Patients with disabilities may enjoin county from closing rehabilitation center

Law Reporter, Jun 2004

Rodde v. Bonta, 357 F.3d 988 (9th Cir. 2004).

Persons with disabilities who require medical services that are offered at a county hospital may sue the county under the Americans With Disabilities Act (ADA), 42 U.S.C. §§ 12101 et seq., to enjoin the county from closing the hospital, the Ninth Circuit Court of Appeals held.

Here, a county decided to close a hospital that provides rehabilitation services to persons with disabilities. About half the patients at the hospital receive state medicare (MediCal). A class of current and future patients of the center who receive Medi-Cal filed suit against the county to enjoin the closure under the ADA. Plaintiffs alleged the hospital provides unique services, and they cannot get adequate substitute care at any orner facility in the county. The trial court granted the injunction.

Affirming, the Ninth Circuit noted that appellate review of decisions regarding preliminary injunctions should be "limited and deferential." In this case, the court said, the trial court did not abuse its discretion in deciding any of the four factors for granting preliminary injunctions: (1) a strong likelihood of success on the merits, (2) the possibility of irreparable injury to plaintiffs if the injunction is not granted, (3) a balance of hardships weighing in the plaintiffs' favor, and (4) advancement of the public interest.

It is undisputed that plaintiffs are qualified individuals with disabilities and the hospital is a health care program covered by the ADA, the court said. However, the county argued the services being denied plaintiffs by the hospital closure arc not covered by the ADA. Citing case law, the court held that the closure of the hospital will reduce or eliminate necessary medical services for Medi-Cal patients with disabilities, but not for those without disabilities. Thus, the court said, closing the hospital without making arrangements to provide the necessary medical services to patients with disabilities constitutes discrimination on the basis of disability. Accordingly, the trial court did not abuse its discretion in deciding that plaintiffs had a strong likelihood of success on the merits.

Turning to the second factor, the court said being deprived of these services would cause plaintiffs irreparable injuries such as medical complications, amputations, infection, and increased risk of death. Third, in light of the evidence of these likely irreparable harms, the trial court did not abuse its discretion in concluding that plaintiffs would suffer greater hardship were the injunction not granted than defendants would suffer if it were granted. Finally, although public interest considerations exist on both sides, the court said that closing the hospital would overwhelm the county health care system, tipping the balance of public interest in favor of granting the injunction.

Plaintiffs' Counsel

Jeffrey S. Davidson,

Christopher J. Heck,

Joseph M. Graham Jr.,

Tony Richardson,

Melinda Bird,

Marilyn Holle,

Maria F. Iriarte,

Eve Hill,

Paula D. Pcarlman,

Felicia Yearwood,

Kimberly Lewis,

Robert Newman, and

Gerald A. McIntyre, all of Los Angeles, Cal.