The Homeless

Homeless patients were left on the streets by hospitals. This law could end ‘dumping’

Spurred by news stories about hospitals “dumping” poor people onto the streets, a new law will soon require health care providers to develop specific policies for safely discharging homeless patients.

Beginning in July, hospitals must document in writing that shelters have beds for homeless patients before sending them to the facilities. Hospitals also must offer homeless patients a meal, appropriate clothing, medications and transportation upon discharge.

The Sacramento Bee this year detailed several cases in which hospitals left homeless people in tenuous situations, which helped spur Senate Bill 1152 by Sen. Ed Hernandez, D-West Covina.

In one case, Lara Woods, a cancer patient, was discharged from UC Davis Medical Center following a double mastectomy to a shelter that had no bed for her. She wound up sleeping in a car for weeks. In another instance, an elderly Sacramento man, Arlan Lewis, landed on the streets after a Woodland hospital dispatched him to a shelter that was unable to take him. Similar stories have surfaced across the state.

A recent poll by the Sacramento Regional Coalition to End Homelessness found that improper discharges of homeless patients from hospitals are not uncommon in the capital city. Seven of 13 homeless service agencies that answered a survey by the group in January reported that recently released patients had been delivered to their campuses without prior notification, some of them still in hospital gowns and with open wounds.

The new law marks a solid first step toward preventing improper discharges, said the coalition’s Bob Erlenbusch.

“I hope hospitals are going to properly train discharge planners so that this really makes a difference,” Erlenbusch said.

The law does not carry specific penalties, but hospitals that violate the law could face repercussions from the state Department of Public Health and the federal government, both of which regulate health facilities. The new law also allows local governments to pass ordinances that impose more stringent requirements for discharging homeless patients.

Hospitals opposed the law.

“Local ordinances could do something much more stringent than this state law, and that’s where we remain opposed,” said Peggy Wheeler, vice president of rural health care and governance for the California Hospital Association. “This law is really the floor and not the ceiling.”

Wheeler said health care facilities strive to safely discharge all patients, but the task can be difficult in the case of homeless people, some of whom have complicated medical and mental health issues. Shelter beds are scarce, Wheeler said, and homeless patients cannot be forced to accept them.

“Our hospitals don’t dump patients,” said Wheeler. “Sometimes, patients elope from the hospital in their gowns and with their wristbands. They’re not prisoners. We attempt to get people into shelters, but sometimes they refuse, or there are simply no beds.”

Wheeler and Erlenbusch said many communities, including Sacramento, are in dire need of more “respite beds” for homeless patients who are ready to be discharged from hospitals but remain too frail to survive on the streets. Sacramento has about three dozen such beds.

A recent census found that homelessness in Sacramento County surged 30 percent between 2015 and 2017, to about 3,665 people on any given night.

The new law requires every hospital in the state to have a written “homeless patient discharge planning policy” ensuring that people are sent to “a safe and appropriate location.”

It requires hospitals to help connect homeless people with treatment, community resources and shelter if they are willing to accept such services. Hospitals must identify a destination for homeless patients upon discharge, and “shall document the name or the person at the agency or provider who agreed to accept” such patients, according to the law.

The new measure amends an existing law that prohibits health facilities from transferring homeless patients from one county to another without proper planning. Beginning in July, hospitals will be barred from sending homeless patients to a destination more than 30 minutes or 30 miles away from the discharging facility.

Hernandez, the legislation’s author, said the new discharge policies will encourage hospitals to work more closely with community organizations, social service agencies and others in releasing vulnerable patients.

The new rules will “help homeless people get back on their feet and be treated with the dignity they deserve,” he said.

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