Rancho Rehab Hospital Has Backer and Believer

Of the five county supervisors who voted on the fate of Rancho Los Amigos National Rehabilitation Center last month, only one had been driving behind Alex Beanum the night he lost control of his Volvo and suffered a paralyzing back injury.

Four supervisors voted to close or privatize the county hospital to help bridge a health department budget deficit of several hundred million dollars.

Don Knabe, who two decades earlier had come upon Beanum’s accident and witnessed his rehabilitation at Rancho, voted against the proposal.

Though a colleague said Knabe wasn’t “willing to stand up to reality,” the supervisor defended his steadfast support of the hospital as the product of firsthand experience.

“I’ve touched it, and felt it and seen it,” Knabe said of Rancho. “I know what they do there.”

Because the Downey hospital sits in Knabe’s supervisory district, his support for Rancho is not surprising. But the prism of constituent services offers only a partial view of his ties to the hospital, which extend back to a clear Palm Springs night on March 26, 1980.

Knabe and Beanum, friends and members of the Cerritos City Council at the time, were there on city business. Following Beanum back to the hotel after dinner, Knabe rounded a corner to find Beanum’s car off the road and overturned.

In the time it took the Volvo to tumble onto a rocky outcropping, where it landed upright, Beanum’s back was broken, paralyzing him below the chest. The accident would profoundly change his life and have a lasting effect on Knabe as well.

Although not the most outspoken or visible of Los Angeles County’s five supervisors, Knabe has become a central figure in Rancho’s survival. As the county has faced periodic health-care crises, Knabe has been Rancho’s principal champion, purposefully resisting any attempt to reduce or eliminate the hospital that gave his friend a second chance.

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Knabe and Beanum became friends after moving to Cerritos in the early 1970s, during its transition from dairy town to bedroom community.

That they lived within a block of each other and had children of roughly the same age mattered more than Beanum’s being an African American Democrat and Knabe a white Republican. When Beanum decided to join the Optimists Club, Knabe sponsored him. When Knabe ran for City Council in 1980 against a Democrat, Beanum, elected two years earlier, voted for him.

“I backed my friend, and he won,” Beanum said.

The two often voted together on the council, helping to bring Cerritos its first auto mall and watching as their city became one of the fastest growing in the country.

On their trip to the annual meeting of contract cities in Palm Springs in March 1980, Knabe and Beanum made a bipartisan decision to sneak away from the dinner table to catch a Lakers game. They left together, Knabe following Beanum, and made it only a few miles before the accident.

Beanum was rushed to a Palm Springs emergency room that night and spent six weeks there. Then he was transferred to Rancho, which even then was a leader in the specialized field of treating victims of head, neck and spinal injuries.

For six months, Beanum learned how to function in a world tailored to the needs of other people.

His physical limitations transformed the most mundane tasks -- bathing, making his bed, getting dressed -- into awkward, frustrating ordeals.

There was also a completely new set of necessities to attend to: building enough arm and shoulder strength to propel a wheelchair, waking every hour or so at night and shifting his body position to avoid bedsores. And physical survival skills were only part of it. Rancho psychologists helped Beanum cope with the emotional toll of a paralyzing accident.

“It’s like a part of your body is dead, but you can’t bury it,” he said. “You have to learn how to love a part of yourself that’s no longer useful.”

Knabe was a frequent visitor. Though he had never spent much time in a hospital, he did what he could to look after his friend.

“I’d sneak him chili dogs sometimes,” Knabe said. “He was pretty sick of hospital food.”

“He’d sneak me hamburgers and sometimes beer,” is how Beanum remembered it.

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There’s a telling term in Rancho parlance, used by doctors, patients and therapists alike. It’s called “building a bridge to independence” -- shorthand for the thousand small tasks a patient must master for rehabilitation from a paralyzing injury. If a patient can regain enough strength and mobility to maneuver into a car from a wheelchair, the chasm is nearly crossed.

When Beanum’s training for the “transfer” was done and the day came to do it for real, it was Knabe’s car that he hoisted himself into.

“I can still see the car and Don and Alex,” said Robert Waters, who was chairman of Rancho’s surgery department during Beanum’s stay. “That day was Alex’s passage out of the hospital and back into the community.”

Beanum returned to his council seat. He returned to his private consulting business, to church, to friends and family.

Knabe began attending Rancho fund-raisers.

He was hired in 1981 by then-4th District Supervisor Deane Dana, and when redistricting in 1990 landed Rancho in Dana’s district, Knabe relished the opportunity to help the hospital at the county level.

“I didn’t know the battles that were ahead,” he said.

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The 114-year-old hospital remained an innovative leader, pioneering surgical techniques and teaching patients how to paint -- some with brushes held between their teeth.

But changing times created new difficulties for the hospital. When gang warfare and the crack cocaine epidemic ravaged the county in the late 1980s, many of the casualties ended up at Rancho.

By 1995, the percentage of Rancho patients with insurance -- 12% the year Beanum was admitted -- had dwindled nearly to zero, leaving taxpayers to foot patients’ bills.

Faced with a crippling budget deficit of its own, the county decided to privatize Rancho, or to close it if a buyer couldn’t be found.

County law required a public hearing on the matter, and as Dana’s chief of staff, Knabe helped arrange for the hearing to be held at the hospital, where the supervisors heard hours of testimonials from patients.

Knabe was elected to the Board of Supervisors when Dana left office in 1996 and, according to Connie Diaz, the hospital’s chief executive, the new supervisor immediately started working on Rancho’s behalf.

He began emceeing Rancho’s annual Amistad fund-raising event. He put on an apron on employee appreciation day, serving food for hours to janitors, therapists and doctors. He started collecting art by Rancho patients. And in his role as a county supervisor, he fought each attempt to cut the hospital, appointing former patients such as Beanum to a citizens committee that reviewed proposals from companies interested in taking over Rancho.

“He has a passion for Rancho, and he doesn’t just talk about it; he lives it,” Diaz said.

The county backed away from the privatization plan after a 1997 audit said it didn’t make sense. But with the latest budget crunch, the plan was dusted off.

When the issue came to a vote last month, dozens of Rancho patients approached the dais to plead with the Board of Supervisors, again, to spare Rancho.

Knabe interjected several times during the procession, noting which speaker was a world-class artist, which a wheelchair basketball Olympian. For him, each speaker who crossed the bridge to independence at Rancho was one fewer person lounging in a nursing home, one more argument for keeping the hospital a county facility.

He reflected afterward on the time and effort it had taken each patient to get to the meeting, reminded of what had struck him about his experiences at Rancho.

“They don’t demand anything. They never say, ‘You owe us something,’ ” Knabe said. “All they ask is for the opportunity to live an independent life.”

Another audit is being done to determine whether the hospital can generate enough income to remain part of the county system. Failing that, legislation is pending that would appoint an independent authority to run the facility. It could end up being privatized, but Knabe says he will continue to resist any move to close it.

“Something has to be done to keep it open,” he said.

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Beanum, an active advocate during the last privatization effort, has been less visible and less vocal this time around. He’s retired now, and doesn’t talk much about his accident.

He still visits Rancho as an outpatient, and sometimes when he meets people and says his name, there’s a flash of recognition.

“They’ll say ‘Oh, you’re Mr. Beanum,’ and their faces will light up,” Beanum said.

It’s in those moments that he realizes someone else has heard his story -- because Knabe continues to tell it to make the case for Rancho’s future.

“It’s really a compliment; it’s genuine,” Beanum said. “I feel honored by it.”