Supporters of Palm Drive Hospital in Sebastopol said Monday they'll do everything possible to keep the cash-strapped facility open — even if requires civil disobedience in the form of a physician takeover of the hospital's emergency room.

That was the promise made by Dr. Jim Gude, director of Palm Drive's intensive care unit, at an evening public forum at Community Church in Sebastopol.

The event, which drew about 200 people, featured hospital supporters who rallied behind a physician-driven proposal that aims to head off the scheduled April 28 closing date.

The proposal would essentially turn over management of the hospital to a foundation, eliminate the hospital's expensive inpatient ward and introduce a host of new services focused on lucrative outpatient business.

"If the proposal is accepted, they have to rescind the closure," Gude told the crowd at the forum.

If the proposal is rejected, Gude said he and others would take "public action" to keep it open.

After the meeting, Gude explained in an interview what he meant by "action."

"If they don't accept our proposal, we're going to keep the emergency department open at 12:01 a.m. April 29," he said. "I will be there with my physicians on the barricades...physicians on the barricades."

The threat of civil disobedience is strongest sign yet of the formidable resistance that Palm Drive administrators face in their bid to close the financially troubled hospital.

The move came one week after the Palm Drive Health Care District board voted 4-1 during a special meeting to close the hospital in two weeks and suspend the operating license. Hospital officials last week also filed Chapter 9 bankruptcy — the second such filing since 2007.

Hospital officials say Palm Drive can no longer operate with so few overnight patients, reduced payments from government and private insurance and increasing competition from health care giants in Santa Rosa. They say the hospital must close and be reborn as something else.

But hospital supporters argue that such a transition would be difficult, if not impossible, if the hospital closes its doors even temporarily.

The audience at Monday's forum included local residents, hospital employees and doctors with ties to Palm Drive. The event was organized by the Palm Drive Health Care Foundation, which raises money for hospital operations.

At least one board member of the Palm Drive Health Care District was in attendance.

The meeting focused on a now-unified proposal supported by Gude and Dr. Michael Bollinger, a prominent Sebastopol orthopedic surgeon who operates at the hospital. Last week, the two doctors floated separate proposals, but they've since joined forces.

Glen Minervini-Zick, a former Palm Drive board member now acting as a consultant to the group of doctors and hospital supporters aiming to keep the hospital alive, gave a thumbnail sketch of the plan.

Minervini-Zick said the hospital would be "shrinking" its array of services to focus on emergency room, intensive care unit and outpatient services. The main service that would be eliminated would be the medical surgical unit, what is commonly known as an inpatient hospital ward.

That alone would reduce the cost of running the hospital by 40 to 50 percent, said Minervini-Zick, adding that a hospital ward requires many nursing hours and lab tests.

The services that will be kept are those that still make money, he said, adding that the emergency department alone makes $2.5 million annually in profit.

"It's pretty dramatic," he said.

Gude explained that the 5-bed ICU would be converted to 2 ICU beds and 3 medical/surgical beds. The entire 32-bed inpatient ward would be moth-balled. Up until recently the hospital was staffed for 12 beds, but its recent average daily census has been about nine patients.

Gude said other services that would be eliminated include hospitalist service — the doctors trained to care for patients staying in hospitals — and the expensive electronic medical records program.

"I've looked at things that have to be eliminated to make us financially viable," Gude said.

Dan Smith, a former hospital board member who supports the proposal, said much of the hospital's financial problems are a result of mismanagement.

"What we're proposing here is something very simple, a business-managed hospital," Smith said.

He said the proposal needs about $2 to $3 million to successfully resurrect the hospital. He said he and others have raise a little more than $1 million.

Mary Ely, a Sebastopol resident who attended the forum, said she was prepared to switch to a west county doctor to help keep the hospital open. Ely said her primary care physician is affiliated with Sutter Health.

"It's time to go local," she said.

(You can reach Staff Writer Martin Espinoza at 521-5213 or martin.espinoza@pressdemocrat.com)