Despite Bailout, Eviction of Comatose Patients to Proceed : Health care: County officials hear appeals from families. But Rancho Los Amigos Medical Center ward still faces closure.

Despite the promise of $364 million in federal funds to bail out Los Angeles County’s financially strapped health care system, the county is pushing ahead with plans to evict 17 comatose and semi-comatose patients--many of them on life support--from its Rancho Los Amigos Medical Center.

A county legal team showed up Monday to do battle with patients’ family members who challenged the eviction order at a state administrative appeals hearing.

The daylong hearing ended without a decision. The families are asking the state to intervene to give them more time to find placement for their relatives. Joseph Conkle, a state Department of Health Services attorney who conducted the hearing, said he would make a decision by Thursday.

But as they await the decision, the family members are in a nerve-racking standoff with the county as they face the planned closing of the nursing facility Sunday.

The hearing was held down the hall from the ward where their children, spouses or parents lay helpless. During frequent breaks in the hearing, the family members went to the bedsides of loved ones.

All the patients require 24-hour care, and almost all are fed intravenously.

Their relatives came to the hearing hoping that the federal bailout might have softened the county’s stance. But James Kashian, a deputy county counsel, who headed a team of administrators, social workers and nurses aligned against the families, said plans are moving ahead to close the nursing facility to help the Board of Supervisors eliminate a budget deficit. Kashian noted that the two doctors and all the nurses in the unit either have been laid off or transferred.

“There will be absolutely no staff at this facility on Oct. 1,” Kashian said.

The county contends that it has been “diligently working” to find new placements, but family members say they were given insufficient notice of the county’s move and have not been able to find suitable alternatives.

“The people are here because they have special needs, and there is no place for them,” said Elena H. Ackel, an attorney with the Legal Aid Foundation of Los Angeles who represented the families.

During the hearing, testimony by county employees and the patients’ guardians showed that notices were delivered days and, in one case, two weeks late. Lists of prospective alternative nursing homes never made their way to the families, county employees conceded. Important patient health-care summaries were still being put together Monday, frustrating the families who say they need them before they can seriously negotiate with nursing homes over care for family members.

Kashian argued that the families had not cooperated in letting representatives of private nursing homes examine patients, a necessary step to placement. But the families complained that they were contacted by the Rancho staff the morning that the examinations were to be conducted.

Kashian said Julia Connell, the mother of one of the patients, was making private placement of her son, Jeffrey, difficult because she insists that he be fed by hand. Unable to feed himself since he suffered massive head injuries in an automobile accident 14 years ago, Jeffrey Connell has been fed by his mother and nurses, who take turns spooning food to him.

“It’s not medically necessary that your son be fed by hand,” Kashian told Connell.

“Would you like a tube in your belly if you could eat [without it]?” Julia Connell asked.

Leaving the hearing, Antoinette Morgan, daughter of one of the patients, said: “I am taking it one day at a time and praying that a miracle happens.”