# CA SB 1152



## RocketMedic (Oct 1, 2018)

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

SB 1152 passed into law, which now means that hospitals have to discharge homeless people to appropriate places, provide clothes and food and care, etc.

I reckon this is going to really hurt hospitals. To the point where they become de facto homeless shelters.

Your thoughts


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## PotatoMedic (Oct 1, 2018)

Sucks to be a hospital in California.


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## E tank (Oct 1, 2018)

I just skimmed it, but where does it say the hospital must discharge these patients to "appropriate" places. I just see where referrals to such places with contact information etc. must be made. As for everything else, Highland has been doing all of that stuff for decades.


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## Qulevrius (Oct 14, 2018)

E tank said:


> I just skimmed it, but where does it say the hospital must discharge these patients to "appropriate" places. I just see where referrals to such places with contact information etc. must be made. As for everything else, Highland has been doing all of that stuff for decades.



Section 1, starting with subparagraph (n).


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## luke_31 (Oct 14, 2018)

Qulevrius said:


> Section 1, starting with subparagraph (n).


Yup reading that it seems that food, clothing, and shelter are now the hospitals responsibility.


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## johnrsemt (Oct 15, 2018)

That is going to make it tough on  hospitals;  are they going to have to run their own homeless shelters?

Is it going to make hospitals close down?

Sounds like typical CA laws;  lets pass a law that can't be followed, then we can fine the company that can't follow it and force them to close which will punish other people in the state


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## terrible one (Oct 21, 2018)

Ridiculous.

This state spends an extraordinarily high amount on the homeless population yet it continues to grow each year. 

Dumb law.


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## Qulevrius (Oct 21, 2018)

terrible one said:


> Ridiculous.
> 
> This state spends an extraordinarily high amount on the homeless population yet it continues to grow each year.
> 
> Dumb law.



That’s exactly why it continues to grow. There’s a reason why wild animals shouldn’t be fed; they stop providing for themselves and keep coming back for more.


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## DrParasite (Oct 23, 2018)

as heartless and uncaring as I have been accused of being over the years, I'm really surprised by the comments about this.  This appears to be a legislative response to the Los Angeles City Attorney's charges against Kaiser Permanente, which had been accused of discharging homeless people and dumping them on Skid Row back in 2007, which violated no laws at the time.

What's the alternative?  throw them out on the streets, and wait until they end up back in the ER the next night?  If the hospitals can assist in getting them off the streets, they can break the endless cycle and prevent them from coming back.  If you kick a hungry man out of the ER, who has no money, he's going to call 911 in 20 minutes with chest pains, especially if it's close to dinner hour.  If you arrange for him to get food, that call doesn't happen.

I think section (o) is aimed at giving some items that can prevent the homeless person from returning (in theory anyway), and section (n) is all about having a plan in place to prevent them from returning.

With the amount of EMS people who live paycheck to paycheck, with no savings, how many can be homeless in a month if they lose their job?  Are you really that much better?


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## terrible one (Oct 24, 2018)

If the hospitals are now required to provide food, clothes, shelter on top of medical care why would a homeless person try and better themselves? They have everything they need, no reason to improve their situation. 

I don’t see how requiring hospitals to provide these social services will “break the cycle”?


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## Carlos Danger (Oct 24, 2018)

DrParasite said:


> *What's the alternative? * throw them out on the streets, and wait until they end up back in the ER the next night?  If the hospitals can assist in getting them off the streets, they can break the endless cycle and prevent them from coming back.  If you kick a hungry man out of the ER, who has no money, he's going to call 911 in 20 minutes with chest pains, especially if it's close to dinner hour.  If you arrange for him to get food, that call doesn't happen.



Why not put the onus on EMS? Or even police or fire, for that matter? Why shouldn't it be their responsibility to direct these people to appropriate services? The hospital system should never even enter into the equation. It is far more efficient to keep people who are really just after a meal and a warm bed for a night from ever entering the hospital in the first place. For the cost of a single ED visit you can probably put someone up in a shelter for a full week, at least.  

The healthcare system (hospitals especially) is constantly asked to do more with less, and constantly burdened with more and more regulation. To think that the answer to these types of chronic problems (opioid addiction, homelessness, increasing rates of obesity and diabetes, etc.) somehow lies in putting even more responsibility on hospitals (which everyone agrees should be reserved for acute medical needs) and continue to completely ignore the lack of personal responsibility anywhere in the equation is absurd.   

CMS is 28% of the federal budget and growing every year. Medicaid and related programs cost most states about that much as well, and is growing even faster than the federal share. We need to completely re-think our fundamental approach to healthcare and healthcare financing.


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## gotbeerz001 (Oct 25, 2018)

E tank said:


> I just skimmed it, but where does it say the hospital must discharge these patients to "appropriate" places. I just see where referrals to such places with contact information etc. must be made. As for everything else, Highland has been doing all of that stuff for decades.



@E tank, are u an ALCO medic?


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## Qulevrius (Oct 25, 2018)

DrParasite said:


> as heartless and uncaring as I have been accused of being over the years, I'm really surprised by the comments about this.  This appears to be a legislative response to the Los Angeles City Attorney's charges against Kaiser Permanente, which had been accused of discharging homeless people and dumping them on Skid Row back in 2007, which violated no laws at the time.
> 
> What's the alternative?  throw them out on the streets, and wait until they end up back in the ER the next night?  If the hospitals can assist in getting them off the streets, they can break the endless cycle and prevent them from coming back.  If you kick a hungry man out of the ER, who has no money, he's going to call 911 in 20 minutes with chest pains, especially if it's close to dinner hour.  If you arrange for him to get food, that call doesn't happen.
> 
> ...



I don’t share this sentiment. Fire/PD are already going out of their way to get the transients off the street, but they aren’t doing it out of the kindness of their hearts. The PD have their hands tied with public oversight, and FD sees them as a liability and wants them out of sight, out of mind. 

Every (or nearly every) bum in SoCal knows how to play this game - if arrested for vagrancy/public intoxication, or simply not wanting to spend a night on the street or in a shelter, start complaining of chest pain & go to the ER. There are those of them who’re at a hospital every other night, to them it’s like clocking in for work. “Oh, you guys have a bed for me ? Good, I haven’t slept in 2 days.”

So what do you think happens to a homeless drunk, with or without this legislation ? He won’t stop drinking or find a job or a place to live. He’ll keep being brought to ERs in an ETOH induced coma, get bolused until he comes to, demand a meal, then sign AMA & go back to his “normal” life. Until next time.


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## E tank (Oct 25, 2018)

gotbeerz001 said:


> @E tank, are u an ALCO medic?



MICN back in the 80's and 90's


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## CCCSD (Oct 27, 2018)

I’m a prior Fremont-TriCities Ambo dude.


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## Bullets (Nov 5, 2018)

DrParasite said:


> What's the alternative?  throw them out on the streets, and wait until they end up back in the ER the next night?


 Become a for profit that doesnt accept CMS funds to avoid EMTALA and turn them away at the door


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