Lifeline in Poor Health : County Budget Woes Put Many Services in Danger

Rosalva Galvan could not afford a doctor for her 3-year-old daughter, Jesenia, when she recently came down with a high fever.

The mother of two finds herself in the same financial situation every month. After she pays for rent, utilities and groceries, she has nothing left of her $600-a-month budget.

So Galvan took Jesenia to the county’s Venice Health Center, which provided a free exam and antibiotics.

The Venice clinic has been Galvan’s lifeline to health services. But the clinic is one that the county plans to close to save money.

Without the clinic, Galvan would have only two local options. One is the Venice Family Clinic, a private, nonprofit center on the other side of town that is already so busy it turns away 50 to 100 people a day. The other is the county’s Yvonne Brathwaite Burke Center in Santa Monica that, for Galvan, is three bus rides away.

“I’m really worried that the clinic will close,” she said. “It will really affect my family. Getting medical care will be much more difficult for us.”

Her fears have echoed throughout Los Angeles County since Chief Administrative Officer Sally Reed proposed last month eliminating staff and services to close a $1.2-billion budget gap. If the Board of Supervisors implements the cuts, more than 18,000 county workers will lose their jobs and many county departments will have to slash their budgets by 20%.

The board has been holding public hearings on the budget proposal and begins deliberations on the cuts Monday. Some county officials say final decisions may not be made until September.

The county’s budget crisis will be felt most deeply by the poor, homeless and mentally ill, who depend on the county for everything from public assistance stipends to medical care. But other residents will be affected too, if libraries and parks are closed.

In the Westside, not only the Venice county clinic is on the chopping block. So is a 29-day residential mental health treatment program in Santa Monica. And Ladera Park is scheduled to close in September.

The decision has already been made to shut down these three county-funded facilities if the board approves Reed’s suggested cuts. But most of the final decisions on closures and layoffs have yet to be made.

Cuts being considered in the Westside include:

* Reduced hours at county libraries in Culver City, Malibu, Marina del Rey and West Hollywood, which already are only open a few days a week.

* Staff reductions at the Santa Monica Probation office, which will force most probation officers to supervise 5,000 cases rather than 1,000.

* Cutting sheriff’s services in unincorporated county areas near Malibu and Marina del Rey.

* Using less-experienced part-time lifeguards for overtime shifts.

Meanwhile, Westside city officials wonder how the county’s budget cuts will affect their own constituents.

“Cities may have to step in and take over,” said John Jalili, Santa Monica city manager.

The sure cuts start on the Westside at the Venice county clinic, which is one of 25 such health centers the county plans to close.

The clinic receives 1,000 patients a month, mostly poor Latino families and the homeless. Most are seen for prenatal care, pregnancy tests, family planning, immunizations and tuberculosis screenings.

“The community trusts our little clinic,” said Connie Eastman, the nurse manager of the clinic. “It’s a safe place to go, especially for those individuals who are a little intimidated by larger clinics.”

The staff at the Westside’s two other free clinics expect to be inundated with new patients, and the situation will worsen if County-USC Medical Center closes as Reed has suggested.

Patients may wait days at a time to be seen by a doctor at either the Venice Family Clinic or the county’s Burke Center in Santa Monica, health experts say.

“It’s kind of hard to imagine because it’s so overwhelming,” said Dr. Susan Fleischman, director of medical services for the Venice Family Clinic. “But we will try to rise to the occasion.”

The outlook is no better for the Westside’s mentally ill residents, many of whom also are homeless. The county Department of Mental Health plans to close Jump Street, the only residential crisis treatment program in the Westside.

Residents who enter Jump Street are those who have nowhere to go when they are released from hospitals or other programs for the mentally ill.

On a recent afternoon, Rich Tarvin, 27, a recovering heroin addict who suffers from depression, was in the kitchen, cooking a pork roast dinner for his roommates.

The week before, Tarvin was hospitalized for the fifth or sixth time after he overdosed on heroin in a suicide attempt. And two weeks earlier, he had been living on the street.

“Since I’ve been here, the change has been incredible--I’m not depressed like I was,” Tarvin said. “In the hospital, they medicate you, stabilize you and send you on your way. But you walk out with the same feelings as when you [went] in--you’ve got no one to call, no one to talk to.”

