Effort to criminalize patient 'dumping' may be facing defeat
Some fear bill's penalties for street drop-offs would shut hospitals.
By Aurelio Rojas - Bee Capitol Bureau
Last Updated 12:37 am PDT Tuesday, June 26, 2007
Story appeared in MAIN NEWS section, Page A3
Story appeared in MAIN NEWS section, Page A3
Judy Harris, 47, who injured her leg in a fight, recuperates at an interim care program run by the Salvation Army in Sacramento. The 18-bed shelter allows patients to recover at a fraction of the cost of a hospital stay. But proponents say such programs alone cannot solve the problem of patient “dumping.” Sacramento Bee/Randy Pench
In March 2006, a homeless woman in a nightgown was dropped off by a taxicab near the Union Rescue Mission in Los Angeles' Skid Row.
Carol Ann Reyes was suffering from high blood pressure, a low-grade fever and dementia, according to hospital documents.
Yet she had been discharged by a Kaiser Permanente hospital in Bellflower, 20 miles away, and dropped off on one of the meanest streets in the nation.
A video surveillance camera captured her wandering in a daze. Since then, Reyes has come to embody the practice of patient dumping and been featured on newscasts worldwide and in "Sicko," the latest film by director-provocateur Michael Moore.
Patient dumping is most prominent in Los Angeles' Skid Row, home to the largest concentration of homeless people in the nation, but has also surfaced in Sacramento and other cities in the state.
Legislation by Sen. Gil Cedillo, D-Los Angeles, would bar hospitals from transporting a patient to a location other than the person's residence, unless they have the patient's informed consent.
Senate Bill 275 cleared the Senate, but it failed last week to muster the necessary votes in the Assembly Health Committee and could meet its end today when it comes up for reconsideration before the panel.
Under the legislation, hospital administrators could be subject to a misdemeanor, punishable by a fine of up to $2,000 and up to one year in jail and a fine of up to $10,000 for a hospital.
The bill was prompted by probes of patient dumping in Los Angeles, where in recent years authorities have recorded 55 cases of sick, homeless patients being left on the streets of Skid Row.
Dubbed "Dante's Inferno" by Los Angeles Police Chief William Bratton, the 50-block area in the shadow of City Hall has 8,000 to 11,000 homeless people.
Since the Reyes incident, there have been more than 35 documented hospital drop-offs. In February, a paralyzed man was found crawling the streets without a wheelchair and wearing a broken colostomy bag.
"When a hospital dumps a paraplegic man without any ambulatory devices between the gutters of Skid Row, they are violating their obligation to the Hippocratic oath ('First, do no harm')," Assistant Los Angeles City Attorney Michael Dundas told the Assembly Health Committee.
In urging the panel to approve his bill, Cedillo called patient dumping "an embarrassment, not just in the eyes of this state or nation, but around the world."
The senator said people are looking at California and wondering how a state can "permit its hospitals to dump patients and place them in greater peril than when they entered the hospital."
Barbara Glaser, a lobbyist for the California Hospital Association, agreed hospitals should get permission from patients before transporting them.
But she told the committee that criminally charging a hospital that does not comply could force it to shutter its doors.
"Should a hospital be convicted of this misdemeanor, the federal government ... will have to exclude the hospital from Medicare and Medi-Cal for five years," Glaser said.
She said the real problem is there are "not enough resources available for the homeless in our community." SB 275, Glaser said, "does nothing for homeless patients."
Assemblyman Mervyn Dymally, chairman of the committee, said he wanted to stop the practice. But the Los Angeles Democrat said he, too, was concerned that criminalizing it would close down some hospitals.
Assemblywoman Patty Berg, D-Eureka, said the incident involving the paraplegic man prompted her to go to Dymally and demand something be done.
"This is absolutely horrid and cannot be tolerated," Berg said. "We have to create major disincentive so this kind of situation never occurs."
But Berg said she also was concerned that making patient dumping a misdemeanor would reduce the number of hospitals in the state.
Cedillo argued -- to no avail -- that there is no documented evidence that any hospital in the nation has closed after being charged with a misdemeanor.
He called that argument a "scare tactic." Cedillo said removing the misdemeanor provision and making the practice an administrative violation punishable by a fine -- as Dymally and Berg suggested -- would render the bill toothless.
In the end, Cedillo could not get the votes of Berg and Dymally, who both abstained while Republicans voted against the bill.
Afterward, Dymally allowed Cedillo to bring the bill up for reconsideration this week after further negotiations.
In advance of today's hearing, Cedillo is holding firm on making patient dumping a crime. He contends making it an administrative infraction enforced by state Department of Health Services will not deter hospitals.
"I don't want to create a scenario that they can buy their way out of it," he said. "At the end of the day, if they cannot stop their actions, it should be a crime."
Joan Burke, director of the Loaves & Fishes homeless service in Sacramento, said there are stopgap measures communities can take to stem patient dumping.
Loaves & Fishes officials say hospitals in the area have long dumped patients at the shelter. But when they were confronted a couple of years ago, hospitals agreed to fund an 18-bed shelter.
The interim care program, run by the Salvation Army, allows patients to recover before they are released.
"The cost of a shelter bed is such a tiny fraction of the cost of a hospital bed," said Burke, who testified in support of SB 275.
But Burke cautioned this is a "very small pilot program -- and we still have dumping."
About the writer:
- The Bee's Aurelio Rojas can be reached at
(916) 326-5545
or arojas@sacbee.com.
Becky Herges, 35, who has cerebral palsy, is staying at the interim care program in Sacramento while recovering from medical problems. Legislation that would penalize hospitals for dropping off patients on the streets could meet its end today. Sacramento Bee/Randy Pench
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