Cutbacks at Hospitals to Add Agony for the Poor : Health care: $7.6 million in reductions will affect many patients and employees of county’s public hospitals. Legal Aid will seek to block implementation of the cuts.

Adults with chronic eye, lung, joint or other problems treated in clinics of public hospitals in Los Angeles County will feel the brunt of $7.6 million in health care cuts ordered by the Board of Supervisors, health officials said.

Some specialty clinics will close. Others, because of reduced hours, will require, on average, four weeks longer for appointments that already must be scheduled eight to 12 weeks in advance, according to Irving H. Cohen, director of administration and finance for the county Department of Health Services.

In addition, nearly 100 employees at the county’s six public hospitals will get layoff notices Sept. 3, effective a week later, Cohen said. Another 129 will be transferred from the clinics to vacancies in other hospital departments.

The cuts in county health services, ordered by the supervisors last week, were forced by the state’s recent budget crisis, officials said.

They are modest compared to about $131 million in service cutbacks projected by county health officials in June, when state finances looked their bleakest. The impact would have been dire, including elimination of all children’s medical services at Martin Luther King Jr./Drew Medical Center and the closure of the pediatric hospital at County/USC Medical Center. These hospitals are the main sources of care for the county’s poor.

All pediatric services have been preserved under the current plan. Advocates for the poor contend that any reduction of services in the already overburdened county health care system is inhumane and illegal, and have launched a court battle to restore the $7.6 million.

Their first effort, seeking to block implementation of the cuts temporarily, failed Monday in Los Angeles Superior Court. Byron J. Gross, of Legal Aid of Los Angeles, said his group will return to court next month on behalf of patients harmed by the reduction in services.

State law has mandated medical services for the poor comparable to those available to nonindigent people. Hearings usually are held to determine whether proposed reductions in county health services would constitute a violation of that standard. In approving the state budget last month, lawmakers suspended the hearing requirement, permitting counties to immediately cut services proportionate to reductions in state aid. They also changed the standard for adequate medical services to those available to patients covered by the state Medi-Cal program.

Retroactive hearings, however, still must be held. On Tuesday, the supervisors heard oral testimony, and have extended the period for submission of written comments to Friday. When these conclude, Gross said his group’s legal case will be stronger.

In the first three days of the service reductions, 1,200 patients had their appointments canceled or rescheduled, according to the health department’s Cohen. Outpatient clinics at the five hospitals affected by reduced funding serve about 1.5 million poor patients a year.

Cohen said no emergency cases are being turned away, only those that the medical staff judges can afford to wait longer for care.

“Our main concern is that the illness (because of treatment delays) doesn’t turn into one of a more critical nature,” Cohen said.

At County-USC, which is absorbing $4.2 million of the cuts, the walk-in clinic has reduced its hours from 16 to 12 a day, with only the first 100 patients accepted. A 5 p.m. closing time at all clinics is being enforced. Formerly, medical staff stayed until all scheduled patients were seen, working as late as 7:30 p.m., according to Richard R. Pacheco, operations officer for the 2,045-bed hospital.

In addition, no new patients will be accepted at the rheumatology, dermatology, ear-nose-throat, eye, general surgery, orthopedics and dental clinics until current patients leave; the asthma and chest clinics are being combined with an overall reduction in patients, and the renal clinic has been closed.

At Harbor-UCLA Medical Center in Torrance, the ophthalmology, urology, oral surgery, dermatology and medical continuing care clinics have reduced operations from five to four days a week, a move expected to double the waiting time for appointments. Rancho Los Amigos Medical Center in Downey plans to eliminate its outpatient vocational education program and Olive View Medical Center in Sylmar has closed its orthopedic clinic and will reduce patients seen in other clinics by 537 a month. Through reduced hours, Martin Luther King Jr./Drew Medical Center will see 35% fewer patients in these clinics: cardiology, hypertension, dermatology, gastroenterology, neurology, diabetic, chest, hematology, renal, urology and ear, nose and throat.

High Desert Hospital in Lancaster, the county’s sixth facility, is not affected by the funding cuts.