County Budget Keeps Most Services, but Clinic Closures Loom : Health care: Medical facilities in Torrance and Lawndale are among more than 20 that officials expect to be shut.

Inside the Torrance Health Center, a county-run health care complex, a notice warns: “Actions by the Governor and State Legislature may result in the closure of this facility. Los Angeles County’s funding in the 1993-94 State Budget is insufficient to meet vital community needs.”

That possibility moved closer to reality last week, when the Los Angeles County Board of Supervisors approved a $13.5-billion austerity budget. Officials expect the spending plan, which calls for $100 million in health care cuts, to force the closure of four of the county’s six comprehensive health centers and 20 of its 39 smaller health centers.

Some South Bay doctors had assumed the supervisors would find funds to keep the doors open at the county’s health centers, which provide vaccination shots, prenatal care and other health services to thousands of people who cannot afford to go elsewhere.

But those hopes withered with Thursday’s budget vote. Though county health centers in Inglewood, Wilmington and San Pedro are expected to remain open under the new budget, officials say two other South Bay centers, the Torrance and Lawndale health centers, are to close Sept. 1. Also slated to close then are two larger centers nearby, the Long Beach Comprehensive Health Center and the Hubert Humphrey Comprehensive Health Center in Los Angeles.

The one hope of preventing the shutdowns appears to be if county officials can persuade the state Legislature to release $72.8 million in tobacco tax funds to shore up its health care programs. Health care experts are not optimistic.

“I think the chances are pretty good that the centers are going to close,” said David Langness, spokesman for the Hospital Council of Southern California. “If I were to bet today, I’d bet the money will not be forthcoming from the state. I think that would be a tragic outcome, but hope is dimming daily.”

Should the health centers close, local doctors and medical administrators foresee a direct and painful effect on South Bay emergency rooms, as thousands of uninsured patients turn to both public and private hospitals as their last hope for obtaining basic care.

Without the preventive care available at the county health centers, they say, many patients will be sicker when they arrive at the emergency rooms, requiring extended--and far more expensive--care.

“We see this potential flood of patients out there, and there’s genuine apprehension,” said Dr. Bayliss Yarnell, director of the emergency department at Daniel Freeman Memorial Hospital in Inglewood.

Particularly hard hit in the South Bay, experts say, will be Los Angeles County Harbor-UCLA Medical Center, a public hospital that already sees 250 people a day in its crowded emergency department. Patients with medical problems that are not severe or life-threatening sometimes must wait up to 12 hours or longer for care.

“What we’ll see here are longer waiting times,” said Dr. Philip Henneman, director of the Harbor-UCLA adult emergency department. “If these people can’t go to what has been their primary care centers, they’ll go to emergency departments all over the area.”

The closing of the Long Beach Comprehensive Health Center could contribute significantly to that waiting time. Already, many patients seeking walk-in care at the Harbor-UCLA emergency room come from the Long Beach area, said William Fujioka, chief executive officer for the county’s coastal area health centers.

The public may not realize how cutting health care will affect them, some officials said.

“They feel it only affects the poor, the medically indigent,” said Fujioka, who points out that the centers slated for closure offer services preventing the outbreak and spread of communicable diseases such as tuberculosis. “But this will impact everyone in the community.”

The beginning of that impact seemed evident Friday at the Torrance Health Center, 2300 W. Carson St., which reports about 26,000 patient visits per year. Inside the vintage, Spanish-style health clinic, staff members expressed uncertainty about the future.

“I’m trying to (prepare) my resume,” said Ping Luh, a 37-year-old public health nurse who is studying for her master’s degree in early childhood education.

Being laid off is a possibility, Luh said, because she has worked only four years for the county. At least one of the four other public health nurses at the clinic has more than 20 years’ seniority, Luh said.

Patricia Person, who manages the clinic office and reception staff, was not as worried about her employment prospects. She said she has 14 years of service. “Hopefully, they’ll be able to place me in another facility,” she said.

Ironically, the county’s health-center cuts come as Clinton Administration officials in Washington ready a health-reform package that is expected to emphasize primary and preventive care in hopes of keeping people out of the hospital.

Dr. Patrick Dowling, chairman of the Harbor-UCLA Department of Family Medicine, said a recent study found that 76% of the people waiting for care at the San Francisco General Hospital emergency room could have been treated in a family medicine clinic or similar facility if one were available.

For many health officials, the prospect of such health centers closing has come as a rude surprise.

“To me, medical care is really a basic right,” said Yarnell of Daniel Freeman Memorial Hospital. “I guess I just thought, somehow, a way would be found to provide that sort of care to people. Realistically, I did not think it would happen. And it appears to be happening. It’s shocking.”

Staff writer Michele Fuetsch contributed to this story.