The situation "also poses a significant public health risk to the community" and though "well documented in court proceedings and publicized extensively by the print and electronic media, some institutions persist in the practice."
As the ordinance was debated and the city attorney was negotiating with the hospitals to stop the practice, hospitals reached a settlement in which they agreed to finance recuperative care projects.
Lott takes issue with the ordinance, which he believes unjustly passes on to hospitals what should be the government's responsibility for the homeless patient's non-acute care needs.
"What the government has chosen to do, instead of trying to solve the homeless healthcare problem, [is to] put a big stick on top of the hospitals' head and say 'if you don't do it we'll whack you,' leaving the hospitals holding the bag," he says.
But the law is the law. Lott acknowledges that long term, the solution is a "win-win-win" and that patients will have fewer bad outcomes.
"The reason you have frequent fliers coming back to the emergency room is because they don't have aftercare education for giving themselves medication, so they do come back and their conditions or worse and they have to be treated again," Lott says.
Caring for the homeless is particularly tough in LA, which Bruno says has the highest number of homeless in the country, estimated between 43,000 and 77,000. A large percentage of them need acute care.
The Reno Motel program picked up where another cooperative venture with a shelter in the nearby city of Bell fell short, Bruno and Grigsby say. That shelter's managers weren't finding permanent housing for these discharged patients, whose stays ended up lasting a month or more, they say. That was frustrating and costly for hospitals, which waited days for an answer on placement, they say.