Drastic Cuts Looming for Health Clinics : Medicine: Four of the county’s six comprehensive centers and 20 of its 39 small facilities face closure. Patients wonder where they will go.

On any given day, a line of women and children snakes around the entrance of the Florence/Firestone Health Clinic as early as 7:30 a.m., half an hour before the doors open.

Hours later, inside the clinic at 80th Street and Compton Avenue, the waiting room is jammed with people who have traveled miles and endured long waits to see physicians for checkups, prescriptions or prenatal care.

It is the same at the Hubert H. Humphrey and H. Claude Hudson comprehensive health centers in South Los Angeles, and the Northeast, Bell Gardens and Imperial Heights health clinics. For years, these centers have provided medical care to scores of poor patients.

But under Los Angeles County’s new budget, funds to sustain these health clinics may be cut off Sept. 1, slashing medical resources in Central Los Angeles and flooding already overcrowded hospital emergency rooms and small community clinics with patients needing simple preventive care.

The $13.5-billion budget approved last month by the Board of Supervisors calls for $100 million in cuts in health care. County health officials say that without a state bailout, the cuts mean four of the county’s six comprehensive health centers and 20 of its 39 small health clinics will have to be shut.

Although health care cuts have been made before, none have been this drastic, county health officials say.

“The surprising thing is that money could not be found for such basic health services,” said Dr. A. Nelson El Amin, south district health officer and head of the Florence/Firestone clinic. “That’s probably the biggest shock, that in order to save money, the county of Los Angeles is doing more harm if they close these clinics.”

Two of the imperiled comprehensive centers, Hudson and Humphrey, and two of the clinics, Florence/Firestone and Imperial Heights, are in South Los Angeles, where the bulk of the county’s health care cases are handled. The two comprehensive centers alone account for 500,000 visits a year, taking much of the brunt of urgent care away from hospitals. The two other clinics--Northeast in East Los Angeles and Bell Gardens--are visited by patients 80,000 times a year.

The one hope of preventing the shutdowns is if county officials can persuade the state Legislature to release $72.8 million in tobacco tax funds for the county’s health care programs. The Legislature reconvenes Monday, and a decision is expected before the Sept. 10 close of the legislative session.

“Literally we’re waiting for the governor to call and tell us that we don’t have to pull the plug,” said Fred Gadson, deputy director for the county’s health center operations.

Most patients who use the centers and clinics in South Los Angeles, the Eastside and in Bell Gardens are Latino. Some are recent immigrants; others are on welfare, recently unemployed, or struggling to make ends meet. Many do not have health insurance, and many cannot pay the nominal fees of $10 to $30 charged by the health centers.

“Right now I don’t have medical insurance and they don’t charge us,” said Nancy Vingen, an 18-year-old Cudahy resident who, with her boyfriend, recently brought her 4-month-old daughter to the small Bell Gardens clinic for immunizations.

“We have to pay rent and can’t afford to pay, so this is good, but without this here, I don’t know,” she said.

Marta Munoz, 54, a Hudson center patient, walks three hours from her home near Pico and Crenshaw boulevards to the center at 28th Street and Grand Avenue because she does not have money for the bus. She has no insurance and cannot afford to pay for her visits or medication.

Hudson is the closest health center to Munoz, who is diabetic and comes for checkups every three months. Although she had heard that health care facilities are slated for closing, Munoz said she was not aware that Hudson was one of them.

“I hope to God they don’t close this clinic, because where would we all go?” she said in Spanish after hearing about the closure plans. “If people can’t come here, they may not go anywhere until it’s too late.”

Spanish and English notices of closure dot the hallways at each of the clinics, some in well-placed areas where patients can easily see them, others obscurely tacked on bulletin boards next to signs for proper CPR procedure and baby care.

“It’s as if they’re saying they don’t care if we live or die here,” said Thelma Guererro, 49, of 81st and Compton Avenue, who was at the Florence/Firestone clinic for a pregnancy test. All of her eight children have been to the clinic for vaccinations. All of her five daughters have come for prenatal care.

“We have hardly anything down here, we need these clinics. We have nowhere else to go,” Guererro said.

County health officials have developed contingency plans if the Legislature does not bail out the clinics. Patients and their medical records will be transferred to other facilities, as well as some equipment and supplies.

Should the closures occur, local doctors and heads of community clinics foresee an onslaught of infections and diseases in South Los Angeles, noting that the area’s two comprehensive health centers provide care in 35 medical specialties, including dentistry, dermatology, podiatry, outpatient surgery and urgent care.

“We’re really just on the verge of controlling some of these things,” said Dr. Lillian Phang Lee, head of the Northeast Health Clinic in East Los Angeles. “We’ve already seen what the lack of immunizations caused in 1990 with the measles outbreak. If these clinics close, we’re talking about soaring cases of (tuberculosis), sexually transmitted diseases and other infections.”

Another problem would be overloaded hospitals and small specialty clinics that currently take excess patients from the comprehensive health centers.

Immediately affected in the Central Los Angeles area would be County-USC Medical Center, King-Drew Medical Center, and Daniel Freeman and St. Francis hospitals. Small clinics such as the T.H.E. (To Help Everyone) Clinic for Women, in the Crenshaw area, may also feel a burden. Half of that clinic’s 700 patients are sent by the Hudson center.

“(Hudson has) 10,000 gynecological patients; we have 2,500,” said Sylvia Drew-Ivie, executive director of the T.H.E. clinic.

“It is incomprehensible to me that they would think of closing down those facilities. We will have no place to send patients that we discover have cervical cancer and have no insurance. Our medical facilities are of a limited nature.”