From the Los Angeles Times
L.A. Targets Patient Dumping
The city alerts hospitals of possible legal action if they leave people on skid row against their will.
By Cara Mia DiMassa and Richard Winton
Times Staff Writers

December 22, 2005

The Los Angeles city attorney's office is warning hospitals across Los Angeles today they are potential targets of an investigation into alleged dumping of patients on skid row.

City Atty. Rocky Delgadillo said Wednesday that the probe could result in criminal charges or lawsuits if hospitals dumped patients against their will.

Police and community activists have charged for years that hospitals and law enforcement agencies were dumping homeless people in the downtown area. But Delgadillo's investigation marks the first time officials have attempted to crack down on the practice.

His office will be sending warning letters to hospitals today. The move comes amid a growing push by politicians and law enforcement officials to clean up skid row, which is mired in poverty, homelessness and the sale and use of illegal drugs. State and local officials have announced new efforts to increase police patrols and stiffen penalties for dealing drugs on skid row, which has the largest concentration of treatment and recovery centers in Southern California.

"We are trying to ensure those illegally dumped on skid row have a voice," Delgadillo said in an interview Wednesday. "We have an allegation that hospitals are dumping people illegally on to skid row…. We take this very seriously."

As part of the probe, investigators for the city attorney's office have been digging through records at the Union Rescue Mission and other skid row service providers to examine the circumstances in which patients discharged from hospitals are being left there. 

Andy Bales, the head of the mission, said Wednesday that he had given investigators admission logs and a videotape showing an ambulance dropping off a man at the facility who was in a stretcher and appeared to be having convulsions.

Delgadillo would not name which hospitals are under investigation. But the LAPD has identified several hospitals it says have dumped patients. 

LAPD officials said that they often see people with hospital wristbands on skid row, often appearing ill and sometimes even wearing colostomy bags. 

Last month, after the department issued a report naming a handful of hospitals that officials believe had dropped off patients on skid row, several institutions conceded the practice but said it was necessary and had been handled appropriately.

Officials at Kaiser Permanente West Los Angeles, Martin Luther King Jr./Drew Medical Center and Hollywood Presbyterian Medical Center said they had no other choice when discharging homeless patients who have nowhere else to go and need the services available from the missions and other providers concentrated there.

Those hospitals stressed that they only send patients to skid row who are healthy enough to be discharged. The acting chief executive of Hollywood Presbyterian said last week that his hospital takes people to Los Angeles Mission only at their request. 

Delgadillo said Wednesday he is concerned that mentally ill patients could be "the perfect victim[s]" for dumping because they are powerless and can't fight back.

"How can they complain?" he said.

There is no law against transporting patients to skid row after they have been discharged. But Delgadillo's office suggested several legal strategies that could result in criminal charges or civil penalties.

The city attorney's letter to hospitals, obtained by The Times, queries them about possible violations of the federal Emergency Medical Transfer and Active Labor Act. That law requires hospitals to screen and stabilize all patients and penalizes them for releasing or transferring patients who are medically unstable. 

The letter also cites a state law dealing with unfair business practices. That law has been used to prosecute alleged slumlords. The law allows a corporation to be sued for unscrupulous behavior. It also allows the government to ask a judge to issue an order forbidding a corporation to take certain actions. If the corporation violates the court order, it can be fined.

The letter, written by Jeffrey B. Isaacs, the chief of the city attorney's criminal and special litigation branch, asks hospitals 10 questions about the types of patients they admit, discharge policies, procedures regarding the transfer or release of homeless patients, and whether the hospitals send patients to social service providers in downtown Los Angeles.

In addition, it asks whether the hospitals have identified any violations of the federal Emergency Medical Transfer act involving homeless patients.

The dumping issue surfaced in September when LAPD Capt. Andrew Smith publicly complained that outside law enforcement agencies regularly had brought criminals downtown after they had served jail sentences. He cited one case in which he saw two sheriff's deputies take a man in handcuffs from their squad car and deposit him on the street.

Since then, the LAPD has also said hospitals and nursing homes have also been dumping people.

On Wednesday, Smith expressed support for the city attorney's investigation. 

"It sounds like a great idea to me, as long as it keeps people from abandoning homeless people on skid row," he said. "If a hospital makes an appointment, and checks in with the providers, that's one thing. But for a hospital to drive up in an ambulance, and drop someone off … in the horrible environment of skid row, like we've seen, that's another. It's unconscionable. It really is."

Estela Lopez, executive director of the Central City East Assn., a business advocacy group, also welcomed the news.

"Institutions need to be held responsible," Lopez said. "How can you take a person who cannot fend for themselves and drop them anywhere, but much less the most dangerous few blocks in Los Angeles?

"Skid row is where people are sent to die or live the rest of their lives in a deathlike trance. And every single day it goes on, we are allowing it." 
 

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Copyright 2005 Los Angeles Times