Implementation and Impacts of California Senate Bill 1152 on Homeless Discharge Protocols

Area of Science:

• Healthcare policy
• Social determinants of health
• Patient discharge planning

Background:

• Growing focus on addressing social needs in healthcare.
• California's investments in care for patients with complex needs, including those experiencing homelessness (PEH).
• Enactment of Senate Bill 1152 (SB 1152) to standardize hospital discharge for PEH.

Purpose of the Study:

• Evaluate the perceived impact of SB 1152 on hospital discharge processes.
• Identify key barriers and facilitators to SB 1152 implementation.
• Inform future legislative investments for PEH care.

Main Methods:

• 32 semi-structured interviews with key informants across 16 hospitals in Humboldt and Los Angeles counties.
• Thematic analysis informed by the Consolidated Framework for Implementation Research.
• Focus on health system stakeholders' perspectives.

Main Results:

• Perceived positive impacts: streamlined services, increased accountability, and greater staff awareness of homelessness.
• Identified challenges: limited scope, unclear accountability, scarce implementation support, and community resource gaps.
• Stakeholders noted improved discharge processes for PEH.

Conclusions:

• SB 1152 is a significant step towards safe discharge for PEH.
• Recommendations include targeted funding for social care staff and improved training.
• Addressing community resource gaps is crucial for long-term health outcomes of PEH.