Dumped On Skid Row

(CBS)  The first rule in medicine is: do no harm. But doing harm is precisely what some Los Angeles hospitals are being accused of when it comes to patients who happen to be homeless.

As CNN's Anderson Cooper reports, the claim is that hospitals don't like dealing with homeless patients, who are often uninsured and sometimes unpleasant to treat. So they literally dump them on the streets of Skid Row, even if the patients come from other places in Los Angeles, and are in no condition to fend for themselves.

While there have been allegations of hospital dumping for years, people only started paying attention to them because of a videotape recorded by a camera outside a homeless shelter.

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The tape shows a 63-year-old homeless woman named Carol Ann Reyes wandering in the street. The pictures may seem unremarkable, but the story that goes with it is disturbing. Reyes had just been discharged from Kaiser Permanente Bellflower hospital where, after taking a fall, she had been treated for three days.

The hospital confirms she was put in a taxi and the driver was told to take her to Skid Row. Why was she wearing little more than a hospital gown? Because the hospital admits they had lost her clothes and sent her away without pants or even shoes. They did, however, give her a diaper.

"The cab came this way. He did a u-turn. Pulled around. And stopped. The driver didn't even get out of the car. The back door opened and this little lady got out in her hospital gown," says Rev. Andy Bales, who runs the Union Rescue Mission, the biggest shelter in Skid Row.

Skid Row is a 50 square-block area home to some 11,000 people, with the highest concentration of homeless in the country.

Asked if he was surprised to see Reyes get out of the taxi, Rev. Bales says, "I was stunned and shocked and frozen for a moment. I couldn't believe my eyes. She was really confused."

She was confused, investigators later found, because she was suffering from dementia. That shouldn't have come as a surprise to Kaiser hospital officials.

Their own medical records show Reyes was disoriented as to time and place. Her speech was slurred, she had extremely high blood pressure, and a persistent cough and fever. Even with these medical problems, they decided to discharge her and sent her to the streets of Skid Row.

"They're dumping a 62-year-old woman with dementia in the heart of Skid Row? That's what's going on. And it's shocking and it's criminal," argues Rocky Delgadillo, the Los Angeles City Attorney.

His office is investigating more than 50 cases of alleged homeless dumping on Skid Row. "These may be the perfect victims. Because a homeless individual dumped on Skid Row disappears into the chaos of Skid Row within minutes. It's hard for us to find them and then get the evidence that we need."

What should hospitals do with homeless patients? The California Health Code requires all hospitals to make "appropriate arrangements for post-hospital care" and for "continuing health-care requirements" before discharging any patient.

Kaiser didn't do that in Carol Ann Reyes' case, Delgadillo says. She was sent to Skid Row last March without any medication or instructions for follow-up care.

Asked what it's like down there, Delgadillo says, "Cardboard shanties. It's a dangerous place, both physically, as well as the drug dealers that congregate on Skid Row, gangs that come here to find easy prey."

"Not the kind of place an elderly woman with dementia should be," Cooper remarks.

"No, in fact, if she'd made it around the corner, she might not be with us today," Delgadillo says.

Carol Ann Reyes is with us today because a worker from Bales' mission rescued her from the street. She's now under the protection of a court-appointed conservator. She suffers from mild dementia and other medical problems. The conservator allowed 60 Minutes to videotape her meeting her lawyer, but not to ask her any questions. Her lawyers have filed suit against Kaiser hospital.

Before she was hospitalized, Reyes had been sleeping in a park, 16 miles away from the crime-ridden streets of Skid Row.

"Sometimes, individuals end up here that are just released from county jail," explains Deputy City Attorney Jose Egurbide, who investigates hospital dumping cases, and showed 60 Minutes around Skid Row.

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[maureenols]

I was appalled to watch this program and I was literally shouting at the television while Anderson Cooper was interviewing the hospital administrator (with respect to the man left on the curb) because I could not contain my anger. I was stunned at the lack of compassion and regard some individuals have for their fellow man. It so disturbed me to think that someone would leave a person on a curb (regardless of the rationale) who was not mobile. And to make matters worse, I quickly scanned the comments on this article and there are those who express such disdain for the homeless that I am again frozen in disbelief. You need to stop pointing the finger at other countries and take a look at what you are doing in your own. This is an issue easily solved, thanks for exposing it Anderson.

[mchllew]

just a few questions Mr.Cooper didn't ask. 1. were these hospitals trying to find a place for these patients to go other than the street? 2. might good people make mistakes that lead to unintended consequences or were they just evil? 3. are there enough shelters for all the homeless in LA? 4. where are most shelters located in LA? 5. why are so many shelters located near what is called skid row? 6. if not a shelter in skid row and if there are't enought shelters, where should a hospital send a patient who no longer needs to be in a health facility? 7. what about the disabled homeless person laying on the sidewalk - where is that person supposed to be taken and by whom? 8. What are the root causes of homelessness? 9. What's being done to get at that? 10. What's the government's role? 11. Would any of us welcome a homeless shelter on our street? hospital have responsibilities, but a regurgitation of a story with no critical thinking or probing of the issue adds nothing except to allow indignation mask public indifference. So what was the point?

