Six of the San Fernando Valley's eight public health clinics, including the Mid-Valley Comprehensive Health Center in Van Nuys, will be closed Oct. 1 for lack of money, the county's Department of Health Services announced Monday.
Countywide, the health department will close 28 of its 39 clinics and all six of its comprehensive health centers to save about $100 million for the cash-starved administration.
In July, a special health crisis task force recommended closing the clinics to reduce a $655-million deficit in the health department. Last week, the Los Angeles County Board of Supervisors approved the closures.
"It's obviously a devastating impact," said Supervisor Zev Yaroslavsky.
In the San Fernando Valley, the clinics to be closed Oct. 1 are located in Canoga Park, Burbank, North Hollywood, Tujunga and San Fernando. The larger Mid-Valley Comprehensive Health Center, which was damaged in the Northridge earthquake and scheduled to be rebuilt, will also be closed, along with the Valencia Health Center.
Clinics in Pacoima, Glendale and Lancaster will remain open.
With the exception of the Lancaster clinic, which will offer a variety of health care services, including care for walk-in patients, most of the county's 11 remaining clinics will offer only public health services for tuberculosis, sexually transmitted diseases, communicable diseases, immunizations and HIV testing and counseling.
Currently, county clinics and health centers offer health services that range from prenatal care and gynecology to general medicine and pediatrics.
Although the closures have been discussed for months, Monday's announcement came as a surprise to some clinic users.
When told the news while waiting for a physician at the Mid-Valley health center, Debbie Colson, 27, of Northridge dropped her head and stared at the floor.
"I'm disgusted they want to close down our medical places," she said.
Colson, a Medi-Cal recipient who is eight months pregnant, worries about getting medical attention for her child after the clinics close.
"If they cared about us as much as they said they do, they'd find a way to keep some clinics open," she said. "You've got people on each side of the Valley. That's still a lot of clinics to close. That's a lot of area to cover."
Asked what she will do when the clinic closes, the former waitress responded: "I have no idea. I don't know."
Health officials have warned that the closures could irreparably damage the public health system and leave many uninsured patients to crowd into overburdened hospital emergency rooms for even relatively minor ailments.
"We realize this is going to have a devastating effect on health service, but unfortunately, we don't have a lot of choice," said Kathryn Barger, health aide to Supervisor Mike Antonovich.
The health department selected the clinics for closure based on geographical distribution, the socioeconomic status of their neighborhoods and the physical size of the clinics, said health department spokeswoman Toby Staheli.
"Obviously, we've been anticipating these curtailments," she said. "But that makes it no less devastating. . . . It is a very difficult time for everyone, staff and patients."
County officials chose to close the clinics rather than shuttering County/USC Medical Center or another of the county's six hospitals.
The targeted facilities were not immediately closed in the hope that some clinics can be sustained as public/private ventures, although negotiations are only now under way with private hospitals, nonprofit groups and other health care providers. Yaroslavsky was skeptical of their prospects.
"We have plenty of people who want to take over our clinics," he said. "The problem is that they don't want to care for indigents. We can't have a county clinic that goes private and then serves only those who have insurance."
At the Mid-Valley center, which last year handled about 75,000 patient visits, Rosario Navarro, 22, of Panorama City is worried even though she receives Medi-Cal.
"It's going to be a real problem," she said. "I don't have money to pay for a private doctor."
At the moment, she is pregnant with her first child and past due--her delivery date was last Wednesday. She said she has no idea what she will do.
"I'll have to start thinking about that," she said.
* CASH-FLOW CRISIS: Supervisors to ask state to rush health-care payments. B8