Embattled Refuge : Quake: Veterans protest the upcoming closure of the damaged Sepulveda VA hospital. Some of its programs are moving to the West L.A. center, which they say is too far away and offers lesser care.

Before the Northridge earthquake gravely damaged it, the stately Sepulveda Veterans Administration Medical Center had an unusual reputation among many local veterans: They liked it.

Many VA facilities are held in low esteem by veterans. But Sepulveda--with its serene, park-like grounds, committed staff and respected rehabilitation programs--was viewed as a caring refuge for those bearing the physical and mental scars of service in America’s military.

“This was a safe place for me,” said Dan Tinder, 45, a Vietnam veteran from Reseda who suffers from post-traumatic stress disorder. “When things got really bad, I had my psychiatric unit to go to.”

But since the quake wreaked tens of millions of dollars in damage on the 39-year-old, red brick federal medical complex, VA officials have made sweeping changes that have left Tinder and other veterans fuming.

The temblor wrecked Sepulveda’s 431-bed hospital and knocked out heat and water supplies in the rest of the 51-building complex. More than 300 patients, many of them elderly and infirm, were hurriedly evacuated to several other VA facilities in Southern California.

In March, citing the high costs of rebuilding the Sepulveda hospital, U.S. Secretary of Veterans Affairs Jesse Brown announced that it would be torn down and replaced by a $65-million ambulatory care center offering no long-term beds but a range of outpatient services. The structure is scheduled to open in 1996.

Meanwhile, Sepulveda’s inpatient substance-abuse and psychiatric programs have been transferred to the West Los Angeles VA Medical Center in Brentwood, 15 miles away over the congestion-prone San Diego Freeway.

The changes at Sepulveda coincide with a drive by the VA--the nation’s largest health care system--to convert from high-cost, hospital-based treatment to outpatient care. VA officials contend that the switch will allow more veterans to get treatment at a lower cost.

But many San Fernando Valley-area veterans are angry about the Sepulveda changes. They say the elimination of its emergency room could jeopardize veterans’ lives. And they complain that West Los Angeles offers lower-quality care, is hard to get to and treats them like ciphers.

“One of the vets said the hardest battle we’ll ever fight is against our own government,” said Ryan Smith, a 24-year-old Marine veteran from Toluca Lake who participated in a street-corner protest by veterans outside Sepulveda last week. “That is so true.”

Since the Jan. 17 quake, Sepulveda has dramatically downsized its staff, dropping to 1,123 employees from a pre-quake level of 1,855. About 360 employees were permanently reassigned to West Los Angeles; nearly 400 others retired, took buyouts or transferred to other VA facilities.

With its operating rooms shattered and its brick walls cracked, Sepulveda’s still-standing hospital, Building 3, remains the most visible symbol of the quake’s destructiveness. But damage is apparent throughout the sprawling medical center, clustered atop a low hill and flanked by long, rolling lawns.

Sepulveda’s Olympic-sized pool--once used for physical rehabilitation--remains closed to veterans. Half of its gymnasium is occupied by displaced medical records, reducing volleyball and basketball games to half-court.

Although Brown said Sepulveda’s 120-bed nursing home would reopen by mid-May, elderly residents were not moved back in until just after Thanksgiving, their return delayed in part by unreliable utilities.

VA officials insist the planned ambulatory care center will be a state-of-the-art facility, providing cardiology, neurology, rehabilitative care and other services, as well as minor surgery. Patients requiring major surgery will be sent to West Los Angeles or other VA hospitals.

While Sepulveda treated about 20,000 veterans in its inpatient and outpatient programs in the fiscal year before the quake, the ambulatory care center will provide outpatient care to 22,500 veterans in its first full year in operation, a hospital spokeswoman said.

Sepulveda must remove low-level radioactive isotopes from the hospital before it can be demolished, a process that will be supervised by the U.S. Nuclear Regulatory Commission. Groundbreaking for the outpatient center is expected to take place in about three months.

Though the hospital’s inpatient programs in mental health and drug and alcohol abuse were transferred to West Los Angeles after the quake, Sepulveda continues to provide outpatient care in those areas.

Sepulveda Director Perry C. Norman said the transfers produced few hitches. With an outpatient configuration, she said, Sepulveda will be able to care for more veterans. She cited studies indicating that 60% of all VA inpatient surgeries could have been handled on an outpatient basis.

But the closure of Sepulveda’s hospital, psychiatric wards with more than 100 beds and the inpatient chemical-dependence unit has sparked disappointment and bitterness among many local veterans.

Those with chronic drug and alcohol problems said Sepulveda’s treatment programs served as a sanctuary for them, allowing them to check in for brief hospitalizations during periods of stress and later check out and resume their lives.

“This place is so different. The staff cares so much,” said Doug Gowdy, a 29-year-old Coast Guard veteran who has been treated for alcoholism and drug problems.

By contrast, veterans said, they face staff indifference, waiting lists and broken appointments at West Los Angeles, the biggest of the 171 hospitals operated by the VA nationwide.

Mike Lacock, who served as a Marine corporal in Vietnam and lives in Northridge, said West Los Angeles doctors canceled three appointments with him before he was able to get surgery on a finger that healed crookedly after an infection.

“In all honesty, it didn’t get worse,” he said. “But it’s aggravating as far as wasted time. Man, I wasted days upon days.”

Sherrie E. Gogerty, a recovering alcoholic from Van Nuys who served as an Army private in Saigon, said inpatient substance-abuse programs at Sepulveda were more in-depth, structured and effective than those at West Los Angeles.

West Los Angeles VA officials said a small number of appointments with Sepulveda veterans have been flubbed. They acknowledged that there is a two-week waiting list to get into the alcohol treatment program, but said there is no wait for inpatient psychiatric care.

“They are a small family there; we are a larger family here,” said West Los Angeles spokeswoman Harriett Bordenave. But, she added, “No one is denied care that they need.”

As for the closure of Sepulveda’s emergency room, the hospital now maintains an “urgent care center”--essentially a first-aid station--that is staffed during the day but not at night. For veterans in medical crisis, Sepulveda staffers dial 911 and send them to nearby private hospitals.

At least 80 veterans have been dispatched to outside hospitals since the quake, with no medical complications, Sepulveda Director Norman said.

Valley veterans said the biggest obstacle for many of them is simply getting to the West Los Angeles hospital.

“A lot of these guys are semi-homeless; they’re just out of recovery,” said Don Williams of North Hills, a recovering alcoholic who served three combat tours in Vietnam as an Army sergeant. “They have to take the bus, and that can take three or four hours to get over there. A lot of them don’t have cars.”

Bordenave said West Los Angeles operates a shuttle service between the two medical centers that carries 15 patients per week. She added that the Disabled American Veterans runs a van service as well.

VA officials argue--and leaders of some veterans groups agree--that as the veteran population ages and treatment technology advances, it makes sense for the VA to place more emphasis on outpatient care, and less on inpatient.

“Although the VA is trying to take something away, they’re trying to give them something back,” said Terry Tracy, the Los Angeles-based state service officer for the American Legion, who also praised the VA for not shutting down Sepulveda altogether.

Some veterans’ advocates concede that complaints about Sepulveda’s conversion to outpatient care “aren’t earth-shattering,” as one put it.

But they argue that health care for veterans should not be disrupted at all.

“These are people who gave us a country,” said Lawrence C. Caird, Sepulveda’s administrative officer for psychiatry. “They gave us a free press. They gave us our suburbs. They gave us all the things we take for granted every day.”

“It’s inconceivable to me to make a decision to make access to medical care less convenient to them. I can’t imagine why you would do that to veterans. They are so special.”