Court Upholds Ban on Closing Clinic

A court order that prohibits Los Angeles County from closing Rancho Los Amigos National Rehabilitation Center without providing patients with comparable care elsewhere was upheld Tuesday by a federal court.

The ruling by the U.S. 9th Circuit Court of Appeals was a victory for eight indigent and uninsured people who rely on the county healthcare system. They had sued the county on the grounds that the health of patients such as themselves would be seriously jeopardized if the county proceeded with its plan to close Rancho and decrease the number of beds at County-USC Medical Center.

Specifically, the court said, eliminating 100 beds from County-USC would worsen overcrowding elsewhere and overburden an already troubled healthcare delivery system.

A coalition of patient advocacy groups also won a temporary injunction in February barring the county from closing the 207-bed Rancho Los Amigos in Downey.

The Board of Supervisors voted in January 2003 to close Rancho, one of the nation’s premier hospitals for treating disabilities. Its closure, the board said, would save $58 million and help avert a countywide healthcare budget crisis.

The appellate court, however, said the county did not face a budget shortfall until 2005-2006 and that “likely harm to plaintiffs far outweighs any hardship the preliminary injunction causes the county.”

The ruling “means their money would be better spent on doctors rather than lawyers,” said Mark Rosenbaum, legal director of the ACLU of Southern California, who argued the case to the appeals court. “The 9th Circuit could not have said more clearly that [eliminating] basic healthcare is not an option.”

Given the 9th Circuit Court’s previous ruling in favor of the patient advocacy groups, Tuesday’s decision was expected, said county Health Department spokesman John Wallace.

“However, it’s disappointing that the court hasn’t recognized the county’s need to live within our budget constraints.”

County officials and patient advocates began confidential negotiations several weeks after the court issued its first decision upholding a preliminary injunction.

A trial to determine whether a permanent injunction will be issued is set for November, but both sides hope to reach a settlement before then.

There is some common ground. Both sides agree that any plan to save the county’s healthcare system will require state and federal assistance.

“The advocates ultimately have the same goal that we do: ensuring there’s a viable safety net in the county,” Wallace said. “You have to think nobody wants to see a collapse of the healthcare system in L.A. County.”