5,200 Get Layoff Notices at Clinics in L.A. County

The real agony created by Los Angeles County’s worst fiscal crisis made itself felt Friday as nearly 5,200 county health workers--from doctors and nurses to lab technicians and custodians--were handed terse notices saying they will lose their jobs or be demoted within two weeks unless financial salvation arrives from Sacramento and Washington.

“In my 31 years of county service, I never dreamed I’d see a day like this,” said Harvey Kern, spokesman for County-USC Medical Center, the nation’s largest public hospital where more than 1,000 employees got layoff notices. “What do you say to people? How do you console them?”

“It is a tragic day,” Los Angeles County health czar Burt Margolin said. “Some very talented people--a lot of very talented people--are losing their jobs and being demoted, and a system that provides vitally needed care is suffering serious damage.”

Even the $100-million-plus assistance package under review in Sacramento would not be enough to solve Los Angeles County’s financial problems, officials acknowledged, but the pressure was on to deliver some kind of help as state lawmakers in Sacramento inched toward their midnight scheduled adjournment of this year’s legislative session.

The Orange and Los Angeles counties’ rescue plans are tied together legislatively, but the approval of the Orange County package and the Assembly’s approval of part of the Los Angeles County package seemed to indicate success for both was at hand. They still need approval of Gov. Pete Wilson.

In Los Angeles, the day began with the first layoff notices going out shortly after midnight--often with a loudspeaker summons to a supervisor’s office and a request to please sit down. Within hours, employees at all of the county’s vast network of comprehensive health centers, community clinics and hospitals had gotten the news.

Many lost jobs even though their facility was not targeted for closure, to make room for others with more seniority.

All told, 4,166 county workers received tersely worded layoff notices, which blamed the state and federal governments for the county’s woes. An additional 1,034 were told they will be demoted, and 1,500 more will be transferred from one facility to another when the closures begin Oct. 1.

“Some expected it. Others were very upset, and understandably so,” said nursing director Irene Recendez at the Roybal Comprehensive Health Center in East Los Angeles, halfway through her list of 75 layoff meetings. “It’s a total nightmare.”

Even though it has been saved from the chopping block, for now, County-USC Medical Center was hit unexpectedly hard. The layoff notices began in the pre-dawn darkness and continued until midnight.

“A lot of people who issued letters got letters themselves,” said a visibly shaken spokesman Kern. “I’ve seen a lot of tears.”

The mammoth Eastside medical center, like other facilities, was reeling from Friday’s hit. Doctors, nurses and technicians alike meandered out of its front doors as if sleep-walking, clutching the manila envelopes that contained information on job fairs and the like, and showed to their fellow employees that they were among those who may soon be gone.

Dick Hebert, a 59-year-old Burbank widower, walked the grounds for hours, dwelling on his 12 years of service as a surgery unit secretary. “I’m devastated,” he said flatly. “I feel crushed and angry and disappointed.”

As employees at one clinic after another found out who received layoff notices, many patients and workers--particularly those in inner-city areas--expressed anger, sadness, frustration and dismay. Many said they’d been in denial that the notices would actually go out.

Some expressed greater concerns about the future of their patients than about their own.

“I have such a sick feeling for my friends,” said Cliota Davis, a licensed vocational nurse at the Hubert H. Humphrey Comprehensive Health Center in South-Central Los Angeles. She will be transferred. But the entire team of pediatric doctors she worked with were told they will be let go. “I feel as though they just destroyed my family,” she said.

Just in case, there was heightened security all around. At the sprawling Roybal Comprehensive Health Center in East Los Angeles, nurse Gabriel Centeno wandered past more than a dozen security police, poring over the same typewritten letter given to thousands of other health workers across the county.

“This is to notify that you will be laid off . . . at the end of your shift on Sept. 30, 1995,” it read. “We appreciate your dedicated service to the County of Los Angeles, and regret the necessity of this action.”

As she read, Centeno was approached by a couple of her nursing colleagues with open arms. “I’m gone,” she told them. “It’s hard. But I feel more for the patients than I do for myself.”

“At least we have our health,” said a colleague, as a small consolation.

*

A few blocks away, Gloria Molina, chairwoman of the Board of Supervisors, faced a sad and angry crowd of health workers and patients who had marched from Roybal to her storefront field office.

“Believe me, this is a disappointing day for me as well,” Molina told them from atop a union sound truck. “It’s been a tough decision, but a decision that had to be made.”

Without a state and federal bailout, Molina warned that entire hospitals, along with the county’s health centers and most clinics, also may have to close.

“Very frankly, we’re not even sure now we can save the hospitals,” she told them, standing aside employee union leader Gilbert Cedillo. “The situation has gotten worse, and I’m disappointed too.

“Hopefully we can keep the clinics open,” Molina said, by forming public-private partnerships with hospitals or medical groups. But the crowd booed and jeered.

Dr. Jack Kent, a physician at Roybal who was wearing a black armband, seized on Molina’s choice of words, and shouted back at her: “Hopefully? You hear that? We’re living on hope!”

To Molina, the crowd chanted, “Fix it!” over and over.

But there were no easy fixes.

“This is not the result of any kind of rational planning,” said Margolin, the county’s health czar. “This is driven by a budget disaster.”

The county’s current financial predicament comes after years of spending far more than it takes in, supporting a massive work force and a wide array of services in part by borrowing that has included mortgaging the Hall of Administration itself.

