L.A. City Atty. Mike Feuer vows to crack down on 'patient dumping'
Despite tough regulations put in place years ago, hospitals are still abandoning homeless patients on skid row, advocates say.
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In this 2006 file photo provided by Los Angeles police, ambulance workers drop off a patient on skid row, even though police reports indicated he wanted to be taken to his residence at a Pasadena convalescent home. (Los Angeles Police Department)
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- uth San Pedro Street & East 5th Street, Los Angeles, CA 90013, USA
Nearly a decade after local hospitals were exposed abandoning homeless patients on downtown's skid row, Los Angeles City Atty. Mike Feuer on Friday vowed to crack down on the illegal practice that still continues.
In a settlement announced Friday, the 224-bed Beverly Hospital in Montebello agreed to pay $250,000 in civil penalties and legal fees after it was accused of taking a patient by taxi to skid row and leaving her there without making any arrangements with a shelter.
"'Patient dumping' is inhumane and intolerable to me," Feuer said. "I do have it in my mind to send a message to other hospitals that this won't be tolerated."
The hospital agreed to the fines and promised to adopt new protocols rather than face civil and criminal charges for allegedly leaving the homeless woman at 5th and San Pedro streets.
Although the Montebello case marks the first time in several years that a hospital has been caught dumping a patient illegally on skid row, homeless advocates say they've seen a surge of people on the streets wearing medical wristbands.
"Sadly, we are seeing patients from hospitals being dumped on skid row again without any plans for their discharge," said Andy Bales, chief executive of the Union Rescue Mission. "It is worse than ever. I am seeing more people — clearly patients — wandering the streets."
For nearly a decade, the Union Rescue Mission has operated "dump cams" outside its shelter. The Los Angeles Police Department has publicly vowed to arrest anyone caught leaving patients outside a shelter. In the last few months, Bales said, shelter officials discovered a patient from an Alhambra psychiatric hospital being dropped off by a taxi in October without any arrangements for care. That same hospital also was accused of leaving several patients at the Midnight Mission.
Feuer's office is investigating the allegations. His staff also investigated reports in the Sacramento Bee that Rawson-Neal Psychiatric Hospital in Nevada had bused about 1,500 psychiatric patients to cities and towns across the country over the last five years, including about 500 to California. Feuer said that even if a hospital is out of state, he will take legal action to prevent it from dumping patients.
"It truly is hard to imagine for a person to be in a more vulnerable position than being delivered to nowhere on skid row," he said.
In 2005 and 2006, patient dumping on L.A.'s skid row grabbed national headlines with images of mentally ill patients in hospital gowns, one holding a colostomy bag, being dropped off in ambulances, taxis and vans.
City prosecutors began aggressively pursuing criminal and civil cases against medical facilities that left homeless patients at shelters. Los Angeles police reported seeing hundreds of patients, sometimes still in hospital gowns, on downtown streets.
The city forced several large hospitals and chains, including Kaiser Permanente, to pay massive civil penalties and agree to tough new regulations and, in some cases, even an independent monitor.
Feuer said he is not sure whether patient dumping subsided, or if the issue "didn't receive the attention it should have." Either way, he said, it clearly remains a problem.
The settlement signed last month by Feuer's office and Beverly Hospital resolves a civil enforcement action, which alleged the Montebello medical center failed to perform a screening on a homeless patient in an emergency medical condition.
Beverly Hospital, the city attorney alleged, failed to stabilize the homeless patient before transferring and improperly discharging her. An attorney for the hospital did not return telephone calls; the hospital also did not acknowledge dumping the patient.
Under the agreement, the hospital said it would follow state and federal laws that prohibit patient dumping. In Los Angeles, patients cannot be discharged into a so-called patient safety zone that encompasses much of downtown Los Angeles unless they are in the care of a relative. The hospital also must obtain written consent from patients to take them to a place other than their home.
The Beverly Hospital case doesn't have the scope of some of the worst offenders of the past. College Hospital in Orange County in 2009 agreed to pay $1.6 million in penalties and charitable contributions to a host of psychiatric and social services agencies. On a weekly basis, the hospital dropped patients off in vans, dumping 150 altogether.
http://www.latimes.com/local/la-me-hospital-patient-dumping-20140104,0,4148379.story#ixzz2pRdTJ9db
Patient Dumping: How Hospitals Treat the Mentally Ill
How do you expect to be treated when you go to a hospital? You probably expect to receive quality healthcare. You probably expect professionals to assess and treat you and, depending on the circumstance, admit you to the hospital. You probably expect to be treated with care and respect and to have your illness treated until you are well enough to go home.
These are reasonable expectations. After all, hospitals are there to care for you when you’re too ill to care for yourself.
But I hope you’re not a person who hears voices or talks of killing yourself, because then those expectations can go right out the window.
Patient Dumping
Patient dumping is a phenomenon in healthcare where patients are stabilized to the point where they won’t die but then they are dumped, pretty much wherever, just to get them out of the hospital. Sometimes patients are delivered with nothing but hospital gowns to the street where they have no place to live and nothing to eat.
And for people with a mental health condition it can be even worse. Some hospitals have been accused of not even stabilizing patients before sending them on a bus to the next state where they are instructed to “call 9-1-1” so they can be someone else’s problem.
Think that couldn’t happen in the United States? Think again.
The Sacramento Bee has chronicled case after case of patients being bused out of a Nevada psychiatric hospital into every other state in the US. According to a US federal agency about 40 percent of patients at the Nevada hospital were discharged without any arrangements made for their care.
Patient Dumping Violates the Emergency Medical Treatment and Labor Act
Not surprisingly, there are laws put into place to prevent this sort of thing—too bad they don’t work. Too bad patients with a mental illness are seen as second-class citizens. Too bad if you don’t have money for treatment you are treated as expendable.
Why No Care for the Mentally Ill?
It is not surprising to anyone who works in the field that one-third of homeless people have a mental illnessand these people often end up in the hospital as many of them are currently untreated. It is also no surprise that mental illnesses can take many days or even weeks to stabilize—all without insurance. This makes them very expensive patients.
But I don’t care.
I don’t particularly care that U.S. hospitals that make millions of dollars have to spend a pittance on people with mental illnesses. It’s this for-profit model that allows so many people to live on the street untreated so why shouldn’t hospitals—who profit from the model—have to pay?
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