THE LONG WAIT; OLIVE VIEW ER CARE STILL NIGHTMARE.

Byline: Janet Gilmore Daily News Staff Writer

When Yolanda Ortiz's mother woke up one day last week complaining of numbness in her right arm, she feared the 55-year-old diabetic might be having serious heart problems.

Ortiz took her to Olive View-UCLA Medical Center in Sylmar, where they sat with roughly 50 other patients and waited most of the morning and into the afternoon to see a doctor.

``I thought maybe one or two hours,'' she said, some four hours into her wait. ``Nobody told me it was going to be so long.''

Apparently, Ortiz had never visited Olive View's emergency room before.

Two years ago, administrators at the San Fernando Valley's only public hospital announced plans to reduce ER waits by shifting patients to a network of neighborhood clinics where nonemergency cases can be handled.

Yet today the emergency waiting room remains clogged - a longstanding problem that community activists brought to hospital officials last week and demanded be corrected.

``It's been a long time. But people felt they couldn't do anything about it,'' said Lenor Ramirez, an organizer for Valley Organized in Community Efforts, a coalition of community religious organizations.

Anderson said Olive View is attempting to address the concerns raised by patients - including the earful that she received during a community meeting in San Fernando last week.

Patients complained that waits can last 12 hours or more. But Anderson said the average wait time in the clinic has been reduced from 12 hours to about five hours, she said, and some clinics have extended their hours and their services.

Ambitious plans

She contends that what stands in the way of Olive View's ambitious plans to pare waiting times in the ER are financial constraints, patients who end up in the ER unnecessarily and difficulties in spreading the word about the clinics and services there.

``We're strapped,'' said Anderson, hospital administrator. ``We're trying to tell people we're open (in local clinics), but the problem is we don't have money to advertise.''

Sixty percent of the patients at the hospital's ER should not be there because their conditions do not require emergency care but have ailments that could be handled in clinics, Anderson said.

In Ortiz's case, she said she goes to the local clinic in Tujunga for her own routine care, but when it came to her mother's complications she did not want to take a chance.

``I'm more comfortable if I bring her here,'' she said.

Anderson said she and others are attempting to spread the word about the vast array of services offered at clinics. They also are trying to staff the ER with a nurse whose job is to quickly determine whether patients should be there or at a clinic, she said.

Changes made

All of this is the result, at least in part, of the massive restructuring of the county's health department following its near financial collapse in 1995. The federal government rescued the sprawling health system, the nation's second largest, but demanded that the county change how it delivers health care to the poor.

The plan was to move much of the treatment out of hospitals, which prompted layoffs and reassignments of doctors and nurses. Now Anderson said the hospital is left with no new money to pump into the hospital's emergency services because new federal funds pay for community-based primary care.

Administrators have to pull workers from one facility to the other to staff the emergency waiting room with a nurse or place more doctors into the community clinics.

For many patients, the change has meant health care is more convenient.

All seven clinics are staffed with doctors and nurses and are open at least Monday through Friday from 8 a.m. to 5 p.m. All of the clinics - located in Burbank, Van Nuys, North Hollywood, San Fernando, Tujunga, Glendale and Pacoima - provide immunizations and a nurse who can determine whether emergency care is needed.

The clinics are designed to provide routine medical care including preventive care and maintenance care for ongoing medical problems. But some clinics offer limited services, while others offer services beyond the most routine such as high-risk pregnancy care or maintenance care for problems like diabetes.

Patients are not guaranteed that they won't be rerouted back to the emergency room at Olive View.

Problems remain

A 23-year-old woman from North Hollywood went to the Pacoima clinic after she was raped a week ago, but workers there drove her to Olive View to see an emergency room doctor.

The woman said she waited from 11 a.m. to 6 p.m. to be tested for sexually transmitted diseases. She came back one day last week expecting to walk in and pick up her results.

``I've been waiting here an hour,'' she said. ``I'm mad.''

Bertha Romero, a 53-year-old San Fernando woman, had also tried a clinic just four blocks away from her home. But staff at the San Fernando clinic suggested that she return to Olive View since doctors there had already been treating her arthritis problems.

``They don't know what they're doing as far as I'm concerned,'' said Romero, who came to the emergency room at 10 a.m. and was still waiting at 2 p.m. ``It's just an all-day picnic. It hasn't changed in five years, nothing's changed.''

Hospital officials said that Romero may need to get a release from her Olive View doctor allowing her case and her records to be transferred to the local clinic.

As for the rape victim, she might have had to wait because she required additional, specialized testing that could be performed only by specialists at Olive View, said Karen Menacker, a nurse manager at two of the local clinics.

Anderson said hospital workers are doing their best to improve services, but in the interim she is prepared to take the heat.

``I'm going to talk to groups even when they want to beat me up, because I understand it,'' she said. ``They need to say these things. A lot of times they think we're not listening and we are.''

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PHOTO Yolanda Ortiz stands in the Olive View Medical Center waiting room for a doctor to see her mother.

Tom Mendoza/Daily News