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Analysis

California Imposes More Rules on Homeless Patient Discharges

By Steven Porter  
   October 10, 2018

Hospitals had opposed the measure, arguing that they do not 'dump patients.'

A bill signed into law late last month by California Gov. Jerry Brown imposes new rules on hospitals discharging homeless patients.

The measure, which the California Hospital Association (CHA) opposed, was motivated by a number of news stories about hospitals releasing poor patients onto the streets without ensuring their safety.

A cancer patient released from UC Davis Medical Center after a double mastectomy, for example, was discharged from the hospital to a shelter that didn't have enough room for her, so she slept in a car for weeks on end, as The Sacramento Bee reported.

Similar stories have been reported across California and the rest of the country. A hospital in Baltimore, for example, was cited for sending a patient with mental illness to a bus stop last January in a hospital gown. (Maryland state senators responded by passing a patient bill of rights, but the measure faced resistance in the House of Delegates, as The Baltimore Sun reported.)

Under the new California law, which takes full effect in July, hospitals in the state will have to write discharge planning policies for homeless patients and coordinate with social service agencies in the area. Before releasing a homeless patient, the hospitals must verify that the patient was fed, clothed, and given appropriate medication. Such discharges may take place only during the daytime, and local ordinances may impose even stricter requirements.

This provision allowing more-stringent local ordinances is the main sticking point that remains for hospitals, CHA Vice President of Rural Health Care and Governance Peggy Wheeler told the Bee, adding that healthcare organizations generally do their best to keep homeless people safe in situations complicated by their health conditions and limited social services.

"Our hospitals don't dump patients," Wheeler told the Bee. "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."

Although there are no penalties prescribed by the law, facilities found to violate it could run into trouble with state and federal regulators.

Steven Porter is editor at HealthLeaders.


KEY TAKEAWAYS

Hospitals will have to write discharge planning policies for homeless patients and coordinate with social service agencies in the area.

Before releasing a homeless patient, the hospitals must verify that the patient was fed, clothed, and given appropriate medication.

Local ordinances may impose even stricter requirements.


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