Valley Community Clinic feels pain of county cuts. (Up Front).

As predicted, the recent round of closures at three L.A. County-run health clinics in the San Fernando Valley has brought thousands of low-income patients to the doorstep of Valley Community Clinic, one of the oldest and largest medical facilities offering free and low-cost care to the region's uninsured.

But the onslaught is simply too much for the non-profit facility and its staff is doing what was once deemed unthinkable: turning patients away.

Judi Rose, director of public affairs for the clinic, said the clinic has turned about 200 patients away each week since the closures.

"We simply just can't take them in," Rose said. "The stress on staff is a big concern for us right now, so we just aren't able to handle the overflow."

State and county budget cuts forced the Sept. 30 closure of Burbank, North Hollywood and Tujunga health centers, leaving only two county-run clinics in the Valley still in operation: Mid-Valley Comprehensive Clinic in Van Nuys and the San Fernando Health Center in San Fernando.

The North Hollywood-based VCC has a staff of four doctors, four registered

nurses and 12 interns to provide care for roughly 30,000 uninsured patients each year, most of whom live in the East Valley.

Rose estimated that the closure of the three clinics has set another 25,000 patients in the surrounding area adrift in search of medical care.

Officials with the Los Angeles County Department of Health Services (DHS) say, to ease the burden on Mid-Valley and San Fernando clinics, they are referring patients to the trauma center at UCLA-Olive View Medical Center in Sylmar.

Although no figures are available for the number of referrals being treated at Olive View, the decision to send patients there may have helped save the facility from having to shut down its emergency room and reorganize as an outpatient care center.

The DHS was directed to craft a spending plan for a voter-approved bond measure expected to generate about $128 million annually to support the county's beleaguered trauma center network. However, there were no guarantees the plan would include the $65 million Olive View administrators say they need each year to run their ER.

According to John Wallace, DHS director of external relations, the need to refer patients to Olive View resulted in a Nov. 26 recommendation by his agency's director and chief medical officer, Thomas Garthwaite, to the County Board of Supervisors that the hospital remain open.

For the moment at least, Wallace said, Olive View will be spared.

Meanwhile, according to Gretchen McGinley, chief operations officer for the DHS-operated ValleyCare Health Centers, unless the county can secure additional state and federal funding within the next few months, the San Fernando clinic will likely be shuttered, followed by Mid-Valley.

According to VCC's statistics, there are about 600,000 uninsured workers in the Valley, roughly half of whom live in the East Valley. Without access to free or low-cost medical care, many who are sick will miss work as they attempt to treat themselves, in turn harming the local economy, Rose said.

"Thirty thousand people without insurance, that's an enormous impact on our economic future," said Rose. "Those are the food industry workers, entertainment workers, the very backbone of our Valley economy. We can't afford to have them going without care."

DHS's McGinley said staff at the three closed clinics notified patients in July of the impending closures and arranged for patients with serious illnesses to be cared for at other facilities. But even she admitted that many of those patients were forced to trek from the Northwest Valley to clinics in other parts of Los Angeles.

"As part of the closure process we reviewed the cases of everybody being seen (at the three clinics) going all the way back to July 1 of 2001 to determine which patients were most acutely ill," McGinley said. "We made every effort to get them appointments in other facilities."

Meanwhile, VCC is searching for new sources of revenue that will allow the facility to take in more patients. One proposal is to change the facility's non-profit standing to one that would allow it to care for MediCal patients and those who do have medical insurance.

Currently, there is no infrastructure in place to process paperwork for insured patients.

In the interim, the VCC's operating costs run about $5.5 mill ion a year and, although gifts from the city and state in 2001 funded the move to a new and larger facility in North Hollywood, plans to open a pediatrics center remain on hold. Rose estimates the clinic needs about $1 million to get the center up and running.

In addition, cuts at the state level this year killed the clinic's Healthy Families outreach program, a state insurance program for low-income children. Those cuts threaten to make re-enrollment difficult, if not impossible, for the roughly 20,000 children in the Valley now in the program, Rose said.