6 County Clinics Go to Private Providers : Health: Nonprofit groups will run the facilities catering to indigent patients for three years. Some view county’s move as a new era for such partnerships.

Los Angeles County handed over the keys of six county clinics to private health care providers Wednesday, beginning a new era in the delivery of health care to indigent patients.

The clinics, two each on the Eastside, the Westside and in the San Fernando Valley, will be run for at least the next three years by well-established, nonprofit community-based health providers.

Some view the privatization of the six county clinics--an outgrowth of the county budget crisis--as an experiment, while others say it is the beginning of a future that will see more public-private partnerships as county health services are overhauled.

County Supervisor Zev Yaroslavsky, participating in a ceremony in Canoga Park, said that ultimately the privatization efforts could involve the remaining 34 county clinics, and maybe even several of the county’s six hospitals and larger regional health centers.

Under the contracts with the private providers, the county will retain ownership of the clinics, but will turn over the buildings and all the equipment to the private groups, which will staff them. The county will continue to provide specialty care and beds at its hospitals for patients whose medical problems go beyond the expertise of the clinics.

Walter Gray, an assistant director of the county Department of Health Services, said: “We are not abandoning these patients. They are still part of our system, and we are committed to taking specialty referrals as the needs arise. It is a shared risk.”

Gray said the county expects to save at least $1 million in salary costs by giving up management of the clinics. If all the clinics are ultimately privatized, the county could save $40 million, Gray said.

But, for the time being, Wednesday’s formal changing of the guard at the six clinics was a big enough bite to swallow.

For its initial foray into privatization, the county chose three providers with proven track records for treating low-income patients: the Venice Family Clinic on the Westside, the Northeast Valley Health Corp. in the San Fernando Valley and the Community Health Foundation of East Los Angeles.

Questions were plentiful Wednesday, most centering on patients. Would they get the same kind of care provided by the county? Better care? How will the clinics--which operate on a mix of federal health dollars, grants from nonprofit foundations and volunteer efforts--deal with what they expect to be the crush of indigent patients?

It was clear that it will be months before those questions can be answered.

Only a small number of patients showed up at the clinics Wednesday. Administrators said the county clinics were still experiencing a drop-off in patient traffic because many thought the clinics were being closed.

One of the first jobs of the new operators is to get the word out that the clinics are open.

But generally the mood was upbeat.

“We are not in this for the short term,” said Liz Forer, the executive director of the nonprofit Venice Family Clinic, which is taking over two clinics on the Westside. “We plan on being here to stay.”

Robert Smith, executive director of the Northeast Valley Health Care Corp., said he was looking forward to the challenge of operating the county clinics in Canoga Park and Valencia.

“It all feels so natural and was bound to happen,” Smith said at a brief ceremony in Canoga Park in which he was handed an oversized cardboard cutout key by a county official. “This fits well into our mission of providing health care for the underserved.”

Founded in 1971, the corporation opened its first clinic in the Valley in 1973, serving the poor. The corporation is run by a board of directors, more than half of whom are treated at Northeast Valley clinics. It has 300 employees, compared to the nearly 30,000 working at the county Department of Health Services. With the two county clinics, Northeast will now have four clinics.

Yaroslavsky joined Smith and others in the small ceremony in Canoga Park that marked the changing of the guard. Yaroslavsky said that although risks were involved in turning over management of the clinics, the county just could not “return to its old ways of operating after the budget crisis.”

“The county can no longer shoulder that responsibility as a closed system,” he said. “The money is just not there.”

Burt Margolin, the county’s health crisis consultant who was instrumental in fashioning the contracts with the private providers, called the county’s privatization efforts “an historic watershed for the county and the health care delivery system.”

As for the future, Margolin is in the process of putting other county clinics up for bid. He hopes to begin soliciting proposals by the end of the month, with contracts awarded in February.

“Though we still have a ways to go, we are hoping that Los Angeles can become the model for the nation,” he said.

He said efforts were made during the first round of privatizing to find clinic operators who had a history in their “words and deeds” in caring for low-income people.

The private operators say they will try to hire as many laid-off county health workers as possible. Hundreds of county workers lost their jobs because of spending cuts.

Marta Dwyer, a registered nurse who had been laid off from the Mid-Valley Comprehensive Health Center, was one of those rehired. She will be a nursing supervisor at the Canoga Park clinic.

“I’m really happy to see that someone else has taken over the center,” she said. “There will be a place for the people to come to.”