Judge Refuses to Bar Cutbacks at County Hospital

An effort to save Los Angeles County’s inpatient hospital services in the Antelope Valley was rejected this week by a federal judge who has protected other county health services slated for elimination.

U.S. District Judge Florence-Marie Cooper denied a request for a temporary restraining order to stop the conversion of Lancaster’s High Desert Hospital into an “ambulatory care clinic,” which would handle less serious medical problems than a hospital and save the county $10 million a year.

The ruling came in response to a request by the nonprofit Antelope Valley Hospital -- one of two remaining hospitals in the region -- which argued that closing High Desert’s 70 hospital beds would dump a number of uninsured patients into its overcrowded Lancaster emergency room, where some patients already wait for three to four days for a bed.

But in a terse, four-sentence order, Cooper said Antelope Valley Hospital failed to show the potential for “irreparable harm” in its pleadings. She also questioned whether the hospital had the legal standing to ask for a restraining order.

County officials say the new ambulatory care clinic will be operating by July 1. Inpatient admissions at High Desert have already been shut down, and the 24 remaining long-term patients will be discharged or moved to other hospitals in the next two weeks, said John Wallace, a health department spokesman.

Technically, Cooper’s ruling was a victory for the county. But few are cheering, given the grim choices they must make to save the ailing public health-care system.

“It’s heartbreaking how this has all turned out,” said Norm Hickling, a field representative for Supervisor Mike Antonovich, who represents the Antelope Valley.

The conversion of High Desert is part of a larger series of cuts aimed at preventing a projected $1.1-billion health-care budget shortfall by the 2007-2008 fiscal year. Concerned about the welfare of patients, the judge has blocked some key elements of the plan, including scheduled cutbacks at Los Angeles County-USC Medical Center and the closure of Rancho Los Amigos National Rehabilitation Center in Downey.

The High Desert case offered two very different ideas of how the county can best serve the fast-growing Antelope Valley, where, by some estimates, as many as 80,000 residents lack health insurance.

According to the plaintiffs, 569 indigent patients used High Desert’s inpatient services in 2002. They argued that if High Desert closed -- and local hospitals were full -- poor patients would have to travel south about 50 miles to get to Olive View/UCLA Medical Center in Sylmar, the closest county hospital

County attorneys argued that High Desert is an “antiquated facility” that would be better off as a clinic. While High Desert provided 43,000 annual outpatient visits in fiscal 2001-02, the clinic is projected to eventually provide 67,000 outpatient visits annually. And seriously ill patients will be able to take pre-existing county van services to the county’s other five hospitals, they said.

The county also said Antelope Valley Hospital’s suit was “motivated by money,” and claimed the facility’s administrators were worried more about the cost of treating the poor than any regional health-care crisis.

Antonovich had backed another plan to save High Desert Hospital that involved leasing it to a private company, but that was rejected by the Board of Supervisors on June 3.