County Health Workers Meet Day of Reckoning : Budget: As 3,000 are laid off or demoted, colleagues fear the impact on low-income residents who need care.

By HENRY CHU, JON D. MARKMAN and JEFF BRAZIL

Oct. 14, 1995 12 AM PT

TIMES STAFF WRITERS

For a weeping Doris Hish at Olive View/UCLA Medical Center in Sylmar, the morning was devoted to firing 35 people--with a dozen more to go in the afternoon.

At County-USC Medical Center, Marsha Murray’s best friend and fellow nurse was gone by day’s end.

And in Van Nuys, denial and devotion came together in Ana Banos, a nursing attendant who refused to consider the idea of losing her job one moment, then prayed to be spared the next.

Across the region on Friday the 13th, about 3,000 doctors, nurses and staff of Los Angeles County’s beleaguered health care system received some of the worst news of their lives in the form of pink slips and notices of demotion. Struggling to stay afloat in their worst fiscal crisis ever, county officials brought the ax down on public hospitals and clinics, cutting both longtime and freshmen employees and threatening the quality of care in the future.

It could have been worse, said county officials, who at first predicted layoffs of up to 5,200 people. But that truism offered scant comfort Friday to those who were swept up in the flood of workers let go by 5 p.m.

And it was also little solace for people like Murray, who kept her job but saw best friend Carrie Corn--voted Nurse of the Year by the emergency room’s residents--leave because she could no longer cope with the instability at her workplace.

“I’ve been here 14 years and people say I’m the lucky one,” Murray said Friday, “that at least I get to keep my job.”

But as she fielded a call from Rescue 15, which had an 80-year-old man with a broken hip, fed a sandwich to an invalid who had just been brought in and hadn’t eaten in five days, and scanned the full bench at the cardiac booth, Murray felt anything but lucky. “It’s like saying you’re the only one to have survived a plane crash and there are 300 dead people lying around you.

“Until it’s Pete Wilson lying in the critical care booth, or Sally Reed, people won’t realize how tragic this is.”

At the Mid-Valley Comprehensive Health Center in Van Nuys, the banner proclaimed brightly, “We Are Here to Serve You,” but it sagged to one side, barely staying mounted to a chain-link fence. As a symbol, it seemed terribly precise as doctors and nurses went about the business of helping patients amid the steady rain of bad news and flagging spirits.

The day started with a bundle of letters in the center’s administrative office--letters that held the fates of dozens of employees at clinics throughout the San Fernando Valley. Some were told that this day was their last; others were given two weeks’ notice.

For those who survived the morning round at the Mid-Valley center, another batch of letters was due later in the afternoon, spawning an air of uncertainty that made it difficult to concentrate on the tasks at hand.

“I’ve been crying a lot. We’ve been very depressed,” said Banos, 32, a nursing attendant on loan from the North Hollywood clinic. She was handed a layoff notice last month but had received no final word on her status by lunchtime.

“I wanted to prepare [for a layoff], but I also wanted to hope until the last day,” said the nervous sole provider for her 4-year-old son. “That’s my problem: I still believe it’ll be OK, that God’s going to be good to me.”

“It really has been awful,” said Diane Cross, a prenatal nurse left untouched after the first wave of letters. The county supervisors have been “vacillating one way and another. They’ve kept us dancing,” she said.

The work schedule in the prenatal unit has been mapped out for the coming weeks. But spaces for names have been left blank, said nurse Socorro Salanga at the center, which has been housed in a cluster of trailers since the Northridge earthquake.

In some ways, this fiscal crisis has seemed more arduous than the quake, Salanga said. “This is prolonged,” she said. “With the earthquake, you knew immediately what you got. This has been going on for how many months now?”

Several. At Olive View, what was dubbed the “Friday the 13th massacre” by its head doctor was bloody indeed.

Hish, a 39-year veteran at the hospital who supervises patient services, fired 35 people by 1 p.m.--and still had a dozen more termination notices to give.

“These people came here for a promotion and more money. Now they’re out of a job,” said Hish, weeping.

Many of her employees attended farewell luncheons for laid-off co-workers, unaware that they would be in the same position by day’s end.

“Little do they know that when they come back to work in the afternoon, they’re going to lose their jobs, too,” Hish said.

After his layoff--one of 499 due at the hospital--Marco Figueroa said his teen-age daughter may have to postpone the college education she was hoping to receive at Cal Poly Pomona.

“I was never told I could lose my job. I thought my seniority came with me,” said Figueroa, a worker in patient financial services. “It’s unfair and unjustifiable to lose 11 years of my life like this. . . . I’m out on the street on Monday.

“Can I really go back to work at age 47?”

Even a transfer proved too much for typing clerk supervisor Rita Nolasio, who broke down and wept.

“This hospital has been like my family, and this has been my house. And now it’s like they’re saying, ‘Get out of our house! Get out, get out!’ ” said Nolasio, the widowed mother of a 4-year-old daughter who attends the kindergarten class held at the hospital.

Irwin Ziment, medical director at Olive View, laid off two doctors Friday morning. One took it stoically. The other?

“The other, I would say as a clinician, was in a state of shock.”

Ziment added: “I really regret the horrible sense that America is the richest nation on Earth, and yet we are seeing an erosion of society’s care for the less fortunate. Our patients might be criminals or drug addicts or sociopaths, but we see them all as humans, as patients, and even as friends. . . . We’ll all be much busier, working in a more mechanical fashion. And that makes me very unhappy.”

Some laid-off doctors, he said, have offered to come back to work as volunteers. “They’ll work for free as they sort out their future,” he said.

“That’s the kind of doctor we have here.”

For professionals bound by their commitment to caring for the underprivileged and by their experiences in serving that calling, recent weeks have been filled with more than the usual doses of anguish and sadness.

