Los Angeles Times Special Quake Report: One Year Later : Still Shaken / Challenges : The Comeback Trail / Twists and Turns on the Road to Recovery : Health Care Recovering

Operations of local hospitals and medical facilities hit hardest by the Northridge earthquake are nearly back to normal, but some major links in Los Angeles County’s health system remain missing, and some have been permanently lost.

Among the slowest to recover has been the sprawling County-USC Medical Center complex, where aging buildings took some of the worst hits. The county shut down two major hospitals at the complex--the pediatrics and psychiatric hospitals--and hasn’t been able to rebuild or reopen them.

Permanently lost is the 431-bed Sepulveda Veterans Affairs Medical Center. Veterans Administration officials have decided to demolish rather than rebuild the facility.

Inpatient services at St. John’s Hospital and Health Center in Santa Monica, which were closed for most of 1994, have been up and running since October, but have been significantly downsized. Today the hospital employs about 1,100 health workers, half its pre-earthquake staffing level. It also is operating 262 beds, also about half its pre-quake capacity.

Elsewhere, the recovery at hospitals and health systems has been moving along, with problem areas getting special attention and nearly all the area’s hospitals operating at pre-quake levels.

Hospitals and health facilities were among the region’s institutions hardest hit by the Northridge earthquake, sustaining an estimated $3.2 billion in damage.

About 1,000 patients had to be evacuated from hospitals because of dangerous conditions caused by extensive damage to medical facilities themselves.

Phone lines and electronic links to emergency command posts broke down and were out for days. Backup power supplies failed, causing some makeshift emergency rooms to be set up in parking lots lit by portable generators.

When not enough emergency medical workers were available locally to handle the disaster, teams of physicians, nurses and paramedics had to be airlifted in from other western states, setting up makeshift tent camps outside quake damaged buildings.

Correcting many of those problems has received top priority in recent months, according to hospital and health officials.

The county is close to signing final contracts that will allow it to create its own special health strike force similar to those flown in from other states immediately after the earthquake.

The Southern California Hospital Assn. is in the middle of revamping its emergency electronic communication system, replacing outdated computer software as well as placing new emphasis on training.

Hospital and public health officials held a countywide earthquake preparedness exercise in November at 4:30 a.m., giving valuable training to night-shift crews who were said in some cases to have been unprepared for the pre-dawn Northridge earthquake.

For officials running county public health facilities, though, the top priority is rebuilding the County-USC Medical Center. They had hoped to receive enough federal disaster relief to help build a state-of-the-art hospital to replace the present medical center. But officials were jolted by a recent response from the Federal Emergency Management Agency to a request for $64 million to repair damages at the medical center’s psychiatric hospital: FEMA offered $1 million to do the repair job.

The county is appealing.

“They want us to plaster up the cracks, paint it and bring back the patients,” said one disappointed county official, who asked not to be identified.