County Proposal Marks 16 Clinics for Closing : Health: Centers in North Hollywood, Tujunga, Canoga Park and Valencia are among those targeted. Officials are preparing for the worst.

Anticipating the worst from the state budget, Los Angeles County officials have tentatively earmarked 16 health centers for closure and plan to sharply reduce hospital clinic services, including prenatal care, immunizations, infectious disease treatment and adult medical services for about 200,000 poor people.

The 16 include the county health centers in North Hollywood, Tujunga, Canoga Park and Valencia.

Reacting to initial reports Monday, the president of the Los Angeles County Medical Assn., Dr. Marie G. Kuffner, called the plan disastrous and said it was the “wrong way to go about solving budget problems.”

David Langness, spokesman for the Hospital Council of Southern California, said private hospitals and clinics will not be able to absorb so many county patients. He predicted a domino effect of closures in the private sector, including the loss of at least 10 hospital emergency rooms and three trauma centers.

The clinic closure plan is one of two being floated in a confidential memorandum by the county Department of Health Services to save $77.7 million. The alternative plan requires persuading county health employees to accept two payless days per month and give back hard-won benefits such as paid parking and overtime premiums.

Clinic closures and service cutbacks do not require union cooperation. More than 2,000 county health care employees would be laid off under that option, which the memorandum labels Plan B.

The memorandum was written by Health Director Robert C. Gates to Richard B. Dixon, the county’s chief administrative officer. Dixon is expected to present the proposals to the Board of Supervisors on Sept. 15, although continued failure by Gov. Pete Wilson and the legislators to agree on a state budget may delay that, county officials said.

The clinic closures and layoffs would be effective Sept. 18 if the board chooses Plan B. In addition to closing 16 of 47 county health centers and 35% reductions in outpatient services at the county’s six public hospitals, Plan B calls for:

* Reducing the number of county beds for psychiatric patients from 269 to 182. Martin Luther King Jr./Drew Medical Center would see the biggest reduction, losing 34 of its 58 psychiatric beds.

* Eliminating most adult dental services at county clinics and hospitals. Only trauma dental services would remain.

* Closing all urgent care emergency rooms at remaining health centers. These services were launched about four years ago to take the load off public hospital emergency rooms.

* Closing the 40-bed skilled nursing facility at Rancho Los Amigos Medical Center, whose patients are mostly comatose or so ill as to need around-the-clock nursing care.

* Closing most adult medicine services throughout the county hospital and clinic system. These treat what county officials have referred to as the “walking sick”--people with diabetes, heart disease and lung ailments who require medication and close medical supervision.

Plan A would require all health department employees to work two days per month without pay, for an estimated savings of $65 million. It would also eliminate overtime, the right of employees to cash in unused sick days and free parking.

Bob McCloskey, business agent for Local 660 of the Service Employees International Union, representing 18,000 county nurses, clerks and medical technicians, said union members will not agree to payless days.

Although several meetings have been held on the proposal, McCloskey said union and county officials are far from agreement on a better way to save money.

“We are looking for a number of ways to save money before they come after the employees’ salaries,” McCloskey said. Union proposals include eliminating management positions at health department headquarters, eliminating some management fringe benefits, and imposing new taxes and fees to increase county revenues.

The health centers earmarked for closure offer basic public health services such as immunizations, prenatal care and treatment for tuberculosis and sexually transmitted diseases, said Irving Cohen, county assistant health director. Gates was on vacation and could not be reached for comment.

Cohen said the county would try to get prenatal patients into comparable services at private hospitals. Such public-private cooperation has worked in the past to alleviate overcrowding in county obstetrical wards.

However, the success of those partnerships depended on the state’s Medi-Cal program, which paid private doctors and hospitals enough to enlist their services. The state’s budget stalemate may have sabotaged that goodwill.

Cohen said he was hopeful that the cooperative relationships could be patched back together once the state has a budget.

But Langness of the Hospital Council said private hospitals are operating under such financial strain that some will be forced by the onslaught of county patients to close emergency rooms and take other steps to limit access by poor and uninsured patients.

Targeted for Closure

These are the health centers the county Department of Health Services has tentatively earmarked for closure in response to reduced state funding for health care. They are among 47 health centers serving poor residents of the county, where about 3 million people lack health insurance. Closing these 16 clinics would save about $15 million, county officials say.

Alhambra Health Center, 612 W. Shorb St., Alhambra.

Bell Gardens Health Center, 6912 Ajax Ave., Bell Gardens.

Canoga Park Health Center, 7107 Remmet Ave., Canoga Park.

Florence-Firestone Health Center, 8019 S. Compton Ave., Los Angeles.

Tujunga Health Center, 7747 Foothill Blvd., Tujunga.

Hawaiian Gardens Health Center, 22310 Wardham St., Hawaiian Gardens.

Imperial Heights Health Center, 10616 S. Western Ave., Los Angeles.

La Puente Health Center, 15930 Central Ave., La Puente.

North Hollywood Health Center, 5300 Tujunga Ave., North Hollywood.

Norwalk Health Center, 12360 E. Firestone Blvd., Norwalk.

Pico Rivera Health Center, 6336 S. Passons Blvd., Pico Rivera.

South Health Center, 1522 East 102nd St., Los Angeles.

Torrance Health Center, 2300 W. Carson St., Torrance.

Valencia Health Center, 23763 W. Valencia Blvd., Valencia.

Venice Health Center, 905 Venice Blvd., Venice.

Whittier Health Center, 9643 S. Painter Ave., Whittier.