Hospitals run by Los Angeles County could make free care available to more of their financially strapped patients under a new proposal aimed at expanding relief from medical bills.
County health officials said the proposed changes, which also include deeper discounts for other eligible patients, could ultimately benefit thousands of people in the county, yet are unlikely to have a significant effect on hospital finances.
The move comes amid ongoing concern across California about residents putting off or forgoing medical care due to the expense, despite state efforts to expand access to charity care and make sure patients know about financial assistance.
Under the proposed rules, free care would be available to eligible L.A. County residents with incomes under 200% of the federal poverty level, or $60,000 for a family of four under current guidelines. The existing cutoff is 138% of the poverty level, which amounts to $41,400 for a family of four.
Last month, Western Center filed a motion for class certification in our case, Freeman v. Riverside County, which challenges how Riverside County charged fees to parents and guardians whose children were involved in the juvenile legal system. The case was filed together with our co-counsel, the National Center for Youth Law.
Families were charged daily “costs of support” – $30 or so per day for each day their child was in detention. State law required the county to assess families’ ability to afford the costs, which were often thousands of dollars, and provide procedural due process before collecting. Riverside did nothing – just calculated the fees and sent the totals to collection. Our case seeks to shine a light on this abuse of government authority, and asks for a refund of illegally collected fees.
Fortunately, the authority to charge these types of juvenile fees has been eliminated in California, as well as counties’ ability to collect older fees. The story behind this case is important, not just for accountability in Riverside, but also because there are still many fees charged to overpoliced communities in California.
Cases like this one demonstrate why advocates are fighting for abolition of juvenile and adult criminal fees – not a reduction or ability to pay process. There are important racial equity principles behind that goal, because of who the juvenile and adult legal systems target. There are also common sense administrative policy reasons for fee abolition, mainly that ability to pay processes are inequitable and don’t work. Our case in Riverside shows that even when state law requires an ability to pay process, it is not followed, or it’s followed so ineptly or inconsistently that it becomes meaningless. Ability to pay processes also replicate racial bias in the courts and legal system.
As this case proceeds, I must share our appreciation and admiration for our clients who have worked with us on this case for over two years, and for their bravery in telling their stories. We are hopeful for a good outcome, and that the class data we may be able to obtain illustrates why shifting the cost of government onto individuals through user fees causes inequity, and in a nutshell, constitutes wealth stripping from low income communities and communities of color.
Mary Lovelace was living in Brentwood, California, and working as an interior designer. As a home-improvement specialist, she would drive a minimum of 365 miles every day in her car, carrying samples including doors, windows, and hardware in the trunk and backseat.
“Then the recession hit, between 2007 and 2009,” Lovelace recalls. “It kept getting worse and worse.” Fewer people were hiring interior designers, and eventually Lovelace was laid off. She received unemployment, which wasn’t enough to cover her rent after other expenses. She tried without success to find other work. She was eventually evicted from her rented house. A friend in nearby San Francisco let her stay in his garage. She parked her car across the street.
Parking tickets began to accumulate on the car. Some tickets, she says, listed the wrong address, a block and a half from where the vehicle was parked; sometimes the dates did not match. After a while, the car was “booted”—a metal device clamped on the wheel to render it immobile.
Nearly 50,000 towing businesses operate in the U.S., and they have already generated more than $8 billion in revenue so far this year.
…Mike Herald, director of policy advocacy for the Western Center on Law & Poverty, a California-based public interest law firm and contributor to the report, points to revelations from Ferguson, Missouri, as an example of what has been happening elsewhere.