Patients Protest Planned Hospital Cuts

The painful face of restructuring Los Angeles County’s vast public health system was seen Monday as dozens of wheelchair-bound patients struggling to overcome crippling injuries pleaded with the Board of Supervisors to save critical services at the nationally acclaimed Rancho Los Amigos Medical Center.

At the first of a series of federally required hearings on planned reductions in county health services, patients delivered a common message that the Downey rehabilitation hospital has meant the difference between life and death, dependence and independence, giving up or maintaining hope.

“Please don’t put us out to pasture,” said Clara Green, a 77-year-old great-grandmother from Compton who has received care at the hospital since suffering a heart attack in 1979 and a stroke two years ago.

“Let this be one of your greatest decisions of 1996 . . . to listen to what we have said and do all you can,” Green told the supervisors during an emotional five-hour hearing in the hospital’s auditorium.

But the harsh reality of limited resources is forcing the county to downsize its $2.3-billion-a-year health system. The supervisors today will consider ordering a new round of layoffs next month of more than 500 health workers at Rancho Los Amigos, County-USC and Olive View/UCLA medical centers.

Health Services Director Mark Finucane said the county has suffered a decline in the number of patients hospitalized at all three facilities and must adjust its staffing accordingly.

In addition, the county must make further staff reductions to move toward its goal of significantly reducing hospital treatment.

In exchange for a $364-million federal bailout that prevented the health system from collapsing last fall, the county agreed to embark on a five-year program to overhaul the way it delivers health services to the poor and those lacking health insurance. The county agreed to reduce the number of hospital beds by at least one-third and to expand its outpatient services at community clinics by 50% by mid-2000.

To delay the layoff of inpatient staff at Rancho Los Amigos, County-USC and Olive View/UCLA is “not the signal we are looking to send” about the county’s will to follow through with restructuring the health system, he said. “We have to do this now.”

However, in the face of strong protests, the board appeared likely to back away, at least temporarily, from eliminating an additional 364 jobs and more than 90% of the outpatient services at Rancho Los Amigos.

Supervisor Deane Dana, whose district includes the sprawling Downey hospital, opened the hearing by declaring that the drastic cut in outpatient services critical to the long-term rehabilitation of the hospital’s patients is “unacceptable to even consider carrying out.”

“I know the miracles that are done here,” Dana said. “I want to make sure this tremendous resource remains for future generations.”

The day began with a march by patients, medical staff and union leaders to call on the supervisors to save the hospital, which the county intends to turn over to a private operator.

The privatization of Rancho Los Amigos is part of the county’s overall commitment to the federal government to move away from expensive hospital care to less-costly treatment at community clinics.

From his wheelchair, muscular dystrophy patient Gene Mitchener told the board members that the words “downsize” and “privatize” do not accurately describe the impact of $28.8 million in planned cuts in funding for Rancho Los Amigos. “The truth is capsize. We can’t afford to capsize because I can’t swim,” he said. “I need your help to stay afloat.”

From midmorning to midafternoon, speaker after speaker told of their personal struggles to overcome severe trauma ranging from brain and spinal cord injuries to gunshot wounds, polio, muscular dystrophy and cerebral palsy.

“Please hear our pleas,” said Irma Resendez. “Try and do what you can for us. We need Rancho.”

Mike Gallagher of Granada Hills, who was seriously hurt in a car accident in 1974, returned to Downey to make the case for the hospital that “put me back together.”

“There is no other place you can go,” he said. “It’s not like closing down a gas station” and there is another one two or three blocks away. “This is it. It’s too important to let this place die.”

Jose Loera of Los Angeles was transferred to Rancho Los Amigos after suffering severe injuries, including brain damage, in a 1989 car accident on the East Coast. Emerging from 26 days in a coma, he began a long regimen of therapy.

“Rancho has taught me I can’t give up,” said Loera. He appealed to the supervisors not to turn over the hospital to a private operator. “Do you really want to have the disastrous results of privatizing Rancho on your conscience?” he asked.

Late in the day, the supervisors resumed their hearing downtown at the Hall of Administration, where patients and staff members from County-USC and its AIDS clinic, in particular, urged them not to proceed with planned cuts.

“I understand difficult times require hard choices, but I disagree with the cuts at the AIDS center,” said nursing care specialist Debbie Alexander. “I know these people. I’m the one they talk to first. I want you to know this will hurt the people we’re supposed to take care of.”

Drew Wilson of Hollywood, who said he has been HIV-positive for more than 15 years, praised the clinic’s staff. “I get compassionate understanding at County-USC. . . . I have gotten so much better, it’s time for me to consider going back to work.”

Elizabeth Cooper, a diabetes patient at Olive View/UCLA Medical Center in Sylmar, warned that the layoffs would lead to longer waits for treatment. “If they have to wait long enough, they won’t need a hospital,” she said. “They can be taken right to the morgue.”