La Jolla activists allege ‘patient-dumping’ of homeless people in San Diego and seek legislative hearing

La Jolla advocates for homeless people in San Diego are asking legislators to investigate “patient-dumping,” which they say still happens at area hospitals years after a state law was enacted to stop the practice.

At an emotional news conference near Scripps Mercy Hospital in Hillcrest on March 22, La Jolla resident Amie Zamudio, co-founder of Housing 4 the Homeless with fellow La Jollan Joanne Standlee, reflected on two homeless men she had come to know who she said died shortly after being discharged from a hospital.

“He was on hospice,” Zamudio said, tearfully reading from a letter from the wife of one of the men, whom she identified only as Mike. “We knew that he was dying. But why did he have to die desperately afraid in the park?”

Zamudio and Standlee wrote a letter dated March 17 to state Assemblyman Corey Jackson (D-Perris), chairman of the Assembly Human Services Committee, requesting a hearing about why homeless patients continue to be released from hospitals, sometimes in the middle of the night with no means of transportation, more than four years after the passage of the state law.

Their nonprofit’s website also has a call to action that asks people to contact their state representatives to look into the issue.

Senate Bill 1152, written by then-state Sen. Ed Hernandez and signed into law by then-Gov. Jerry Brown in September 2018, requires hospitals to have a written discharge plan and process for homeless people. It prohibits a hospital from discharging a homeless patient to a location other than where the person identifies as his or her residence or to a licensed facility, social service agency or provider that has agreed to accept the patient.

It also requires certain conditions to be met before a homeless patient is discharged, including a physician’s determination that the patient is stable. Hospitals also must offer weather-appropriate clothes for the patient and transportation to a facility within 30 minutes or 30 miles away.

Despite the requirements laid out in the bill, Zamudio said 110 homeless people are discharged from hospitals throughout San Diego County each day and that last year she encountered more than 500 who were discharged in the middle of the night, sometimes waiting at a bus stop for hours because they had no other transportation.

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After the news conference, Scripps Health public relations manager Steve Carpowich issued a statement saying the hospital system follows the provisions of SB 1152 and that it had more than 10,500 visits from homeless patients last year.

“We ensure all patients are safe to leave the hospital before being discharged,” he said. “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.”

Carpowich said patients are involved in their discharge coordination and have the right to accept or decline resources that are offered.

If treatment is completed late at night but the patients have no place to go at the time, they can stay until the morning if willing, Carpowich said. While there, they are fed, given weather-appropriate clothing when needed and any necessary medications and immunizations, he added.

Dr. Aaron Meyer, an emergency-room psychiatrist for UC San Diego Health, spoke at the news conference and said he has seen firsthand how the intent of the law has not been satisfied.

What seems on the surface to be a simple procedure is filled with obstacles, Meyer said. Shelters often are full or may not accept an individual who needs respite care because they are not equipped to provide for that person’s needs, he said. Also, there are few beds for recuperative care throughout the county, he said.

Dr. Aaron Meyer, an emergency-room psychiatrist for UC San Diego Health, says “a review of homeless patient logs and discharge destinations will help determine if [‘patient-dumping’] is a statewide challenge.”

(Nelvin C. Cepeda / The San Diego Union-Tribune)

Another problem, Zamudio said, is that most shelters do not accept clients in the middle of the night. An exception is the shelter that opened last year behind the Psychiatric Hospital of San Diego County on Rosecrans Street in the Midway District, but Zamudio said she has not been able to place a client there.

Zamudio said she had been told she could place clients at a new 36-bed women’s shelter that opened in January in the city’s former Central Library, which also has 24-hour intake, but that also has yet to happen.

“Homelessness is 24/7, 365 days a year,” she said. “We need shelters to be able to receive homeless people 24 hours a day.”

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Homeless people would be offered shelter, but camps in some areas, such as shoreline parks in La Jolla, would not be allowed even if no alternatives are available.

Peggy Wheeler, vice president of policy for the California Hospital Association in Sacramento, said in a phone interview after the news conference that SB 1152 requires hospitals to create a discharge plan that identifies a place for homeless people to go and that those facilities must agree in advance to accept a person.

If no place can be found, the hospital cannot discharge the person unless the person wants to be discharged, Wheeler said. In that case, the hospital must allow the individual to leave, she said.

Wheeler said gathering more data about how hospitals are working under the provisions could be illuminating and help hospitals and community-based organizations work together on making improvements.

Meyer said he hopes that will happen with a state hearing.

“A review of homeless patient logs and discharge destinations will help determine if this is a statewide challenge,” he said.

The state also should survey how many counties have access to the coordinated entry system that matches homeless people with shelters, Meyer added.

During the news conference, Zamudio grew emotional as she remembered a homeless man she referred to as Mr. B, whom she described as someone who brought joy to everyone he touched but died on a sidewalk, afraid and alone.

Zamudio said her own father was homeless and was “patient-dumped” in Dallas in the 1990s.

“We have been fighting this fight for 30 years, and this needs to stop,” she said. “No one should ever die alone, outside by themselves with no care and no hope.”

— La Jolla Light staff contributed to this report. ◆