By David Zahniser
COPLEY NEWS SERVICEApril 18, 2003
LOS ANGELES – This county's health system can no longer afford patients such as Isaac Cruz.
Struck by a car six weeks ago, the 37-year-old can barely move, struggling each day through painstaking therapy sessions at Rancho Los Amigos National Rehabilitation Center.
In one exercise at the nationally acclaimed hospital, Cruz works with two therapists to regain his ability to sit upright. In another, he lies on his back with a 3-pound weight on his stomach, building up the strength necessary to breathe if not normally, then with less pain.
But such delicate treatment is about to disappear at the hospital, which has been listed by U.S. News and World Report as one of the top 10 in the United States for patients with brain and spinal cord injuries.
The 114-year-old center near downtown Los Angeles is slated for closure June 30 – a prospect that confounds health care professionals.
"We've always considered Rancho Los Amigos to be the crown jewel of the entire (county) hospital system," said Jim Lott, executive vice president of the Hospital Association of Southern California.
In Los Angeles County, Rancho Los Amigos is the only public facility to provide such extensive long-term care to those who suffer devastating injuries – gunshot wounds and car crashes, skateboarding accidents, and strokes.
But shutting down the hospital would save the county $56.2 million annually.
And at a time of widespread budget cuts, county officials say there's a limit to how much care the health system can provide, particularly to patients for whom it bears no legal responsibility.
"We are serving some people that the county doesn't have an obligation to serve," said John Wallace, spokesman for the county's Department of Health Services.
The county Board of Supervisors will decide April 29 on the future of Rancho Los Amigos.
The mood surrounding the hospital ranges from upbeat determination to outright despair. Health care advocates have gone to court, demanding that a judge keep the hospital open. Patients voice anxiety about where they'll go.
The California Community Foundation has weeks left to come up with a plan to save the hospital by combining it with another private hospital.
In front of the center, employees and former patients have erected a tent city to draw attention to the county's financial crisis.
Bernabe Rivas, 37, who relies on a wheelchair, said he'll stay at the camp as long as it takes to save the hospital. He credits the hospital's staff with teaching him to dress himself, maneuver in and out of the shower and become independent.
"When I was coming here two years ago, I was in big depression – big depression," Rivas said. "They were always giving therapy. Now, I'm not thinking any more of suicide."
If the hospital closes, the county's financial commitment to such severely injured patients will drop significantly, from $70.9 million to $14.7 million, Wallace said.
The remaining money would be used to direct patients to other hospitals.
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