Court Agrees to Keep Rancho Open

The U.S. 9th Circuit Court of Appeals upheld an order Thursday barring Los Angeles County from closing Rancho Los Amigos National Rehabilitation Center, its hospital for people with disabilities, without offering patients comparable care elsewhere.

The ruling was a victory for a coalition of patient advocacy groups that sued the county last year over its plan to close Rancho, which county leaders said would have saved at least $58 million a year in an era of lean budgets.

Attorneys for the patients countered that closing the 207-bed hospital in Downey would have violated the Americans With Disabilities Act by denying disabled Medi-Cal recipients access to necessary medical treatment. In April, a U.S. District Court judge temporarily blocked the shutdown, concluding that patients would have suffered “severe, irreparable harm” if Rancho had closed.

In a 3-0 decision, the appeals panel agreed that the patients would probably prevail on the ADA claim at trial, which is set for November.

“The county is free to reorganize its healthcare system to increase efficiency and reduce costs, so long as it does so in an evenhanded, nondiscriminatory manner,” Judge Harry Pregerson wrote in his opinion. The court also found that the county had overstated the budget problems facing its Department of Health Services, adding that a surplus was expected until 2006.

“I feel fantastic,” said Eve Hill, executive director of the Western Law Center for Disability Rights, one of the public interest groups that sued the county. “We are all pleased and relieved, because if we lost this, people would die. I’m not used to cases where, if we lose, people die. It’s a lot of pressure.”

Patients also were thrilled at the ruling. “I think it’s absolutely awesome,” said Susan Rodde, the 49-year-old lead plaintiff, who has cerebral palsy, arthritis and other medical problems. Because of Rancho, she said, “I can live a very productive, independent life.”

The decision further clouds the financial outlook for the county’s massive health department. Recent projections show that, without a substantial cash infusion, the department will face a $247-million deficit by mid-2006.

“We have to figure out what our next strategy is to provide the maximum services to the poor,” said Dr. Thomas Garthwaite, county health chief. “We still predict a significant budget deficit, and now our hands are pretty well tied in terms of what we can do to reduce it.”

The county may explore the possibility of running a smaller Rancho or finding an outside group to take it over, Garthwaite said. Attorneys involved in the lawsuit said the Rehabilitation Institute of Chicago had expressed interest in the hospital.

The 9th Circuit Court, meanwhile, is expected to rule soon in a related case brought by uninsured patients who rely on Rancho and Los Angeles County-USC Medical Center, where county officials have proposed cutting 100 beds to save money.