New law addresses how homeless are discharged
In response to several high-profile incidents of homeless patients being discharged in a less-than-dignified manner, the city of Los Angeles has enacted a new law that requires obtaining written consent to transport a patient anywhere other than his or her legal residence. Violating the law could result in a misdemeanor conviction.
The problem of how to discharge homeless patients who are medically ready to leave the facility but have no place to go is one that plagues many health care providers, but the topic is on the front burner in Los Angeles. Several providers there have been the subject of highly critical media reports about how the homeless are discharged, including a report in April 2006 that included footage of a 63-year-old homeless woman who had been treated at a Kaiser Permanente facility and then dropped off at a shelter on Skid Row, where she wandered aimlessly on the sidewalk in a hospital gown and socks. The local city attorney filed charges of misdemeanor imprisonment and threatened to pursue the case further, prompting Kaiser Permanente, based in Oakland, CA, to create new protocols for discharging homeless patients. As part of the settlement, Kaiser paid $5,000 in civil penalties, $50,000 in investigative costs to the city attorney's office, and contributed $500,000 to a charitable foundation benefitting local homeless programs.
Hollywood Presbyterian was recently sued in connection with the "dumping" of a paraplegic man on Skid Row in 2006. That incident resulted in scandalous media reports of the man falling out of a van and then crawling in the gutter. The hospital acknowledged that the man was not properly discharged. Civil rights attorneys filed the lawsuit in Los Angeles County Superior Court on behalf of the paraplegic man, 42-year-old Gabino Olvera of Los Angeles, seeking unspecified punitive and compensatory damages against the hospital for elder abuse, negligence and infliction of emotional distress, and an injunction that would bar the hospital from "homeless dumping."
The new city ordinance, believed to be the first such law in the nation, prohibits health providers from transporting patients anywhere other than their homes without written permission. The Hospital Association of Southern California (HASC) released a statement saying the new law may be unworkable because homeless patients may have no residence and can refuse to be transported anywhere else, including homeless shelters. Already overburdened hospitals will be forced to house homeless patients who should be discharged, the group says.
HASC has hired an attorney to determine whether the ordinance violates state laws, and the group is investigating the potential ramifications that a conviction might have on a hospital's participation in Medicare, Medicaid, and other federal programs.
In response to several high-profile incidents of homeless patients being discharged in a less-than-dignified manner, the city of Los Angeles has enacted a new law that requires obtaining written consent to transport a patient anywhere other than his or her legal residence. Violating the law could result in a misdemeanor conviction.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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