New Law Does Little to Guarantee Support to Discharged Homeless People

The community departments, the local government and the Department of Health jointly issued guidance on discharging homeless hospital patients. The guidance explains the proper practice for groups or organizations that supervise the needs of the people while inside the hospital, including admission itself. The guidance report was drafted and drawn up by expert groups, including Homeless Link and The Health Inclusion Project Advisory Group.

According to California Health Report, a 58-year-old homeless man who suffers from problems related to a hernia has been in and out of hospitals in Ventura County more times than he can count over the past two years. Each time he got treated and was released back onto the streets, he said it wasn’t long before his health started deteriorating again. “I’d just sit there. I had no place to live,” he said. “I’d just hang out places and eventually the ambulance would come and get me.” It is now time to do something about these homeless patients.

The newly signed Senate Bill No. 1152 requires the State Department of Public Health to regulate general acute care hospitals, psychiatric hospitals, and special hospitals. The existing law requires each hospital to make a written discharge planning policy and process stating the appropriate arrangements for post-hospital care. These arrangements are to be made prior to discharge of patients, especially those who suffer adverse health conditions, and upon discharge if there is not any adequate discharge planning.

Beginning in July, the hospitals need to perform documentation stating that a certain shelter where homeless patients are being sent have beds for them before sending them into facilities. The hospitals must also offer homeless patients their main needs such as food, proper clothes, medicine, and even transportation upon discharge.

Essential tools for discharge planning

With readmission penalties that increased up to 3% this year and the newly added conditions to the Readmission Reduction Program, it is more important than ever to focus on discharge planning. Different public and private associations and establishments contribute to homelessness by discharging patients into the streets. Ending this practice to help put an end to homelessness.

The American Hospital Association panel found that the following discharge tools are shared in three cross-cutting themes:

  1. Most appropriate post-acute care placement and setting
  2. Reducing readmissions
  3. Managing the patient transition from acute to post-acute care setting

Hospital discharging tools are only used within general acute-care hospitals so that they will be able to inform the planning process for the transition of patients from an acute-care hospital to a post-acute care setting. The tool is required for use by hospital personnel so that they can assess a patient’s clinical and demographic characteristics, expected post-acute care needs, and risk of hospital admission.

Service providers face challenges

The real problem has something to do with the number of service providers who are willing to handle the increasing number of homeless patients who still need proper care and a housing facility after being discharged from the hospital. Service providers who are currently helping homeless patients are facing challenges.

One common challenge that they encounter is the budget that they are using to run. The local government payment model is either impractical or unsustainable, which is why these service providers cannot accommodate more specialized services. To be able to attain a better result in services that communities would welcome, higher payment rates could solve both problems at once.

Recuperative care centers for the homeless are still a relatively new concept. Almost 80 programs operate across the country and are run by a variety of nonprofits, according to a directory published by the National Health Care for the Homeless Council. California has 24 of these programs, more than any other state.

Looking beyond the new law, more people need to ensure that the neediest citizens in the country can receive care in clean, safe, well-staffed places so they can heal quickly. Making more reasonable, sustainable, and realistic payment models can effectively help in the creation of emergency housing that many people desperately need.

References:

https://www.theguardian.com/us-news/2018/may/04/los-angeles-hospitals-homeless-patients-skid-row

https://link.springer.com/article/10.1007/s10935-007-0095-7

https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180SB1152

http://www.calhealthreport.org/2018/10/03/new-law-little-guarantee-support-homeless-discharged-hospital/