What are the Material Changes to the Current Law?

Governor Jerry Brown signed Senate Bill (SB) 1152 into law on September 30, 2018. SB 1152 modifies Section 1262.5 of the Health & Safety Code which currently requires hospitals to have a written discharge planning policy and procedure that provides for appropriate post-hospital care for patients after discharge. Existing law focuses on those patients who are likely to suffer adverse health consequences after being discharged from the hospital if there is no adequate discharge planning. The new law goes further by focusing specifically on homeless patients.

Effective January 1, 2019, SB 1152 will require hospitals to modify their current hospital discharge policies by including a written homeless patient discharge planning policy and procedure. Hospitals must revise current discharge policies to assist homeless patients in preparing for their return to the community by helping them identify a post-discharge destination, with priority given to identifying a sheltered destination with supportive services. Prior to discharging a homeless patient, hospitals are required to document and perform a checklist of events, such as offering the homeless patient a meal, screening for infectious disease, weather-appropriate clothing and transportation to a certain destination within a 30 mile radius. Beginning July 1, 2019, hospitals must also have a written plan for coordinating services and referrals for homeless patients with the county behavioral health agency, health care and social services agencies in the region, health care providers and nonprofit social services providers. Each hospital will be required to maintain a log of the homeless patients discharged from their facilities and the post-discharge destinations of each homeless patient.

Who is Affected by the New Law

The law applies directly to general acute care hospitals, acute psychiatric hospitals and special hospitals licensed by the California Department of Public Health. However, the new law may indirectly affect behavioral health or other health care facilities that accept homeless patients discharged from a hospital.

Practical Tips and Takeaways

• Hospitals should review their discharge planning policies and procedures now and revise them as appropriate to ensure compliance with this new law. Hospitals should also consider circumstances where they may need to take legal action to discharge a homeless patient.
• Hospitals should consider appropriate training for discharge planning staff, certain medical staff and other personnel who may be part of a patient’s care team to ensure organization-wide compliance with the new law.
• Training protocols and other required aspects of a written homeless discharge plan must be in place as of July 1, 2019, although it may be advisable to put them in place as of January 1, 2019 given the close relationship they will have to other homeless discharge policies and procedures that must be implemented by January 1, 2019.
• Affected hospitals should begin or continue coordination and communication efforts with appropriate agencies, other health care providers and nonprofit social services providers now.
• Currently, SB 1152 only focuses on hospitals and does not contain language that obligates receiving behavioral health or other health care facilities to accept homeless patients. Receiving facilities should consider implementing their own policies regarding homeless patient transfers and how to address the risks associated with accepting homeless patients. 
• Behavioral health or other health care facilities should be aware of the homeless patient discharge planning policies of the hospitals from which they regularly receive patients. Hospitals may want to seek written acknowledgement from the receiving entity that it will accept the homeless patient and assume responsibility for the patient.