L.A. County Plans to Cut Health Jobs

Los Angeles County’s health department is preparing to lay off between 1,375 and 2,475 workers by June 30 in a mass dismissal meant to stabilize a teetering system whose long-term costs are steadily outstripping money to pay them.

By the end of June, the county hopes to close Rancho Los Amigos National Rehabilitation Center in Downey and convert High Desert Hospital in Lancaster to an outpatient center. Fifty beds at County-USC Medical Center in Los Angeles will also be eliminated, with 50 more to follow over the next fiscal year.

These reductions, part of a major overhaul of the county’s beleaguered Department of Health Services, will touch off a tidal wave of transfers, demotions and layoffs across the public health system, as employees with seniority displace those with fewer years on the job. More than 10% of the department’s 23,345 workers, including doctors, lab technicians, physical therapists, clerical workers and custodians, could be affected.

“We are in very, very difficult financial times,” said Rene Topalian, the department’s acting director of human resources. “It’s not pretty.”

The exact number of people who will lose their jobs is difficult to calculate, Topalian said, largely because Rancho’s future remains uncertain. On Friday, a federal judge issued a tentative ruling indicating that she may block the hospital’s closing until the county proves that disabled patients can obtain comparable treatment elsewhere.

Also complicating matters is the health department’s unpredictable attrition rate, which has climbed as high as 7% in recent months -- triple the usual rate -- as employees have reacted to the uncertainty roiling the department.

“I have some colleagues who are really getting fed up with it. They just want to go,” sighed Lorraine Torres, a clerk in Rancho’s laundry room who has worked at the hospital for 23 years. “Then I know some who don’t believe this is really happening here. They are going to stick it out until the last minute.”

The county Board of Supervisors voted in January to close Rancho, a nationally known hospital specializing in the rehabilitation of patients with severe head and spinal injuries. But supervisors also left the door open a crack by directing the health department to work with the California Community Foundation to see whether Rancho could survive as a private, nonprofit hospital.

The foundation plans to issue a detailed report Monday, concluding that such a scenario would be “financially viable,” said Judy Spiegel, senior vice president for programs at the foundation.

The quickest and cheapest solution would be to entice an existing hospital to take over Rancho’s operations in a smooth transition that would not disrupt staffing or patient care. But no such hospital has stepped forward, Spiegel said.

With Los Angeles County struggling to plug an $804-million budget gap for the fiscal year that begins July 1, the Board of Supervisors has shown little appetite for funding Rancho another year. Supervisor Don Knabe, whose district includes the hospital, is still hoping his colleagues will agree to finance a slimmed-down Rancho until a nonprofit hospital can take it off the county’s hands.

Rancho Lawsuits

Other wild cards in the mix include two lawsuits that public interest groups have filed against the county to halt Rancho’s closing, neither of which has been resolved. On Monday, U.S. District Judge Florence-Marie Cooper will hear arguments in one case and may issue a preliminary injunction that would prevent Rancho’s closure.

From the county’s viewpoint, any delay in shutting Rancho means lost savings.

The health department is already spending money that it had counted on saving as it explores the possibility of privatizing Rancho.

Health officials had originally planned to begin layoffs in May. With the move delayed until June 30, “the department will not achieve approximately $7.5 million in savings,” Director Thomas Garthwaite informed the supervisors in an April 1 report.

The health department has endured painful layoffs before. In 1995, the county laid off or demoted about 3,000 health workers.

Under the county’s civil service rules, the department can lay off employees on the basis of their job classifications, cutting people with poor performance evaluations first. Within any given class of workers, those with less seniority are dismissed before those who have been there longer.

The result is a cascading effect whereby a medical technician with 20 years at Rancho, for example, might displace a medical technician who has been working at County-USC Medical Center for five years.

That worker, in turn, might bump a technician at Olive View-UCLA Medical Center in Sylmar who was hired just six months ago, who would be laid off.

The uncertainty has rattled workers throughout the public health system.

“If my job goes, we’re going to be hurting,” said Eric Servin, a warehouse manager at Olive View who oversees the hospital’s medical supplies. “I don’t know if I’m going to be able to provide for my kids.”

Like other health workers, Servin is also deeply troubled by the thought of what will become of all the ragged, sick people crowding his hospital’s waiting room. “I’ve gone to work and seen the mothers with sick babies in their arms, sitting there,” he said. “When I leave, the same people are still sitting there, eight hours later. What’s it going to be like when they close more hospitals and lay off all these people?”

Looking for Work

Across the county at Martin Luther King Jr./Drew Medical Center near Watts, Dr. Roberta Bruni, a neonatologist who is the sole breadwinner for her three kids, said she is already looking for another position.

“I don’t have any doubt that I will lose my job. It’s very, very likely,” she said. “But I’m much more worried about my patients.”

Bruni said that cutting King/Drew’s obstetrics and gynecology services or the neonatal intensive care unit would have a devastating effect on a poor community where the number of babies born to teenage mothers is triple the national average.

Health officials declined to specify which of the department’s roughly 800 job classifications could be targeted for layoffs, saying the affected employees would not be informed until June 15.

“We will go right down to the wire,” Topalian said.

He did confirm, however, that one class of employees is relatively safe. Given the nationwide shortage of nurses, he said, “We wish to keep all of our nurses.”

Under the terms of their labor agreements, county officials must hold a series of meetings with union representatives to outline the layoff process.

Some meetings have already been held, but union leaders complain that, so far, information has been “fuzzy.” Many workers are still holding out hope that Rancho, at least, will be spared.

If Rancho is eventually downsized or closed, other hospitals may hire some displaced workers if their skills match the hospitals’ needs.

Job Fairs Scheduled

“I know some of the people over there, and if they don’t have a job, I’d love to give them one,” said Dr. David Alexander, medical director of the rehabilitation centers at Daniel Freeman Memorial Hospital in Inglewood.

Alexander said that his hospital was already considering expanding its 48-bed acute rehab center, which specializes in neurological injuries, before the county moved to close Rancho.

The county health department, meanwhile, has scheduled three job fairs in June to help its ousted employees find work.