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.