Despite State Law, San Diego Hospitals Accused of ‘Patient Dumping'

Some homeless hospital patients in San Diego are being discharged and put back on the streets after receiving treatment, despite a state law requiring hospitals to have a homeless discharge policy in place.

On Wednesday, the issue of so-called “patient dumping” was at the center of a public discussion. with homeless advocates saying more and more San Diegans are dying on the streets.

A man known as Mr. B, who was suffering from heart disease, according to friend and homeless advocate Amie Zamudio, was in and out of hospitals. He was finally discharged by Scripps Mercy Hospital six months ago and died hours later.

“Mr. B was an extraordinary human being, and he was loved by all," Zamudio recalled tearfully. "He brought joy to everyone he touched, but he died on the sidewalk afraid and all alone."

Zamudio, who founded Housing 4 the Homeless, said Senate Bill 1152 should have saved Mr. B’s life.

Since 2019, SB-1152 has required hospitals to have a homeless discharge policy in place. For transients who are not in need of long-term treatment, hospitals are required to provide a meal and find them a shelter or safe place to go. Homeless advocates said this isn’t happening and want a hearing in the California Senate and Assembly Human Services committees on what they call continued “patient dumping.” 

Scripps Health sent NBC 7 the following statement:

"All of us at Scripps Health share the community’s concern and compassion for the unsheltered individuals and families in San Diego. Scripps complies with all provisions of SB-1152.  Last year, at Scripps Mercy Hospital San Diego alone, we had more than 10,500 homeless patient visits. 

We ensure all patients are safe to leave the hospital before being discharged. We work with each patient to develop a discharge plan, which includes giving them discharge instructions, follow-up for medical or behavioral health care needs they may have and providing them with information about community resources so they can access food, clothing, shelter and transportation to their chosen destination, as applicable. Hospitals cannot directly secure homeless shelter beds for patients.

Patients are involved in their discharge coordination. They have a right to self-determination and can accept or decline the resources we offer.

If we complete a patient’s treatment late at night and determine they have nowhere to go at that time, we wait to discharge them until morning if they are willing to stay. While unsheltered patients are with us, we give them a meal, any weather-appropriate clothing needed, as well as necessary medications and immunizations.

As health care providers, our compassionate team at Scripps treats unsheltered patients every day, sees their suffering first-hand and does everything in their power to alleviate it. For more than 100 years, we have been dedicated to serving San Diego’s underserved. And we always will be.”

Lauren Chechel, a nurse and homeless advocate, told NBC 7 that change needs to be made by everyone, not just one particular hospital system.

“Too often, people are found in the streets in medical crisis or, sadly, dead, as was the case last year for 572 San Diegans,” Chechel said, “This is not only a crisis of public health, it’s a crisis of humanity. The solution to this crisis does not reside in one organization or one hospital but instead requires that we as a community stand up and say this is unacceptable, to have people left alone and to suffer and die on the curb.”

Ashley Bailey, strategic communications officer for public safety & homelessness for the city of San Diego, sent NBC7 a statement:

“It is the responsibility of the hospitals to create a discharge plan that is appropriate for each person’s care needs. The city of San Diego has worked over the past year to create more shelter options for those with specific and higher needs, and continues to advocate for more recuperative care options across the county. The city stands ready to assist hospitals in developing strategies for improving how individuals experiencing homelessness are released following medical care at one of San Diego’s hospitals.”

Another big issue? Homeless advocates said there are no homeless shelters that will accept people in the middle of the night if they have been discharged from a hospital.

Referring to the Homelessness Response Center (HRC), Bailey said, "There is a stipulation in the conditional-use permit for the facility that states it cannot be used as a shelter, so having folks stay there after their release from a hospital after-hours would not be possible. Also, the staff and even shelter staff are not equipped sometimes to know the best care options for persons being exited from the hospital. As we discussed, it really comes down to the hospital staff knowing the conditions of the person’s needs and finding the appropriate care setting for them."

Other hospitals systems also sent written statements to NBC 7:

Sharp HealthCare Statement

"Discharge planning at Sharp hospitals is focused on ensuring our patients are prepared to care for themselves after they leave one of our medical facilities. Of paramount importance is confirming they understand their discharge instructions and know to contact us or other health care providers if they have health concerns after discharge. The homeless population unquestionably provides unique challenges. We attempt to transition these individuals to supportive housing facilities, but many choose not to take advantage of these resources. As the largest local provider of care for the un- and underinsured, we are committed to providing quality care for all San Diegans and assuring our patients are safely discharged."

Kaiser Permanente Statement

"It is not only our mission but a core value to ensure that anyone who comes to us for care and healing is treated with dignity and respect, especially those who are most vulnerable. This commitment to well-being extends beyond a patient’s discharge.

Kaiser Permanente developed a robust policy and process for discharge planning for our patients experiencing homelessness in accordance with all the requirements under SB-1152, as well as federal law and accreditation requirements. Our policies and processes for discharge planning are reviewed annually and audited monthly to ensure we are appropriately addressing the needs of our unhoused patient population. 

Hospital physicians, clinical staff, social services, discharge planning personnel and other hospital staff most likely to be involved in the discharge planning undergo extensive training to assist these patients who are experiencing homelessness. We provide direct assistance to secure post-discharge shelter, schedule follow-up care appointments and connect patients to community resources specific to their needs and stated preferences."

UC San Diego Health Statement

"Safety is a priority for all patients at time of discharge. When patients no longer need acute hospital care, our team follows a discharge planning process that includes reasonable attempts to identify available housing and multiple free transportation options, all in compliance with the state's SB-1152 homeless discharge legislation. Additionally, we also provide a free meal, prescribed medications and weather-appropriate clothing, if needed.

It’s important to note that SB-1152 requires hospitals to utilize available resources but does not require hospitals to hold patients if local resources do not exist."