Warnings on Closure of Clinics : Health: Doctors say the public will be endangered by plan to shut down 35 L.A. County facilities because of budget cuts.

A plan under consideration by the County Board of Supervisors to shut down clinics in some of the poorest parts of Los Angeles may be what is needed to get the county through another fiscal year.

But doctors at the clinics and even those who proposed the closings agree that unless the clinics are reopened soon the health of all county residents will be endangered and that the long-term costs will far exceed the money saved.

Closing the clinics “moves the county in the wrong direction,” said Burt Margolin, chairman of the task force that wrote the plan adopted by the supervisors.

The 35 outpatient clinics and health centers recommended for closure provide same-day services such as prenatal care and treatment for tuberculosis, hepatitis, diabetes and sexually transmitted diseases. Caring for patients at the clinics can prevent costly hospital care and keep diseases from spreading throughout the population.

“All over the country, outpatient clinics are seen as the best, most cost-efficient way to preserve health,” Margolin said.

The board put off voting on the plan last week, and is likely to take it up Monday.

In inner-city Los Angeles, three health centers--H. Claude Hudson near Downtown, Hubert Humphrey in South Los Angeles and the Edward Roybal Center in East Los Angeles--would close under the plan, along with several smaller neighborhood clinics yet to be named.

Margolin’s task force recommended shutting down the the clinics to keep County-USC Medical Center open. The plan’s premise is that emergency medical facilities should remain open while preventive care centers would close until more money can be found to reopen them.

If the plan is approved by the board, the clinics and health centers will remain open for one to two months. County officials hope that federal funds could then be found to keep some of them operating and that others can be run as public-private partnerships involving the county and private hospitals.

Mary Abbott, medical director at the Hudson health center, said that closing the clinic could cut off care for many of the county’s poorest residents and overload hospital emergency rooms. Hudson receives about 19,000 visits a month, many from patients with no public or private health insurance.

The Humphrey center in South Los Angeles gets 18,500 visits a month, and the Roybal center in East Los Angeles gets 14,000 patients.

The few other options for the uninsured include going to a hospital emergency room or paying cash to see a private doctor, which many can’t afford. “I don’t know where I’ll go if the clinic closes,” said Adriana Contreras, a diabetic South-Central resident who receives medical care at the Hudson center.

Contreras, 56, said she wouldn’t be able to pay for a doctor because she earns just $80 a week sticking labels on computer diskettes.

County officials are hopeful that federal funds that now emphasize hospital care can be redirected to outpatient clinic care, which could keep some of the clinics open.

Phyllis, a 39-year-old patient at Hudson who asked that her last name not be used, said such a policy would have helped her avoid a recent two-week stay at County-USC Medical Center, where she was treated for a large abscess on her arm. “All they did was make an incision and drain it. I wish it could’ve been done at a clinic, and I could come in for follow-up care.”

If the clinics are closed and federal or state money doesn’t come through to reopen them, it is doubtful that private hospitals could care for all of the patients in their emergency rooms, said James T. Yoshioka, chief executive officer of California Hospital Medical Center, which is near the Humphrey and Hudson centers.

Yoshioka said his hospital might have to work with other hospitals and the county to form a partnership to keep the clinics open.

Nancy Delgado, acting administrator of the Hudson center, said cutting off the patients who now use the clinics would endanger the entire population because many have communicable diseases. “A lot of the people who work in hotels and restaurants or clean houses in suburbia are our patients,” she said.