Court Orders State to Provide Home Nurses for Disabled Baby

An East Los Angeles woman won a court order Monday requiring the state to supply in-home nurses for her severely handicapped baby after her insurance carrier refused to supply further nursing care for the infant.

Superior Court Judge Jack M. Newman’s interim order, effective until state officials determine a permanent placement for 10-month-old Enrique Lopez, came in response to evidence that his mother’s nurturing may be the brain-damaged child’s only hope of communicating with the outside world.

Under the judge’s order, the state Regional Center for the Developmentally Disabled in East Los Angeles must provide nursing care for 16 hours each day.

Newman’s order is effective at least until Friday, when a state hearing officer will hear evidence on the regional center’s assertion that Enrique could receive better treatment at a state hospital than from his mother at home.

The baby has been hospitalized for the past two months at White Memorial Hospital pending the outcome of the dispute between Evangelina Lopez and her insurance carrier, PacifiCare, which contends that Lopez does not need the help of expensive in-home nurses to care for her son.

Enrique, born several weeks premature and severely brain damaged, is nearly blind, hearing impaired and suffers from breathing and heartbeat irregularities. Besides receiving eight medications to control infections and seizures, his windpipe must be suctioned frequently to keep it clear and he must be connected to a monitor to ensure that his heart continues to beat.

The Regional Center for the Developmentally Disabled, the state agency that often picks up the bill for the care of disabled children whose parents cannot afford it, contends that Enrique should be in a state hospital, where specialists trained in the treatment of severe handicaps can help him develop.

But Lopez, represented by attorneys for the Legal Aid Foundation of Los Angeles and Protection and Advocacy Inc., claims that her son responds to her in a way that no state hospital employee can hope to match.

His only hope for some semblance of normalcy is through his communication, however limited, with his mother, attorney Marilyn Holle said.

“I really think of him like a miner trapped. Do you try to rescue him?” she said. “He’s part of our family, and I think he’s entitled to be rescued and not be thrown away at (a state hospital).”

Already working 10 hours a day at a pillow factory to support herself and her 7-year-old daughter, Lopez says she cannot afford the $250-a-day cost of in-home nursing care and cannot spare time from her job to care for the baby herself.

Moreover, Lopez says she fears that Enrique could die if left alone at home with her.

An attorney for PacifiCare, Joseph Konowiecki, said the insurer is willing to pay for any acute-care hospitalization that Enrique requires but is not willing to pay for in-home nursing “for the convenience of the mother.”

Lopez said through an interpreter that she is “happy” with Newman’s ruling.

“It was a good decision,” she said. “He responds to me very well. . . . He does things with me that he doesn’t do with anyone else: He stands straight, he’s able to move his hands with me.”