Seniors Speak Out on Patient Dumping

by Paul Hogarth, 2007-08-27

If you saw the movie “Sicko,” you know what patient dumping is all about. When a hospital discharges a homeless patient, they will drop them off at a local shelter – or on Skid Row in Los Angeles – without any guarantee that the patient will get the necessary help to make it through the night. Many patients, though deemed fit to leave the hospital, suffer from dementia – so the streets are the last place they should be. A new state law that passed last year mandates that hospitals hold a regional meeting with “key stakeholders” to discuss how to prevent patient dumping – but in San Francisco, a group of senior advocates for the homeless complain that stakeholders were not invited. At an August 23rd press conference at City Hall with Supervisor Tom Ammiano, advocates said the Northern California Hospital Council needs to do more to stop patient dumping – and comply with the letter and spirit of the law.

Sponsored by Assemblyman Dave Jones, AB 2745 requires hospitals to develop specific plans for how to deal with homeless patients after they get discharged. To develop this policy, the Hospital Council must call a regional planning meeting with stakeholders, which include – but are not limited to – “county board of supervisors, law enforcement, social service agencies, health care service providers, continuum of care coordinators, nonprofit service providers, and regional advocates for the homeless.”

In San Francisco, the Hospital Council and the Department of Public Health hastily called a meeting on August 14th – with very few community advocates informed, or invited, to attend. AB 2745 requires such a meeting be held before the end of the year. At the press conference, advocates read a statement from Assemblyman Jones’ office that expressed concern about how the law was being implemented.

“The reason we’re here,” said James Chionsini of Planning for Elders, “is for community input. There was a law passed last year, and that law required a community meeting. A meeting was held, but key stakeholders were not invited.” Other advocates were even more blunt. “I’m upset that you had a meeting without a single homeless senior,” said Bruce Allison of Seniors Organizing Seniors.

Roland Smith of the Hospital Council watched the press conference in front of City Hall, and expressed support for what the advocates were calling for. “We’re glad these folks are letting us know they were not included,” he said. “Our lists only included homeless coordinators – not community advocates.” But the text of the law clearly says that homeless advocates must be invited.

Smith agreed that patient dumping is an appalling practice, but that “I don’t know of any hospital in San Francisco that is doing it.” Which is not what the advocates are saying. Jazzie Collins, an SRO tenant who lives in South-of-Market, spoke about how patients from SF General Hospital get routinely dropped off in her neighborhood – literally at the doorstep of a homeless shelter, without guarantee that the shelter will have a free bed.

At the press conference, advocates distributed write-ups of recent true stories of homeless patients being discharged from the hospital – only to be “dumped” at a shelter. One patient, from SF General’s Crisis Resolution Team, was in an almost catatonic state and was sent to the MSC South Homeless Shelter with no paperwork, no medication and just a cab voucher with MSC’s address on it. The case manager at the shelter reported that the kid was so shell shocked that he probably wouldn’t make it through the night.

“Many times I’ve learned at City Hall,” said Supervisor Tom Ammiano, “that the left hand doesn’t know what the right hand is doing. When people don’t feel like they’re being included, they get paranoid – and they should be. It’s a very justifiable attitude, and we can always improve that inclusion.”

For now, Smith said that the Hospital Council will hold another meeting – and invite more of the homeless advocates. He also added that the City will soon be opening up 60 respite beds at 39 Fell Street and at 1001 Polk Street – which can be used to provide a transition for homeless patients after they get released from the hospital.

That, said Smith, should help resolve many of the current problems we have about how to deal with homeless patients.

Send feedback to paul@beyondchron.org