Los Angeles City Attorney investigating new cases of possible Skid Row 'patient dumping'

The Los Angeles City Attorney is investigating new accusations of “patient dumping” in Downtown’s Skid Row. That is the practice of hospitals discharging homeless patients to somewhere other than their home without their consent, in violation of an L.A. city ordinance.

City attorney spokesman Frank Mateljan said they were alerted to the issue by Skid Row service providers, who are usually the first to spot the recently discharged patients. Mateljan declined to speak about specific cases, but said they've received more complaints recently.

"There was a lull there for a while, but we have seen an increased number of alleged incidents that were allegedly occurring on Skid Row," Mateljan said.

Patients seen wearing hospital gowns, ID bracelets

Over the past nine months, people who work on Skid Row report seeing at least a dozen ex-patients wearing hospital gowns or a hospital ID bracelet on their wrists. Mai Lee is the director of public affairs at the Midnight Mission. She said over the last few years they’ve seen very few homeless hospital patients. But lately, it's been almost one per week.

“They’re showing up via taxi or the patients inform us they were given a bus token to come down to the Skid Row area, to the Midnight Mission," Lee said.

These homeless individuals are often mentally ill, have physical ailments or both.

Recently, a male patient was sent from BHC Alhambra to the Union Rescue Mission, according to a transportation voucher obtained by the LAPD. But mission workers say they were not expecting a patient.

Officers became involved when the man refused to exit the cab. Police said the incident was then referred to the city attorney's office. Spokesman Mateljan would not confirm if they are investigating, but said they take every allegation of patient dumping seriously.

BHC did not respond to repeated calls seeking comment.

Discharging homeless patients the right way

Hospitals must follow specific procedures in order to discharge a patient to Skid Row.

The method was developed after hundreds of homeless individuals were brought to to the area by hospitals and medical centers between 2006 and 2008. This rash of "dumpings" resulted in new hospital discharge policies and a new city law. The "anti-dumping" ordinance, approved by the L.A. City Council in 2008, makes it a misdemeanor for healthcare facilities to discharge a patient to someplace other than their home without their written consent. 

In addition, many Skid Row shelters adopted new procedures for admitting discharged patients to their facilities. At the Midnight Mission, they ask hospitals to fill out a patient referral form and call ahead. This allows time to set up a "warm hand-off" and get a brief history of the patient.

"It's a simple process. They basically call us, we have one individual that manages or handles all hospital referrals, and that individual then reviews the patient's discharge plan," Lee said. "They'll review it and if they're a good fit for us, we say 'yes.' He puts his ID on the form, and then the hospital will drop them off and we'll greet them at the gate."

Most recently, Lee said she's seen an increase in patients showing up unannounced.

"The wrong way to do it is to send somebody here and just say: 'Go down to the Midnight Mission,'" Lee said.

Rev. Andy Bales runs the Union Rescue Mission. He said although many hospitals follow the established protocol, there are still a few bad seeds.

"We worked out a system of proper referral and really worked out a good agreement with all the good hospitals and the hospital association," Bales said. "But there are some, I think, renegade hospitals that may be continuing to drop patients off."

Many allegations have been made, but few have been proven

Many allegations of "patient dumping" have been made over the years, but few are substantiated, according to the Hospital Association of Southern California. And city attorney spokesman Mateljan said cases can take months to solve.

"These cases are difficult to prove because you have victims that are very transient and hard to identify," Mateljan said.

Jennifer Bayer, vice president of external affairs at the hospital association, said they don’t keep data on how many homeless patients are discharged to Skid Row. But she said many homeless patients request to be taken there because it’s where most of the social services are located. And it’s where many of them came from before they entered the hospital.

“Maybe it’s time for both sides to a have a refresher,” Bayer said, referring to the proper guidelines for a patient hand-off. She cited employee turnover at the hospitals and the shelters as possible reasons why proper protocol may not be followed.