This year, however, the budget process has taken on added urgency because of decreasing revenue due to a punishing recession, cuts in state and federal funding, a huge shift of county property taxes to help the state out of its fiscal woes, and newfound scrutiny of county fiscal practices after Orange County declared bankruptcy.

On Friday, those forces came together in the mass layoff notification.

“It’s a frustration to everybody,” said outgoing county Health Services Director Robert Gates. But he was especially concerned about the patients. “We’re used to treating everybody who comes through our doors. . . . They need our system for care,” he said. “We’re not going to be able to respond unless something improves.”

After 3 1/2 months of ups, downs, rumor and recrimination about what the fiscal crisis might bring, the impact was sweeping.

More than 1,000 health workers in the San Fernando Valley area received layoff notices. At the county’s newest hospital--Olive View/UCLA Medical Center in Sylmar, 746 of about 2,400 employees received notices.

“People are devastated. I am devastated,” said Melinda Anderson, Olive View’s administrator. “But even though we’re in the middle of a curtailment, people are still getting sick, and we have to collect ourselves so we can take care of them.”

At the area’s nine health clinics--five of which are scheduled to close--workers reacted to receiving pink slips with emotions ranging from teary outbursts to tight-lipped silence.

Some expressed relief, saying that after spending their summer relying on second-hand gossip and hinging their hopes on shifting plans to save the health-care system, the layoff notices finally brought some resolution.

“It’s done, finally, so now I can move on, decide whether to look for [another] job or go into private practice,” said Shung Cheung, a pediatrician who received a layoff notice at the Canoga Park Health Center.

Cedillo, general manager of county’s largest labor union, Service Employees International Union Local 660, also urged workers to stay at their posts and provide care. He spent the day crisscrossing the county in his new black Mustang speaking at clinic after clinic, exhorting workers not to give up. The money will come from Sacramento and Washington, he said, because it simply has to. The system cannot shut down. “Don’t give up!” Cedillo told one group. “This is not over yet.”

As the day ended, the fate of Los Angeles County’s bailout package was in the hands of weary lawmakers whose session has been more notable for its bitter political infighting than its accomplishments.

In a departure from the internal chaos that has wracked the Assembly for months, Los Angeles area Democratic legislators scored a major victory when the lower house voted 61 to 8 to divert $150 million from the MTA to the county. The bill was sent to the Senate.

Though it is only a fraction of the money needed to rescue the county’s deeply troubled ahealth-care system, the proposed transportation fund shift was substantially more than the $50 million that had appeared possible only days ago.

The transit funding maneuver still faced an unknown reception from the Los Angeles Board of Supervisors because $100 million of it is a loan that must be repaid over the next five years, a continuation of the borrowing that has aggravated the county’s financial problems for years.

*

Determined to help the county, the Democrats won over important former foes in securing approval from the governor. The package of bills had the added insurance of being linked to the Orange County rescue that all along has enjoyed broader support.

Assemblywoman Martha M. Escutia (D-Huntington Park), the author of the MTA measure in Assembly, said she was “very happy that Republicans and Democrats alike saw the wisdom passing a measure that will give some vital relief to L.A. County.”

She said the linkage to Orange County’s rescue was crucial. “That may have been the carrot, but I’m glad that colleagues on both sides of the aisle, as well as the governor, worked hard to get this.”

Assemblyman Kevin Murray (D-Los Angeles) credited “vigorous lobbying of Republicans and the Administration” for the lower-house victory. “It’s not a perfect solution but it’s a solution. We didn’t even have a raucous floor debate. For once the system worked.”

Out of the running, however, was a proposed new tobacco tax that would have been levied only in Los Angeles County with revenue estimates of hundreds of millions over the next five years. Republicans killed the tax plan late Thursday in the Assembly.

Of the lesser proposals still before the Legislature in its closing hours:

* A trade-off with the state on the costs of jailing juvenile offenders, involving $18 million from the state to the county to run probation camps, but $4 million from the county to state in new costs for accepting county offenders into the California Youth Authority penal system, with county costs rising in future years. Built into the equation would be incentives for the county to send to state confinement only its most violent young criminals.

* Ending the requirement that Los Angeles County provide health services at previous levels in order to receive its share of state tobacco tax revenue collected under Proposition 99. Instead, the county would be obligated only to “exert its best effort” to provide at least 75% of the health services it offered in 1992-93. Estimated benefit to county: $50 million.

* An additional $60 million would be coming the county’s way under a bill that would accelerate the payment of federal funds to county hospitals. The federal funds are used to supplement Medi-Cal payments to so-called “safety net” hospitals that serve large numbers of poor patients.

Another controversial feature was a list of “accountability” requirements that came wrapped into the fund-shift bill--a component that county officials were reported to abhor and that the MTA and others applauded.

Under the bill, Los Angeles County would be required to submit for review its budget and other financial dealings to the governor, Legislature and state auditor general, who would order up periodic audits on the county’s fiscal condition and report findings to the governor and Legislature. That section of the funding bill, while eliciting strong reactions, was nevertheless mild compared to a bill introduced earlier by Assemblywoman Debra Bowen (D-Marina del Rey) that would have essentially removed county finances from county control and placed them under the aegis of the state.

Rabin and Meyer reported from Los Angeles, Vanzi from Sacramento. Also contributing to this story were Times staff writers Jack Cheevers, Timothy Williams and Richard Simon in Los Angeles, Paul Richter and John M. Broder in Washington, and Jenifer Warren in Sacramento.