This week, Tarvin starts work as a printing press operator, a job he got through connections he made at a Narcotics Anonymous meeting.

“When I told them here [at Jump Street] about getting this job, they were real excited, like a family,” he said. “I’d hate to see places like this close if someone out there is feeling as bad as I was.”

The program’s 15 staff members, eight of whom may be laid off, counsel the mentally ill, help them sign up for public assistance programs and find places to live.

Operated by the Didi Hirsch Community Mental Health Center in West Los Angeles, Jump Street and its sister program Excelsior House in Inglewood, got $820,000 from the county last year.

The only other residential crisis program is Compass House near USC.

If Jump Street is closed, mentally ill patients who are released from hospitals and other programs probably will end up homeless or in jail, Jump Street mental health workers say. Most will be hospitalized again and again, with each hospital visit costing 2 1/2 times what care costs at Jump Street, said Fern Seizer, Didi Hirsch’s director of community relations.

Based in a Santa Monica apartment, Jump Street serves six patients at a time and sees about 100 patients a year. Seizer says the program has a 90% to 95% success rate in keeping people out of the hospital.

Although discussions of the budget crisis focus on the loss of benefits for the county’s neediest residents, the impending closure of Ladera Park also concerns the people who frequent the 13-acre county facility.

The park is in Ladera Heights, an upscale and predominantly African American community near Fox Hills, where most households earn $100,000 to $149,000 a year, according to the 1990 census. But it draws people from all over the area.

Starting in mid-September, the county plans to end all childrens’ activity programs at the park, which is the only one in the community. Play equipment will be taken down, trash bins removed and the grass will be allowed to grow wild.

“It’s cutting out all this activity for youngsters and [county officials] wonder why kids are getting in trouble,” said Shannon Burch, who lives in Inglewood but visits Ladera Park two or three times a week.

On a recent weekday evening, children played on swings and jungle gyms as a private security company held practice sessions nearby. Two tennis courts were filled; nearby, a basketball game was under way.

An outdoor amphitheater echoed with music as more than 30 young girls practiced a modern dance routine.

Daytime staff run after-school and summer programs for area children, which cost parents $50 to $120. And, every day, park workers hand out free lunches--sandwiches, milk, fruit and cookies--to anyone in the park who is 18 or younger.

Counselor William Campbell, who has worked at the park since 1986 and grew up in Ladera Heights, handpicks about 25 youth counselors to work at the park during the summer.

“Some of the parents are saying that [the park is closing] because the county thinks in a community like ours . . . they can afford to put kids into private programs.”

While some of the children may have alternatives, gang-bangers will take over Ladera Park in the absence of staff, Campbell predicted.

As the people involved with the Venice Health Center, Jump Street and Ladera Park prepare for cuts, others in the county hope the ax does not fall on them.

Westside city officials are worrying about the trickle-down from the county cuts. If, for example, the district attorney’s office is forced to cut back, city attorneys in Santa Monica could end up prosecuting more cases.

Domestic violence, assault with a deadly weapon, drunk driving and petty theft cases might be turned over to city attorneys, said Alicia Cortrite, chief deputy of the criminal division for the Santa Monica city attorney’s office. But Santa Monica officials say they do not have enough lawyers to handle them.

“We have five attorneys now and we’re busy,” said City Atty. Marsha Moutrie. “If we see a significant number of cases referred to us, we’ll have a problem.”

In Culver City, near Ladera Heights, the concern is about people who used to use Ladera Park using city parks instead.

“We’re surrounded by county property so it hits us doubly hard,” said Syd Kronenthal, Culver City director of Human Services.

“Our parks are already overloaded.”

Malibu officials already are thinking of ways to counter the effects of the county cutbacks--like taking over the county library and collecting the property taxes that fund it, said City Manager Dave Carmany.

For now, however, there is nothing to do but wait . . . and worry.

“The county has exhausted all the creative financing mechanisms it had in the past, and it is staring the cold truth in the face,” Carmany said. “We’re all going to suffer as a result.”

On the Cover

Like many, Rosalva Galvan and her family depend on health care services that are threatened by the budget problems of Los Angeles County.