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Hospitals' role in care for homeless

March 04, 2007

Re "Hospitals can't cure homelessness," Opinion, Feb. 28

The Op-Ed article by Brian Johnston, chief of emergency services at White Memorial Hospital, was an informative and sobering perspective on the challenges facing hospitals in treating and releasing homeless patients. It was instructive to learn that the problem often begins when police agencies, as a means of transferring responsibility, drop off homeless people who don't need hospitalization. Hospitals and their overworked doctors and staff are caught between the requirement to treat everyone brought into their facilities and a lack of adequate funding and community resources with which to do so. The ultimate fault seems to lie with our county and city governments, whose leaders have failed to address the underlying problems of the homeless and their care.

MARCIA GOODMAN

Long Beach

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Johnston doesn't go far enough. Our elected officials have buried their responsibilities. We need a high-powered summit with city and county representatives, hospital administrators, police, managers of homeless shelters and other stakeholders meeting for as long as it takes to work out an equitable, humane approach to the problem. It is time to stop blaming the hospitals for trying to help and start to take real steps (with real dollars attached).

GERALD LEVY MD

Rossmoor

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As a result of the Emergency Medical Treatment and Active Labor Act -- passed by Congress in 1986 in response to egregious examples of uninsured women in labor being turned away from private hospitals -- emergency rooms and hospitals are duly obligated to accept patients regardless of their ability to pay for services.

As Johnston pointed out, the burden of caring for the uninsured in Los Angeles County, for whom the ER all too often becomes their doctor, has led to the closure of many emergency rooms and even some hospitals, resulting in serious overcrowding in the remaining facilities and frequent paramedic ambulance diversion.

Meanwhile, acute-care hospitals cannot be expected to become homeless shelters or long-term treatment centers for the mentally ill. They simply are not designed for such roles. The three interrelated problems -- care for the uninsured, the homeless and the mentally ill -- need to be addressed at the federal, state and county levels. A humane society should demand no less.

HAROLD N. BASS MD

Porter Ranch

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Johnston is missing the point. Punishing hospitals for dumping patients isn't supposed to do anything about homelessness. It's supposed to teach the hospitals not to dump patients, and especially not to dump them on skid row.

P.J. EVANS

Chatsworth

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