Patients Sue to Halt County Health Cuts : Finances: Plaintiffs say closure of facilities would violate Americans with Disabilities Act and other laws. Supervisors cite threat of bankruptcy.

Patients suffering from cancer, diabetes, crippling arthritis and other life-threatening and disabling illnesses Thursday filed a sweeping lawsuit in federal court to block Los Angeles County from shutting down most of its health centers and clinics as part of its deepening fiscal crisis.

Plaintiffs in the suit, filed by a coalition of health advocates, legal services organizations and civil liberties groups, argued that they depend on the county for health care and fear they won’t find care anywhere else.

The suit seeks a preliminary injunction to block the cuts, arguing that the county is in violation of the Americans with Disabilities Act and other federal and state laws governing such things as patient dumping and due process. It argues that the county is required by state and federal law to be the health care provider of last resort, a safety net for those who have nowhere else to turn.

For the financially strapped county, the case poses a major risk and is viewed by officials as having the potential to lead to a “nightmare scenario” that could force the county into bankruptcy if the court rules in favor of the plaintiffs.

Assistant Chief Administrative Officer Sandra Davis said that if the county is blocked from the cuts and does not receive more revenue from the state or federal governments, it will run out of cash. “We can’t spend money we do not have or know is coming in,” Davis said. “It probably will be the ultimate death spiral when the [Board of Supervisors is] spending resources that they don’t have or know wouldn’t materialize.”

But in heartbreaking detail, the suit outlines both the pain and prospects for care that each of the plaintiffs faces.

Among the plaintiffs is Marti Villery, a breast cancer patient and welfare recipient who is finishing up chemotherapy. Once the treatments end, she will need ongoing chest X-rays, heart scans, bone scans and blood tests.

“If the outpatient services are closed down, she would have no place to go,” the suit argues. “Her doctors have told her that her very survival depends on regular checkups for the next five years.”

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Another plaintiff is Mary Hayes, 47, who suffers severe pain from osteoarthritis and rheumatoid arthritis, is able to walk only with great difficulty and must depend on a wheelchair. Although ultimately she may qualify for special Social Security benefits, she currently is on general relief “and has no other source of care,” the suit says.

County Supervisor Zev Yaroslavsky, the most outspoken county official in warning about possible bankruptcy, said the suit was not a surprise. But he again warned that the county could not afford to keep all its health facilities open.

At issue is a vote by the Board of Supervisors to close six comprehensive health centers along with 28 neighborhood clinics and most walk-in medical services at county hospitals on Oct. 1. The cuts would affect a system that accounts for 2.7 million patient visits a year, of which 860,000 are at county hospitals.

“Any judge who looks at this case has to weigh the impact of these closures against the fact that we don’t have the funds to avoid closure,” Yaroslavsky said.

But Beth Osthimer of San Fernando Valley Neighborhood Legal Services, the lead attorney in the case, told The Times, “The county just can’t walk away from these patients while they are in treatment.”

The suit argues that there isn’t sufficient capacity in the private community to handle the county patients.

Each of the plaintiffs receives medical care at county facilities subject to closure or reductions. All six county hospitals are named in the suit.

The suit argues that the plaintiffs have not “received adequate prior notice and opportunity for hearing regarding the termination, reduction or transfer of their care, and have not had an appropriate discharge plan and/or transfer arrangement developed.”

County lawyers said it was too early to respond to specific allegations, but again insisted that they had taken all the necessary legal steps to put the budget cuts into effect Oct. 1.

“We believe we have met all the requirements of state law and all the requirements of federal law,” said Ada Treiger, a deputy county counsel.

Dr. Brian Johnston, chief of staff at White Memorial Medical Center and president-elect of the Los Angeles County Medical Assn., said, “The county is withdrawing vital services without providing an adequate notice and without properly alerting the population to the potential consequences. . . . [The budget cuts] are a precipitous action, which if not reversed may result in death and disability for hundreds if not thousands of people.”