Many seemed most worried about the fate of others. Those who lost their jobs or had abandoned them worried about what would become of their former colleagues. Those who still had their jobs fretted about their patients. Many patients were among those shedding tears, realizing they would never again see some of the people who had treated their families for years.

At the Northeast Health Center near Boyle Heights, some of the adult patients first visited the 40-year-old clinic as children and received their immunizations there. For decades, the red brick building on Marengo Street has served as a haven for the area’s mostly Latino residents to get good medicine and a warm hug from the staff, many of whom have worked there a decade or longer.

Now, the clinic is one of six being privatized.

The staff of 11 public health nurses at Northeast is being transferred to the Central Health Center on Figueroa Street, where their former patients will now have to go for treatment. The Northeast health district serves more than 90,000 people identified as poverty-stricken, and there is considerable concern that they lack the means to make the longer trip to Central.

“It’s another barrier for our patients, whose priority is putting food on the table and having a roof over their head,” said public health nurse Nina Cogan, who has worked at the Northeast clinic off and on since 1968.

“This is going to affect everybody,” said Cogan’s colleague Emily Avila. “The people we treat for TB and communicable diseases work in the food industry . . . and other industries. And if they don’t get treatment, that will facilitate the spread of communicable diseases.”

Some wondered what sort of services the clinics could provide with their whittled-to-the-marrow staffs.

At Martin Luther KDrew Medical Center, 27 people were laid off from a busy, inner-city surgery unit.

“We are not going to be able to provide the proper level of care,” said Mary-Anne Purtill, a surgeon in her fifth year of residency in the trauma center.

“I already work 80 to 100 hours a week. What more do you want from me? What more can I give this hospital, this county, the poor people in this region? My question is, when will the rich white people feel responsible for the poor minorities? Where are all the Christians? They talk big talk and they give lots of money to their pastors, but they don’t help the people in here, the people who need it most.”

Surgeon Romeo Massoud predicted that patients needing non-emergency surgeries would have to wait months. “We already have a backlog,” he said. “Where will these people go?”

Added Melvin Jones, another surgeon: “It’s just sad. The system is broke. You talk about cutting the fat? This system is already down to skin and bones.”

At High Desert Hospital in Lancaster, 102 employees were scheduled to lose their jobs.

At Harbor-UCLA Medical Center, a freak electricity blackout forced the staff to begin the day on an ominous note, leading to an afternoon when 319 employees received the long-dreaded notice that they were being laid off. That represents a cut of nearly 9% in the 3,600-member staff of the sprawling Torrance facility.

In addition to the layoffs, 137 employees will be demoted or transferred to another county facility--the so-called cascade, bemoaned by physicians for replacing highly trained staff with others from different specialties who happen to have Civil Service seniority.

Julie Noble, medical director of pediatrics for the Community Health Program, said the pink slip she received last month was rescinded Friday. But the fact that the county even considered firing her boggled minds, since she oversees the care of 1,000 children and her program, a managed care plan for Medi-Cal patients, brings in $150,000 a month in Medi-Cal fees.

Bill Kingman, director of ambulatory care at the hospital, said he had tried to save employees who were a part of critical programs, such as the HIV and pediatrics sections. But he could not save all of them, including the manager of the women’s breast health program.

“That’s going to be a big problem,” he said. “She was bumped because the Civil Service system did not recognize her specialty.”

As evidence of what the next crisis might be, the earliest available appointment in the cardiology clinic is for mid-December.

In Long Beach, Mel Grussing, administrator of the Coastal Cluster Health Centers, said the number of patient visits had plummeted by two-thirds after residents there had been told weeks ago that the cluster’s seven clinics would be closed.

With words of anger and sadness, employees at the Canoga Park Health Center had a last lunch together and bade their farewells. If it seemed more like a funeral, it felt like one.

“Our family is being divided,” said Lucia Carpenter, head physician at the health center.

Said Alise Unzueta, a 30-year county health employee who was transferred from the clinic down to Rancho Los Amigos Hospital in Downey: “You give your life to something for so many years just to turn around and get kicked down.”

Times staff writers Lucille Renwick, J. Michael Kennedy, Terence Monmaney and Jeffrey L. Rabin contributed to this story.

(BEGIN TEXT OF INFOBOX / INFOGRAPHIC)

Impact of the Layoffs

To cut its budget, the county will lay off or demote 2,656 health workers by Sunday and another 627 by Oct. 31. Major county hospitals and their outpatient clinics will be the hardest hit. Here are breakdowns by job category and location.

Layoffs and Demotions by Job Category

Professionals (includes doctors, nurses, social workers): 1,354

Clerical: 590

General Services (includes nursing attendants, food service, laundry workers, lab attendants): 588

Paraprofessionals (includes lab technicians, physician’s assistants, accounting, physical therapists, licensed vocational nurses): 283

Management and staff: 219

Craft workers: 199

Hospital Layoffs and Demotions

*--*

Temporary Employees Permanent Employees Demoted Location Released Laid Off Employees County-USC 190 440 179 Olive View/UCLA 311 188 89 Harbor-UCLA 115 204 70 King/Drew 127 143 63 Rancho Los Amigos 55 146 47 High Desert 24 78 35

Location Total County-USC 809 Olive View/UCLA 588 Harbor-UCLA 389 King/Drew 333 Rancho Los Amigos 248 High Desert 137

*--*

Layoffs and Demotions at Health Centers and Clinics

Location: Northeast Cluster (includes Downtown, parts of South-Central and east L.A. County as far as Pomona)

Temporary Employees Released: 50

Permanent Employees Laid Off: 131

Demoted Employees: 23

Total: 204

Location: San Fernando Valley

Temporary Employees Released: 28

Permanent Employees Laid Off: 23

Demoted Employees: 8