Arundi Venkayya
Marketing and Public Relations Manager
California SB 1152 was designed to help address the problems associated with discharging homeless patients such as discharging a patient with no place to go, no access to follow-up care and no prescription medication.
The new law institutes a more formalized discharge process for homeless patients involving increased documentation. There are many stipulations in the law about discharging homeless patients:
- The treating physician must assess a patient’s clinical stability for discharge including but not limited to whether the patient is alert and oriented to person, place and time. The physician or designee also has to have communicated post discharge medical needs to the patient.
- The homeless patient must be offered a meal unless medically indicated otherwise.
- If the patient’s clothing is inadequate, the hospital shall offer weather-appropriate clothing.
- The patient has been referred to source of follow-up care if medically necessary.
- The patient has been provided with a prescription to be filled at an onsite pharmacy and an appropriate supply of all necessary medication, if available.
- The patient has been offered or referred to infectious disease screening.
- The patient has been offered vaccinations appropriate to presenting medical condition.
- The treating physician has provided a medical screening and evaluation and made appropriate arrangements for follow-up behavioral healthcare and will make a good faith effort to contact the patient’s health plan, primary care provider or another appropriate provider.
- The patient has been screened for and offered help to enroll in any affordable health insurance for which he or she is eligible.
- The hospital staff must offer the patient transport post-discharge to an appropriate facility within 30 minutes or 30 miles.
This new law affects general acute care hospitals, acute psychiatric hospitals and special hospitals licensed by the California Department of Public Health. This may also indirectly affect behavioral health or other healthcare facilities that accept homeless patients discharged from a hospital.
The law goes into effect in two phases. Effective January 1, 2019, hospitals had to modify their current discharge policies by including a written homeless discharge planning policy and procedure.
This discharge plan needs to help patients identify a post-discharge destination. Hospitals also are required to document and perform a checklist including offering a meal, screening for infectious disease and offering weather-appropriate clothing and transportation.
Effective July 1, 2019, hospitals must have a written plan for coordinating services and referrals for homeless patients with the county behavioral health agency and health and social service agencies. Each hospital is required to maintain a log of the homeless patients discharged and their post-discharge destinations.