Federal Judge Blocks Los Angeles County Proposal To Limit Uninsured Patient Transfers
U.S. District Judge Florence-Marie Cooper on Tuesday signed an order that blocks a proposal by Los Angeles County officials to limit the number of uninsured patient transfers to Rancho Los Amigos National Rehabilitation Center or County-USC Medical Center, the Los Angeles Times reports (Fox, Los Angeles Times, 6/6). Private hospitals in the county currently can transfer uninsured patients to county-administered facilities to avoid the cost of their care, a practice that costs the county millions of dollars each year. In the last fiscal year, the county accepted 11,243 transfer patients -- more than half of whom were such "lateral transfers" (California Healthline, 5/12). The proposal to ban lateral transfers is part of a larger proposal approved Tuesday by the county Board of Supervisors that seeks to require proof of residence from most patients who seek care at county facilities. Under the proposal, scheduled to take effect in October, uninsured individuals who seek care at county facilities must present government-issued identification that includes their address or present some other proof of residency, such as a utility bill. County facilities will continue to provide care to homeless individuals and undocumented immigrants (California Healthline, 6/4). In the decision Tuesday, Cooper said that the county could not take "any steps to limit the referral and transfer of patients from other clinics and hospitals in and outside the county system" to Rancho Los Amigos or County-USC, the Times reports. The decision did not refer to transfers to the other four county hospitals. The decision is part of a preliminary injunction against the planned closure of Rancho Los Amigos and elimination of beds at County-USC.
"The judge recognized that there are ways to close beds without (actually) closing beds," Neighborhood Legal Services attorney Barbara Frankel, who represents low-income patients in the lawsuit against the county, said. She added, "You can take steps to limit the referrals, which in effect limits the number of patients you're taking care of." Dr. Thomas Garthwaite, director of the county Department of Health Services, said that the county plans will comply with the decision. However, Garthwaite said that Cooper issued the order "simply to keep the county from blocking transfers until the patient load drops -- and then cutting beds because there were fewer patients," the Times reports. "The point of the change was to improve our ability to control the flow (of patients) so as not to create a dangerous backup in our ER. I just find it hard to imagine that we are being ordered to take an unsafe transfer. That just defies logic," Garthwaite said (Los Angeles Times, 6/6).
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