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Fines for Patient Dumping Supported

LOS ANGELES -- Hospitals that discharge homeless patients on the streets of Los Angeles without their consent could be charged with misdemeanors and fined up to $25,000 under a proposed ordinance that received preliminary approval Wednesday from the City Council.

The measure is intended to curb dumping, the practice of taking patients from a hospital by taxi or ambulance and leaving them on skid row downtown. Under the new law, a health facility would not be allowed to transport a patient to a location other than his or her residence without written consent.

In the last few years, city officials have mounted a concerted effort to halt patient dumping. The city attorney's office has investigated more than 50 cases since 2005 but has filed cases against only a few hospitals.

"The only reason we are here is because people have been dumped on the streets," said Councilwoman Jan Perry, who introduced the ordinance. Perry, who represents much of downtown, said the measure would provide the city attorney with additional tools to combat the problem.

Until now, prosecutors have relied primarily on civil actions against hospitals suspected of dumping, often citing a state law regulating unfair business practices.

Under the proposed ordinance, hospitals could be criminally prosecuted for patient dumping and, if found guilty, could be fined, put on probation or both.

Jeff Isaacs, head of the city attorney's criminal division, told council members the new ordinance "sets up clear guidelines" about what hospitals can do.

The council approved the ordinance by a 12-1 vote, with Ed Reyes and Bernard C. Parks absent and Tom LaBonge the lone dissenter.

LaBonge said he thought that the city should not take responsibility for patient dumping without seeking the participation of Los Angeles County, which oversees public health for the region.

Because the vote wasn't unanimous, the measure will go before the council again next week. If a majority approves it then, it will go to the mayor for final approval.

Officials from the Hospital Assn. of Southern California, which represents more than 170 hospitals, opposed the ordinance, saying hospitals could risk losing federal funding if found guilty of a misdemeanor. Officials from the city attorney's office disputed that interpretation of federal law.

Some hospitals have agreed to abide by strict discharge rules. The city attorney filed a case against Kaiser Permanente Bellflower Medical Center after Carol Ann Reyes, a 63-year-old discharged patient, was dropped off by taxi on skid row and videotaped wandering the area in a hospital gown in March 2006.

As part of the settlement of that case, Kaiser Permanente agreed to establish new discharge procedures, provide more training for employees and allow a former U.S. attorney to monitor its progress.

The city attorney also filed civil actions against Hollywood Presbyterian Medical Center and Methodist Hospital in Arcadia. A spokesperson for the city attorney's office said that settlement discussions are underway with Hollywood Presbyterian, which was alleged to have dumped a homeless paraplegic man in February 2007.

City officials said the proposed ordinance was necessary in part because their efforts to create a similar law at the state level had failed.

Gov. Arnold Schwarzenegger vetoed a bill last October that would have prohibited hospitals from taking patients to locations other than their homes without patient consent.

The Rev. Andy Bales, chief executive of the Union Rescue Mission, applauded the City Council's action, calling it the culmination of "several years of struggle to make sure patients are properly discharged."

"If you can't get help at a hospital," Bales asked, "where can you get it?"

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