In January 2018, a dazed and confused woman wearing nothing but a hospital gown and socks was left to wander the streets of Baltimore. With wounds on her head and seemingly unable to talk, anyone's first thought when they saw her would be to send her to the hospital. But astonishingly, the 22-year-old had actually just come from the University of Maryland Medical Center. Clearly in no state to be discharged, medical staff had dumped her, with her possessions in a plastic bag next to her, at a bus stop in freezing cold temperatures, with nowhere to go.
You'd think this situation would be rare. Just one case that slipped through the system unnoticed. But you'd be wrong. Patient dumping is a pervasive problem in certain parts of the United States. Defined as the discharge of homeless or poverty-stricken people from hospitals and other healthcare providers to shelters or the streets without advance planning, it has been a regular feature in local news for a while now.
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In the case of the unidentified 22-year-old, the medical centre in question could have gotten away with it, if it wasn't for Imamu Baraka, a local psychotherapist who happened to stumble upon the young woman - whose attorney later claimed that she was having a psychotic episode when the institution turned its back on her - in her time of need. After reassuring the woman and calling 911, he uploaded a distressing video of the incident onto social media. The footage went on to receive millions of views, bringing the University of Maryland Medical Center to state that they "share the shock and disappointment of many who have viewed the video. In the end, we clearly failed to fulfil our mission with this patient."
But the issue deserves more than admitting wrongdoing. Instead, lawmakers and medical facilities need to stand up and take notice. The term "patient dumping" was first coined back in the late 1870s and described the practice of private New York hospitals transporting poor and sickly patients to a public facility, according to a 2011 report in the American Journal of Public Health. However, this changed in 1986 when Congress passed the Emergency Medical Treatment & Labor Act, signed by President Ronald Reagan. This law prohibited emergency rooms from denying hospital services to anyone, even if they couldn't pay, as well as from transferring or discharging patients without stabilizing them first. In addition, it required hospitals to have a discharge plan for patients. However, it seemed not every hospital was willing to follow their own guidelines.
Perhaps one of the most famous instances of patient dumping was in 2007 when mentally ill paraplegic man Gabino Olvera, 42, sued the Hollywood Presbyterian Medical Centre for $1 million after staff took him across town in a van and left him in a soiled hospital gown without a wheelchair in the heart of the city’s homeless area. In what his lawyer named "the most obscene and callous example of this practice that we have seen", Olvera was discovered dragging himself along the ground with hospital papers and documents clenched in his teeth while the driver reportedly sat in her van and applied makeup before driving off.
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A few years later, the Good Samaritan Hospital in Los Angeles was forced to pay $450,000 to settle allegations that it dumped a homeless patient on the street in 2014 after he was treated for a foot injury. According to a 2014 report by the U.S. Commission on Civil Rights on patient dumping, in the same year the Rawson-Neal Psychiatric Hospital in Las Vegas was accused of shipping hundreds of patients out of Nevada by bus. The incident in January with the unidentified 22-year-old is not even the most recent publicised instance of patient dumping; Lara Woods, a cancer patient was sent via a ride-share car from UC Davis Medical Center to the Salvation Army following a double mastectomy just a few weeks ago. The shelter had no bed to offer her, and she reportedly wound up sleeping in a car.
In fact, when the Sacramento Regional Coalition to End Homelessness surveyed agencies that serve the poor in the Sacramento area about whether homeless people recently had been dropped off at their organizations following discharge from a health care provider and without prior notification, seven of the 13 agencies answered that recently released patients had been delivered to their campuses. In addition, one agency reported the practice occurring two or three times a week, and three facilities said it happens about once a week.
Altogether, the cruel practice exposes the colossal problems that run throughout America's medical and welfare systems. Patient dumping is currently being targeted by a bill introduced in the California State Senate, which proposes that hospitals would be required to get written confirmation from homeless shelters before discharging patients and sending them to them. In addition, legislation in Maryland to outline a bill of rights for Maryland hospital patients passed the state Senate recently.
However, how helpful these laws be will remains to be seen. Although reforming hospital guidelines is certainly a start, it is not targeting the root of the problem. The real problem? The sheer levels of homelessness and poverty seen across California, and many other places in the United States.
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Take Los Angeles County, for example, which has the largest population of homeless people of any region in the United States after New York, according to a 2017 government report. In 2017 alone, Los Angeles' homeless population jumped by a staggering 23 per cent to nearly 58,000, making an overall surge of 75 per cent in just six years, according to the Los Angeles Times. Or look at Central Florida, where at least 350,000 people are living in poverty, more than ever before.
Amid the tragedy, more and more people are arguing that hospitals are there to take care of medical needs, not housing ones. And, to a certain extent, they're right. It is down to local government to provide support for homeless people. But ultimately, it's a case of betrayal from all directions.
At the end of the day, through a combination of ineffectual laws, corrupt workers and all-around lack of support, homeless and poverty-stricken people are not only being left out on the streets in their daily life, they're cast aside in their most desperate time of need by the very establishments that are designed to care for them.
