LAUSR

It started slowly. On February 12, 2013, James Flavy Coy Brown arrived in downtown Sacramento after being placed on a three-day Greyhound ride on discharge from a Nevada psychiatric hospital. Less than three months later the story was exposed by the Sacramento Bee1 and ultimately led to a class action lawsuit on behalf of the patients, and a Pulitzer nomination for the paper. The following year brought a lawsuit against a hospital in Los Angeles for discharging a patient to a local shelter. In late 2016, an outbreak of Hepatitis A in San Diego’s homeless population again highlighted the poor health conditions of California’s growing homeless population. The following years brought a flood of news stories highlighting the plight of California’s homeless populations, culminating in a general sense that something should be done. On February 14, 2018, we learned what that something was. California Senate Bill (SB) 1152 was introduced by Senator Ed Hernandez, an optometrist representing the San Gabriel Valley. At the time, while he was serving the final year of his Senate term, he was still the powerful chair of the Senate Health Committee and he was running for lieutenant governor. With the support of powerful state unions, the bill proposed limits on both hospital and emergency department (ED) homeless patient discharges. As introduced, the bill essentially prohibited discharging homeless patients from hospitals and EDs. Homeless patients could not be discharged at night, or into inclement weather. Homeless patients could only be released to a care facility or social services agency that had agreed in writing to accept that patient. Prior to discharge, homeless patients were to receive a meal, appropriate clothing, a 30-day supply of all medications, all necessary durable medical equipment, infectious disease screening, all appropriate vaccinations, a source of regular follow-up care, a psychiatric evaluation, and transportation to any place of their choosing. Remember this was not a guideline or a University of California, Davis, Department of Emergency Medicine, Sacramento, California California American College of Emergency Physicians, Sacramento, California *