3 L.A. Hospitals Take Patients to Skid Row

Three Los Angeles hospitals regularly put discharged patients with nowhere to go into taxicabs bound for skid row, hospital officials acknowledged this week.

Officials at Hollywood Presbyterian Medical Center, Kaiser Permanente West Los Angeles and Martin Luther King Jr./Drew Medical Center said the practice is necessary because skid row is the only place in Southern California with a concentration of social services for the patients, including homeless shelters and drug and alcohol programs.

Los Angeles Police Department officials agreed that the hospitals have few other options. But they said the practice worsens the already grim conditions on skid row. They also disputed the hospitals’ contention that the patients taken to skid row are always ready for release.

The hospitals are the first agencies to acknowledge a practice of routinely delivering their wards to skid row. They did so after being named in a report by the LAPD that accused the three hospitals and several suburban law enforcement agencies of leaving homeless people and criminals in downtown. The suburban police departments have denied the accusation.

The new disclosures come at a time of heightened public debate about the practice of “dumping” indigent people in the heart of downtown Los Angeles. Earlier this week, city and state officials pledged a new attack on the area’s persistent problems, beginning with a crackdown on rampant drug dealing, which police say generates roughly one-fifth of the city’s drug arrests.

Workers at skid row social service agencies this week said several other hospitals discharge patients in the area. Those reports could not be confirmed.

Representatives of the three hospitals insisted that the practice is in the best interests of the patients because skid row offers their best chance of receiving the follow-up services -- as well as shelter -- that they need once they are discharged. They also stressed that the patients are sent to skid row only after they are healthy enough for discharge.

“One of the challenges is that there are very few places that will take patients coming out of the hospital, even when they are medically cleared,” said Mehera Christian, director of public affairs for Kaiser Permanente Metro Los Angeles, whose hospital on Cadillac Avenue is eight miles west of downtown. “There are just a scarce number of places in the community to assist our homeless.”

Typically, social workers at the hospital meet with patients before they are discharged and “try to connect them with resources in the community,” Christian said. “We provide them with free transportation to that agency. Some of the only places to send them for social assistance are the agencies recommended to us by the Los Angeles Homeless Authority. Those are predominantly in the downtown area.”

Christian said that about 50% of the patients designate where they want to go, and sometimes, she said, that may not be where services are available. “We don’t force them,” Christian said. “We have to respect that patient’s wishes.”

Despite the statements by the three hospitals that patients are transported only when they are medically stable, LAPD Capt. Andy Smith, who oversees the Central Division, said he routinely sees “individuals with not one but sometimes two different hospital bracelets, and people with bandages on, people who are barely ambulatory, and we’ll end up calling an ambulance.... Sometimes they are in such bad shape they are incoherent.”

Smith also said that patients sometimes don’t end up at their correct destinations.

“A taxi will pull up in front of the Volunteers of America shelter on San Julian [Street], and the taxi driver, hired by the hospital or retirement home or halfway house, will offload somebody, help them out of the taxi, give them their bags, close the door and drive away,” Smith said. “Here is this person on the sidewalk, not knowing where they are, in need of assistance, and they are left there on the street with 200 homeless people, a significant portion of whom are nothing but parolees or criminals looking to do harm to them.”

Smith’s boss, Assistant Chief George Gascon, said the hospitals’ practice underscores the need to place services across the region so that skid row doesn’t bear a disproportionate load.

“Many of these hospitals may well be taking people there to providers for legitimate reasons,” he said. “But it illustrates ... that whenever an institution needs to send someone for services, they opt for skid row.”

Several of the examples cited by the LAPD came from the Union Rescue Mission. Since Oct. 17, the mission has had 11 discharged patients arrive at its door on San Pedro Street unannounced, either by ambulance or taxi, according to the group’s president, Andy Bales.

Eight of the 11 patients told mission staff that they had come from six hospitals not named by the LAPD.

The other three patients “were not competent enough to tell us what hospital they were dropped off from,” said Scott Johnson, director of the mission’s program services.

None of those hospitals had called ahead to make sure that the shelter had beds or could accommodate the patients, Johnson said.

Officials from the six hospitals did not return calls seeking comment.

Smith recalled one case this fall when “an ambulance opened up [with] a guy strapped to a gurney who couldn’t even speak. He was thrashing around on this gurney. They were trying to push him inside the doors of the Union Rescue Mission to get him inside.... The mission said, ‘We can’t take someone who can’t even get out of his ambulance gurney.’ ”

Officials at the three hospitals named by the LAPD insist they don’t simply dump the patients on skid row.

Joseph Epps, an attorney representing Hollywood Presbyterian, said the hospital’s written transportation policy calls for homeless and indigent patients to be transported by hospital van to the Los Angeles Mission or be given vouchers to take taxis wherever they wish.

The decision about how to best help homeless people being released from the hospital is “a conundrum,” Epps added. “The patient certainly has the right to go wherever they want,” and staff members can’t control where the patients decide to go, he said.

King/Drew officials declined to comment. But in a statement provided to The Times by the Los Angeles County Department of Health Services, which oversees the hospital, officials said “we do provide taxi vouchers to some patients without means to be transported home. In some cases, our patients are homeless or live in shelters. In those cases, they oftentimes go back to the neighborhood or shelter where they reside. Given King/Drew’s relative proximity to the skid row area and its mission of serving the poor and uninsured, we serve a lot of patients that live in that area.”

Service providers on skid row said they sympathize with the hospitals but believe they need to do more.

Jim Howat, the Volunteers of America’s group director for homeless services in Los Angeles, said he is troubled by the constant stream of ill patients arriving on his organization’s doorstep in taxis and ambulances. But until other communities allow services for the homeless and poor into their neighborhoods, he doesn’t see the situation changing.

“A lot of times, where are they going to take them? What are the alternatives? At this point, there aren’t many alternatives.”

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BEGIN TEXT OF INFOBOX

In skid row

Some social service providers in downtown’s skid row area

1. Los Angeles Mission

2. Fred Jordan Mission

3. Union Rescue Mission

4. Volunteers of America detox center

5. Weingart Center

6. Midnight Mission

7. Los Angeles Men’s Project

8. Volunteers of America drop-in center

Social service agencies in Los Angeles’ skid row: More than 60

Homeless in Los Angeles County: 80,000

Homeless living on streets of Los Angeles’ skid row: 4,000

Single-room hotel units in Los Angeles’ skid row: 6,500

Source: Times reports. Graphics reporting by Brady MacDonald