Hospitals Hope D.A. Hasn’t Derailed Dumping Solution

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Hospital and social service officials who have been working to prevent homeless patients from being dumped on Skid Row are hoping that L.A. District Attorney Rocky Delgadillo’s prosecution of Kaiser Permanente won’t derail efforts for a private sector solution to the problem.


Final touches on a pilot program to test the voluntary hospital discharge procedures were taking place Nov. 15 when Delgadillo’s office filed civil and criminal charges against Kaiser Permanente, a participant in the discussions.


It’s the city’s first criminal prosecution of a hospital accused of “dumping” patients in a neighborhood known as one of the nation’s largest and most notorious concentrations of homeless and indigent people.


Jim Lott, spokesman for the Hospital Association of Southern California, called the prosecution not only “politically motivated and pernicious” but a distraction from efforts to create a solution without adding more government regulation.


“It appears this (prosecution) is about more than solving the problem,” he said.


A task force organized by the hospital association has been working for several months on a discharge-and-referral procedure by which hospital discharge counselors would contact and confirm that a shelter has room for a patient.


Under the plan, Volunteers of America vans would provide escorted door-to-door transportation from a hospital to the designated shelter. The process would be documented at every step.


Midnight Mission, Union Rescue Mission and the Weingart Center are among Skid Row facilities that have agreed to participate in a pilot project expected to launch in the next few weeks with hospitals in and around downtown.


Participating hospitals are expected to include Kaiser’s flagship Sunset Boulevard hospital, L.A. County/USC Medical Center, California Hospital Medical Center, Good Samaritan Hospital, White Memorial Medical Center, Los Angeles Metropolitan Hospital and Hollywood Presbyterian Medical Center.


“We think this program holds a lot of promise, but we’re continuing on our own to make changes in our internal procedures and discharge policies,” said Kaiser spokeswoman Diana Bronta, noting that Kaiser’s revamped procedures were submitted to the D.A.’s office for feedback.



Criminal charges

However, Kaiser now has to face criminal false-imprisonment and dependent-care-endangerment charges, in addition to a civil charge of unfair business practices more commonly used by prosecutors to force unscrupulous slumlords to clean up their buildings.


The suit seeks a judge’s order to forbid all Kaiser medical facilities from dumping homeless patients on Skid Row and to impose financial sanctions if it violates the order.


However, Skid Row has long been the default destination for law enforcement, health care and non-profit agencies around the region needing a place to send homeless people in need of more social services than they can provide.


City officials began encouraging an array of shelters, substance abuse treatment centers and subsidized residential hotels to concentrate in the 50-block district on the east side of downtown in the mid-1970s as part of the redevelopment of Bunker Hill on the west side.


But the area has long lacked adequate shelter beds for the homeless, and options are even starker for patients who have completed a course of treatment at a hospital but have no home or family where they can recuperate.


Only one facility, the Weingart Center across the street from Union Rescue, has a 40-bed wing set aside from recuperating patients. A loose coalition of non-profit agencies and public officials, including downtown’s City Councilwoman Jan Perry, is working to secure ongoing funding for at least 45 more beds at other shelters.


The D.A.’s charges against the Kaiser Foundation Hospitals subsidiary pertain to a March incident in which a 63-year-old patient discharged from Kaiser’s Bellflower hospital wearing little more than a hospital gown and socks was left by a hospital-chartered taxi to wander in the streets near Union Rescue Mission until rescued by shelter staff.


Investigators charge that Carol Ann Reyes, who had been living in a Gardena public park and was later diagnosed with Alzheimer’s disease, was put in harm’s way because she had not consented to be taken to Skid Row and the hospital had not made advance arrangements with mission staff to receive her. Kaiser’s Bronta disputes several facts about the incident detailed in the lawsuit.


Most of the incident was captured on a video that was shown during a press conference that Delgadillo held at the mission’s chapel the day after the charges were filed.


“We seek to end the inhumane practice of homeless patient dumping and obtain some measure of justice for Carol Ann Reyes,” declared Delgadillo, who has refocused his efforts on high-profile prosecutions since losing a June primary bid to become the Democratic Party nominee for state attorney general.


Kaiser officials contend that the case was an instance in which a frail patient slipped through the cracks, and that the managed care giant has since improved hospital discharge procedures and staff training at Kaiser facilities around the county.


But Delgadillo said Kaiser’s promises during several months of negotiation were insufficient because its officials would not agree to a court-approved consent decree that would be easier for his office to enforce.

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