Hospitals dump sick people on the streets


Richard Moore

Original source URL:

February 23, 2007

ŒDumping¹ of Homeless by Hospitals Stirs Debate

LOS ANGELES, Feb. 22 ‹ For a year, reports have surfaced that hospitals here 
have left homeless patients on downtown streets, including a paraplegic man 
wearing a hospital gown and colostomy bag who witnesses say pulled himself 
through the streets with a plastic bag of his belongings held in his teeth.

Now, prosecutors are hoping a bill introduced last week in the State Senate will
give them stronger legal firepower to charge the hospitals.

Of the 55 or so reports of ³patient dumping,² principally in the dilapidated 
quarter known as Skid Row, only a handful are being investigated for criminal 
activity, said Rocky Delgadillo, the city attorney. Only one hospital has been 
charged, using a misdemeanor count that has never been tested in court.

The problem is that while California state law requires hospitals to have 
written procedures outlining follow-up care for patients, it does not expressly 
prohibit leaving them on the street.

Advocates for the homeless said it was common in many cities for homeless people
still requiring medical treatment to end up on the street or at the doors of 
shelters ill prepared for their medical needs.

³Hospitals don¹t know what to do with them, and they think it¹s the homeless 
agencies¹ responsibility,² said Michael Stoops, executive director of the 
National Coalition for the Homeless, a Washington advocacy group.

Mr. Stoops said local and federal laws were murky, at best, over where homeless 
patients should be discharged.

The proposed California law, written by members of Mr. Delgadillo¹s staff and 
introduced by Senator Gilbert A. Cedillo, a Democrat from Los Angeles, would 
require hospitals to transport discharged patients to their residence or, if 
they lack one, to the place they identify as their home, typically a shelter.

³There currently is no law making dumping homeless hospital patients on Skid Row
a crime,² Mr. Delgadillo said Thursday at a news conference. ³What we really 
need is legal clarity that specifically prohibits it.²

The bill calls for a jail term up to two years and a fine of $1,000 for anyone 
violating the law. Hospitals could be fined $10,000 and placed on probation, 
opening the way to court orders dictating how they treat discharged patients who
are homeless.

Mr. Delgadillo said homeless patients often lacked insurance or other means to 
pay for their care, prompting hospitals to discharge them quickly. Skid Row 
seems a logical place to take them, with its profusion of shelters and social 
service agencies, but advocates for the homeless said few places could provide 
the necessary medical care.

³We are set up to get people back on their feet, but we are not set up as a 
hospital,² said the Rev. Andrew J. Bales, president of the Union Rescue Mission 
on Skid Row.

Prospects for the bill were unclear. A spokesman for Fabian Núñez, a Democrat 
from Los Angeles who is the Assembly speaker, said he supported it, but a 
spokeswoman for Gov. Arnold Schwarzenegger, a Republican, said it was too early 
to take a position on it. A similar measure Mr. Cedillo introduced last year was

Among the suspected patient-dumping cases that have drawn attention is one in 
which Mr. Delgadillo has charged Kaiser Permanente with misdemeanor false 
imprisonment involving a case last year caught on videotape.

The case that has drawn headlines and indignation more recently involved the 
paraplegic man found crawling in the street on Feb. 8. A dozen people say they 
saw a woman driving a van from Hollywood Presbyterian Medical Center leave the 
man in the street, with some saying she got back in the van and spruced up her 

Mr. Delgadillo said he was still investigating the case. Dan Springer, a 
spokesman for the hospital, said it had acknowledged that its procedures for 
releasing the patient had not been followed. Mr. Springer said the hospital was 
taking steps to ensure it did not happen again.

James Lott, an executive with the Hospital Association of Southern California, 
criticized the proposed legislation, calling it ³in a word, stupid,² and an 
example of Mr. Delgadillo¹s ³grandstanding.² Mr. Lott said federal laws already 
required hospitals to treat and stabilize patients before discharge and to 
provide a plan for follow-up care if needed.

In addition, he said, hospitals downtown agreed two months ago to new procedures
ensuring that homeless patients were not left on the street. He conceded the 
protocol had been violated in the case of the man found crawling in the street.

Copyright 2007 The New York Times Company

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