First of County Health Layoffs to Take Effect : Labor: Most of 3,200 workers involved will lose jobs or be demoted this weekend. Federal bailout saved some positions.

In the largest layoffs in Los Angeles County history, 3,200 county health care workers will lose their jobs or be demoted, a majority of them this weekend, because of the county’s worst-ever fiscal crisis.

About 1,600 permanent employees will be laid off, about 1,000 temporary employees will be released and 653 employees will be demoted and see their pay reduced. Most of the layoffs and demotions will become effective Sunday, although today is the last day of work for many. The remainder will be effective at the end of the month.

A broad array of health workers are affected, including doctors, nurses, lab technicians and custodians who were handed pink slips Sept. 15.

“It is very painful,” said the county’s personnel chief, Mike Henry. “I think it’s the largest layoff in the county’s history.”

The layoffs are the first wave in an inevitable downsizing of the nation’s second-largest public health system, the vast network of hospitals, health centers and community clinics that serve millions of county residents who are poor or have no health insurance.

“It’s a significant first step,” Henry said. “‘This is the first step in getting that house in order.”

“These layoffs are shameful,” said Gil Cedillo, general manager of the Service Employees International Union, Local 660, which represents about half the county’s work force. “The county has been unwilling to pursue real alternatives to all these firings.”

For the employees, the past month has been an emotional roller coaster.

In mid-September, when the first round of layoff notices were handed out, the crisis in the health system was threatening to force closure of all of the county’s comprehensive health centers, most of its community clinics and possibly the nation’s biggest public hospital, County-USC Medical Center.

But just when the situation looked the worst, marathon negotiations in Washington produced agreement among federal, state and county representatives on a rescue package for Los Angeles. The $364-million federal bailout announced in Santa Monica late last month by President Clinton during a campaign-style swing through California was enough to save about half the threatened jobs.

A grateful Board of Supervisors backed away from the most Draconian cuts, sparing the hospital and health centers and the community clinics from shutting down. Employees originally scheduled to be laid off Oct. 1 breathed a sigh of relief when the supervisors gave them a two-week reprieve. But the grim reality was merely postponed and the inevitable came to pass Thursday when county officials announced the extent of the layoffs.

Even the huge amount of federal aid was not enough to save the entire health program. Significant cuts still will occur by the end of this month in the outpatient clinics at county hospitals and at the health centers and clinics that will remain in operation.

“You will still have people shocked by the fact that they are being laid off,” Henry said.

Before the federal bailout, nearly 5,200 health workers faced layoffs or demotions. With the new money, the latest estimates sent to the supervisors Thursday are that 3,283 employees will be laid off or demoted by the end of the month.

The supervisors decided late last month to delay the original layoffs and demotions until a plan was in place to restructure the vast system of health centers, hospitals and community clinics. The board has voted to turn over, effective Nov. 1, six of the community health clinics--in the San Fernando and Santa Clarita valleys, East Los Angeles and on the Westside--to private operators.

Local 660 has sued to stop the layoffs of workers in clinics that are scheduled for closure.