Doctors at College Hospital diagnosed Steven Davis as suffering from schizophrenia, bipolar disorder and schizoaffective disorder. Doctors at the Costa Mesa mental institution prescribed him numerous drugs to deal with paranoid delusions that had led to an earlier suicide attempt.
But that didn't stop the hospital from hauling Davis into a van and driving him more than 40 miles north to downtown L.A., where they dropped him off outside the Union Rescue Mission. When mission officials complained to the hospital, the van returned and drove Davis a few miles south to another shelter. Davis wandered away without ever entering.
Davis turned out to be the key to uncovering what Los Angeles prosecutors described as the largest case of homeless dumping they've investigated to date.
In a settlement announced Wednesday, the L.A. city attorney's office said that College Hospital had dumped more than 150 mentally ill patients on skid row -- long a magnet for the region's most vulnerable citizens -- in 2007 and 2008.
As part of the settlement, the hospital will pay $1.6 million in penalties and charitable contributions to a host of psychiatric and social-service agencies. The hospital also agreed to a first-of-its-kind injunction that prohibits it from transporting any homeless psychiatric patient discharged from their facilities to the streets or any shelter within an established "Patient Safety Zone," a swath of downtown and South Los Angeles where most of the region's homeless shelters and missions are concentrated.
Until now, the city attorney's office had developed cases involving specific patients. But with College Hospital, prosecutors say they uncovered a much larger pattern of sending patients from its facilities in Cerritos and Costa Mesa to downtown L.A.
"In the city of Los Angeles, we will not stand idly by while society's most vulnerable are dumped in the gutter of skid row," said City Atty. Rocky Delgadillo.
An attorney for College Hospital said the hospital did nothing wrong and that its actions didn't amount to "homeless dumping." While the hospital agreed to the civil court settlement, attorney Glenn Solomon maintains that it broke no laws and that the settlement sets up a protocol for dealing with homeless patients that the hospital can work with.
"It is the policy of the hospital . . . to discharge each and every patient appropriately," Solomon said.
Details of the new protocols are still being finalized. But they probably will include specific regulations on how patients are released from the hospitals, a system for having them evaluated after their release, and a process for getting those who need additional care placed in medical or social service programs.
Union Rescue Mission Chief Executive Andy Bales praised the settlement as another victory in a long fight against homeless dumping. "This is another step toward living up to our name, the City of Angels," he said.
Over the last four years, authorities -- along with many service providers in the skid row area -- have cracked down on the practice of dumping people onto the streets of skid row by hospitals and some law enforcement agencies. The Union Rescue Mission installed "dumping cams" outside its shelter, and the Los Angeles Police Department vowed to arrest anyone who dumps patients on skid row, using a law against false imprisonment.
The city attorney's office has mounted a campaign targeting specific hospitals believed to be engaging in the practice, using a state law concerning unfair business practices that allows a corporation to be sued for unscrupulous behavior.
Two years ago, Kaiser Permanente agreed to a settlement requiring the HMO to establish new discharge rules and provide more training for employees, both of which were aimed at preventing further patient dumping. A retired U.S. District Court judge was assigned to oversee how the hospital chain complied with the rules.
But prosecutors said the scope of the College Hospital case was much larger.
Jeffrey Isaacs, who is in charge of the city attorney's criminal division, said the hospitals would send vans up to Los Angeles once a week, dumping one or two patients at a time in the downtown area. Van drivers were told to drop the patients off near the shelters but not go inside with them, Isaacs said.
"They would average more than a dumping a week," he said.
The practice may never have been discovered had it not been for Davis.
The mental health patient who was left near a South L.A. shelter was being sought by authorities for several days in the spring of 2008. They finally caught up with him at California Hospital Medical Center downtown, where he was being treated for his psychiatric ailments.
After authorities interviewed Davis, they began investigating College Hospital. Over the next year, they interviewed shelter workers, van drivers, patients and others, Isaacs said.
Davis reached an undisclosed financial settlement with College Hospital.
Homeless psychiatric patients "are the ones that are taxing the resources, in a very sort of fractured way, and are the ones who really need to be focused on to get the bridges connected . . . so that a continuum of care exists," said David Daniels, the directing attorney of Public Counsel's Homeless Prevention Law Project and one of Davis' lawyers.
Delgadillo said his office is continuing to investigate other medical facilities accused of discharging and transporting homeless patients to skid row or other neighborhoods without the patients' consent. Despite the lawsuits and settlements, Delgadillo says his office continues to get reports regularly of dumping of patients.