Update Regarding the Requirements for the Discharge of Homeless Patients as it Relates to MedData Services (Updated as of 12/20/18)
On September 9, 2018, California Senate Bill 1152 from the 2017 legislative session was signed into law by Governor Jerry Brown. The bill amends California Health and Safety Code Section 1262.5, and requires all California acute general hospitals, acute psychiatric hospitals and special hospitals (a health facility that provides inpatient or outpatient care in dentistry or maternity), unless a state-run institution, to create and implement policies and procedures regarding the discharge of homeless patients.1 Most relevantly, the amended section 1262.5 requires the following:
(o) The hospital shall document all of the following prior to discharging a homeless patient:
(1) The treating physician has determined the homeless patient’s clinical stability for discharge, including, but not limited to, an assessment as to whether the patient is alert and oriented to person, place, and time, and the physician or designee has communicated post discharge medical needs to the homeless patient.
(2) The homeless patient has been offered a meal, unless medically indicated otherwise.
(3) If the homeless patient’s clothing is inadequate, the hospital shall offer the homeless patient weather-appropriate clothing.
(4) The homeless patient has been referred to a source of followup care, if medically necessary.
(5) The homeless patient has been provided with a prescription, if needed, and, for a hospital with an onsite pharmacy licensed and staffed to dispense outpatient medication, an appropriate supply of all necessary medication, if available.
(6) The homeless patient has been offered or referred to screening for infectious disease common to the region, as determined by the local health department.
(7) The homeless patient has been offered vaccinations appropriate to the homeless patient’s presenting medical condition.
(8) The treating physician has provided a medical screening examination and evaluation. If the treating physician determines that the results of the medical screening examination and evaluation indicate that followup behavioral health care is needed, the homeless patient shall be treated or referred to an appropriate provider. The hospital shall make a good faith effort to contact one of the following, if applicable:
(9) The homeless patient has been screened for, and provided assistance to enroll in, any affordable health insurance coverage for which he or she is eligible.
(10) The hospital has offered the homeless patient transportation after discharge to the destination identified in paragraph (4) of subdivision (n), if that destination is within a maximum travel time of 30 minutes or a maximum travel distance of 30 miles of the hospital. This requirement shall not be construed to prevent a hospital from offering transportation to a more distant destination.
These requirements (among numerous other requirements) must be incorporated in the written discharge policies of the relevant hospital.
A “homeless patient” is defined in the amended statute as “any individual without a fixed regular nighttime residence, or whose main nighttime residence is a public or private temporary living shelter, or who is residing in a public or private place not designed to provide temporary living or sleeping for a person.”
While some sections of the new section 1262.5 are already in effect, the most relevant section highlighted in bold and italics above will go into effect on January 1, 2019. Additional elements of the amended section will go into effect July 1, 2019, but these are not directly relevant to MedData’s services.
1 The amended section 1262.5 contains numerous requirements for hospitals. This Update is not intended to be a comprehensive analysis of all requirements; however, it is intended to provide information on the new hospital requirements that intersect with MedData’s hospital services.
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