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Hospital Industry Response to L.A. City Attorney’s Hospital Homeless Investigation

James Lott Jim Lott

Though it is the association’s policy not to comment on criminal investigations, “we are dismayed by the City Attorney’s decision to use his prosecutorial authority against hospitals to address the problem of homelessness,” said Jim Lott, Executive Vice President. “It seems to be a rather excessive, pernicious approach to solving a problem that hospitals have agreed needs to be addressed and are addressing,” Lott continued.

Though no statistics are kept on the numbers of homeless treated by hospitals, 76 hospitals with emergency rooms are the medical safety net for the estimated 80,000 homeless residing in the county, including the almost 1,200 who congregate on the streets of Skid Row in downtown Los Angeles. In fact, these hospitals are required by law to receive, treat and stabilize any of the County’s almost 3 million uninsured residents who present with life-threatening illnesses or injuries, and they meet this obligation at a collective financial loss of approximately $1.6 billion annually.

On behalf of hospitals serving communities throughout Los Angeles County, the Hospital Association of Southern California is working with non-profit organizations, the L.A. County Health Department and homeless service agencies to address the issues the City Attorney raised last November with regard to homeless patients being sent to Skid Row in downtown Los Angeles after being treated by hospitals. The association is very close to completing plans that would:

— Allow the Volunteers of America to pick up homeless patients no longer needing hospital care and transport them to homeless service providers.

— Increase the number of beds now available in the County to transition homeless patients no longer needing hospital care from a meager 40 to 95.

— Establish a standardized service referral process and training program for all hospital workers involved in planning the post-hospital care for homeless patients.

“We need our government officials help with this, not their vilification,” Lott said. “No reasonable or thinking individual wants hospitals to house the homeless when they no longer need medical care at $1,286 per day in a hospital bed.”

 

Comments

How can government officials

Submitted by member on November 17, 2006 - 11:10am.
How can government officials (both city and county) assist with this societal problem? Can you elaborate a little more on what options can be done (if any) to help correct the societal problem of the homeless that has been plaguing our streets for over a decade? T Duncan 11/17/06 11:10 AM

In reply to T Duncan

Submitted by admin on November 20, 2006 - 9:11am.
In any given year, approximately 3.5 million Americans experience homelessness, 39 percent of which are children. Why we allow so many people to live in abject poverty and desperation is an indictment against our humanity; it most certainly tarnishes the badge our nation flashes to the rest of the world when we claim to be the standard bearer on human rights. In partial defense, though, those who study homelessness readily acknowledge that lasting solutions are illusive because homelessness is a multidimensional and complex problem. Hospitals should not be vilified by elected officials who are frustrated over not being able to solve this complex problem. After all, hospitals do provide medical care to the homeless with no expectation of ever being paid for doing so, and the industry has stepped up to the plate with specific proposals for real solutions to patient dumping. The industry needs our government officials' help with solving this problem. If we could figure out how to put a man on the moon, we should be able to figure out how to resolve homelessness in America, however complex the issue. Arguably, all that is really needed is the political will to make this happen. Jim Lott 11/20/06 9:11 AM

The challenges hospitals face

Submitted by member on November 20, 2006 - 6:31am.
The challenges hospitals face today in caring for the homeless are many. Often when homeless patients are admitted to an acute care hospital they may be experiencing both medical and mental health diagnosis aling with the possibility of substance abuse. The homeless patient's potentially limited ability to participate in care provided compounded by a high potential to refuse care or become non-compliant are documented issues in acute care hospitals today. Hospitals are organized to provide medical services and return people to their prior level of function and that includes where they live. I do not condone or support just leaving a recently discharged patient on a street corner, but the fact is the patient entered the system from the street. I have personally experienced homeless patients refusing to be discharged to a long term care facility, board and care, half-way house or mission, rather expressing a desire to return to the street and patients have the right to choose unless deemed incompetent. We cannot force them to enter a facility. As previously stated in a comment within this blog hospitals daily cost is prohibitive in "housing" the homeless. Two possible changes that could impact this problem are: City work WITH hospitals to better manage the recently discharged hospitalized homeless. THe development and funding of transitional shelter settings for the post-hospitalized homeless during the first few days after discharge, thus serving a need and expanding shelter bed availability. Incentivize The greater involvement of agencies associated with the homeless during hospitalization utilizing, standardized communication methods between these agencies and Hospital Discharge Planners, physicians etc. It is clear that it is time for the City Attorney's office to begin to work in partnership with area hospitals and utilize their expertise in solving the issues, rather then using blame, accusation and threat of prosecution tactics. mary ann calles California State Long Beach University 11/20/06 6:31 PM

Comments

How can government officials

Submitted by member on November 17, 2006 - 11:10am.
How can government officials (both city and county) assist with this societal problem? Can you elaborate a little more on what options can be done (if any) to help correct the societal problem of the homeless that has been plaguing our streets for over a decade? T Duncan 11/17/06 11:10 AM

In reply to T Duncan

Submitted by admin on November 20, 2006 - 9:11am.
In any given year, approximately 3.5 million Americans experience homelessness, 39 percent of which are children. Why we allow so many people to live in abject poverty and desperation is an indictment against our humanity; it most certainly tarnishes the badge our nation flashes to the rest of the world when we claim to be the standard bearer on human rights. In partial defense, though, those who study homelessness readily acknowledge that lasting solutions are illusive because homelessness is a multidimensional and complex problem. Hospitals should not be vilified by elected officials who are frustrated over not being able to solve this complex problem. After all, hospitals do provide medical care to the homeless with no expectation of ever being paid for doing so, and the industry has stepped up to the plate with specific proposals for real solutions to patient dumping. The industry needs our government officials' help with solving this problem. If we could figure out how to put a man on the moon, we should be able to figure out how to resolve homelessness in America, however complex the issue. Arguably, all that is really needed is the political will to make this happen. Jim Lott 11/20/06 9:11 AM

The challenges hospitals face

Submitted by member on November 20, 2006 - 6:31am.
The challenges hospitals face today in caring for the homeless are many. Often when homeless patients are admitted to an acute care hospital they may be experiencing both medical and mental health diagnosis aling with the possibility of substance abuse. The homeless patient's potentially limited ability to participate in care provided compounded by a high potential to refuse care or become non-compliant are documented issues in acute care hospitals today. Hospitals are organized to provide medical services and return people to their prior level of function and that includes where they live. I do not condone or support just leaving a recently discharged patient on a street corner, but the fact is the patient entered the system from the street. I have personally experienced homeless patients refusing to be discharged to a long term care facility, board and care, half-way house or mission, rather expressing a desire to return to the street and patients have the right to choose unless deemed incompetent. We cannot force them to enter a facility. As previously stated in a comment within this blog hospitals daily cost is prohibitive in "housing" the homeless. Two possible changes that could impact this problem are: City work WITH hospitals to better manage the recently discharged hospitalized homeless. THe development and funding of transitional shelter settings for the post-hospitalized homeless during the first few days after discharge, thus serving a need and expanding shelter bed availability. Incentivize The greater involvement of agencies associated with the homeless during hospitalization utilizing, standardized communication methods between these agencies and Hospital Discharge Planners, physicians etc. It is clear that it is time for the City Attorney's office to begin to work in partnership with area hospitals and utilize their expertise in solving the issues, rather then using blame, accusation and threat of prosecution tactics. mary ann calles California State Long Beach University 11/20/06 6:31 PM