided a directory of community services, such as bus routes and information on what restaurants have ramps for the handicapped.

A hospital work program for handicapped outpatients also was eliminated. The program employed outpatients as clerical workers, among other things, to help prepare them for outside jobs.

To some patients, the cutbacks mean longer trips to other hospitals or rehabilitation centers where some of the same services are provided. To others, who may not be able to afford private rehabilitation services, the cutbacks may mean doing without. Of the 409 patients affected, 95 are indigent, Yokoyama said.

And even for those who can afford them, some of the rehabilitation services cut at Rancho will be hard to duplicate, officials said.

Rancho is known for its treatment of head injuries, and many of the outpatients who used the vocational services at Rancho were victims of such injuries. Some of those outpatients were receiving extra help managing problems such as short-term memory loss before they could qualify for State Department of Rehabilitation programs.

“It was (a) unique (program) for people who weren’t quite ready for us,” said Maureen McIntyre, a state rehabilitation supervisor.

Melvin E. Burns, 40, is one of those people who needs extra help. He doesn’t remember the 1982 auto accident that damaged his brain and changed his life forever. He was driving his Volkswagen from his Norwalk home to his teaching job at Whittier Christian High School when he collided with a truck, his wife, Lynnette, recalled.

Burns emerged from a coma two months later. But when he started to talk, the former history and math teacher spouted algebraic equations. He had to learn how to walk and run and to relearn words such as refrigerator. Burns’ short-term memory will never be the same.

For several years, Burns has helped his wife clean houses to supplement the family income. He knows he has to vacuum, mop and shake out rugs. But without a reminder, he tends to forget the order in which the tasks should be done.

Burns underwent vocational testing at Rancho and was receiving outpatient counseling to help him get a job best suited to his abilities. For the Burnses, the cutbacks at Rancho and the loss of counseling could be significant. They said they do not know where to receive similar services.

“Obviously he’s not going back to teaching,” said Lynnette Burns, a reading tutor. “It’s important we know what his capabilities are. You can go out and get a job at McDonald’s, but what if you can do better than that?”