[ll11ksord]

Why should the hospitals be responsible for homeless people? We had a system here in the United States to take care of these people but thanks to the ACLU they were forced to close. Why don't you do an expose on all the things that the ACLU has done to ruin the country.As usual you missed the problem.

[ll11ksord]

Why should the hospitals be responsible for homeless people? We had a system here in the United States to take care of these people but thanks to the ACLU they were forced to close. Why don't you do an expose on all the things that the ACLU has done to ruin the country.As usual you missed the problem.

[ll11ksord]

Why should the hospitals be responsible for homeless people? We had a system here in the United States to take care of these people but thanks to the ACLU they were forced to close. Why don't you do an expose on all the things that the ACLU has done to ruin the country.As usual you missed the problem.

[bigdhomeless]

While individuals may have the right to suffer, which is what happens when your homeless, not even to speak of the "silent genocide", as a formerly homeless individual and one who works for an MHMR (Mental Health, Mental Retardation) treating and doing outreach to mentally ill homeless, it is amazing that there are programs which have been proven 80% plus effective for these individuals yet are largely ignored. Yes, I do think we as a society have an obligation to meet the basic needs of all our people (Maslow's Hierarchy of Needs).
Certainly I agree laws need to be changed. If we find someone with dementia or Alzheimer%u2019s on the streets, do we really justify this politically & morally; too leave them there incapable to fend for themselves because they are not a %u201CPhysical%u201D danger to themselves or others. We have Child Protective Services & Adult Protective Services. What about MHMR Protective Services? I understand that the value of life finally has a number when it comes to budgets. I also fully understand that we finally have a part of society in which we can now discard in a manner to which we can balance that budget.
By the way as an independent, homelessness increased both during Republican and Democratic Administrations over the last 27 years.

[randalds]

RANDAL05.... WELL SAID THANK YOU FOR ALL YOUR COMMENTS. I too am a psych RN in an opposite region, working with the homeless, and the homeless vets it is an on going problem. Thanks to people like you and your wife .
Posted by JDUBS63 at 11:13 AM : May 21, 2007

Thanks to you too. Far too many people don't really understand the homeless problem. Politicians like those here in L.A. think that all they have to do is to send psych teams into the inner city and have the ones who are mentally ill committed to get them out of the way of the newly gentrified regions. They don't seem to understand that a doctor or nurse must meet a specific standard when trying to decide to put someone on a "hold" (a 5150 as it's called here). They can't do it unless the person is clearly a danger to themselves, a danger to others or is gravely disabled. Sounds easy enough, but being mentally ill and homeless by themselves does not meet the criteria. They have a right to be homeless, even if you suspect they only are because they're mentally ill. To be gravely disabled to have to be shown to not be aware of their surroundings and be incapable of taking care of themselves to the point where they can't feed themselves. Doctors and nurses are not going to put their licenses on the line unless they are certain a person meets that standard, and rightly so because they risk their career and livelihood every time they write a 5150. It's just not as easy as it sounds.

[randalds]

But, Expenses incurred by treating, feeding...etc these illegals cuts down for our own citizens. As you said this is an AMERICAN issue, not illegal immigration, but we the people (taxpayers) are the ones footing the bill for these illegals. I would much rather see our tax dollars go to helpout the homeless, than take care of some illegals, and their anchors.

Posted by Klingon69 at 01:51 PM : May 21, 2007

Yes, but I still maintain that the expense of having the illegal aliens here is hugely over stated for political reasons. I mean the most widely quotes figures that show this alleged abuse of the system always seem to come from organizations like the Heritage Foundation or the Club for Growth which are about as unbiased as the RNC or FOX Noise. I mean their motto ought to be "We love only white conservatives".

[dequi4]

Not all homeless people are lazy. Not all folks abuse the system. Lets not stereotype. There are many genuine reasons for homelessness. Some folks lost their jobs due to layoffs, or a company shutting its doors. Some women who relied on their husbands to provide for the family find themselves in a situation where he has decided to leave. There are People who are in abusive situations but dont want to be anymore, and they reach out for help. Of course there are those who have mental illness, or a physical disability. There are those who have drug and alcohol problems, and they cant take care of themselves because no one ever taught them how, or that they were worthy of anything. Believe it or not, but there are also homeless folks who want to be homeless. It's their chosen way of life. I believe in accountability too. I also believe in compassion. Let's not forget about that....

[weareone2]

It is no wonder that we have people so lacking in empathy that they can gun down a bunch of others, when we have a culture in which we allow mean-spirited, uncaring people to dominate the public discussion, and define what attitudes are acceptable.
We can see here one of the reasons why large societies in the past have always fallen. In the small communities in which people lived for most of human history, if you didn't help others, others would know not to help you when you needed it. In our society, you can be totally uncaring and selfish, but if you need help, some kind person or group will help you. So such people can proliferate. Eventually, there will be many more of them than the helpful, and then the system will not be able to sustain itself.