{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T13:51:49Z","timestamp":1762782709852},"reference-count":38,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,3,22]],"date-time":"2022-03-22T00:00:00Z","timestamp":1647907200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Milbank Quarterly"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:sec><jats:label \/><jats:p>\n<jats:boxed-text content-type=\"box\" position=\"anchor\"><jats:caption><jats:title>Policy Points<\/jats:title><\/jats:caption><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Clarifications to Senate Bill (SB)\u00a01152 are necessary to address the differences between inpatient and emergency department (ED) discharge processes, determine how frequently an ED must deliver the SB\u00a01152 bundle of services to a single patient, and establish expectations for compliance during off\u2010hours when social services are unavailable.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Because homelessness cannot be resolved in a single ED visit, the state should provide funding to support housing\u2010focused case workers that will follow patients experiencing homelessness (PEH) through the transition from temporary shelters to permanent supportive housing. Medi\u2010Cal could fund the delivery of the SB\u00a01152 bundle of services to defray the costs to public hospitals that provide care for high numbers of PEH.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>California legislators should consider complementary legislation to increase funding for shelters so that sufficient capacity is available to accept PEH from EDs and hospitals, and to fund alternative strategies to prevent poverty and the upstream root causes of homelessness itself.<\/jats:p><\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:boxed-text><\/jats:p><\/jats:sec><jats:sec><jats:title>Context<\/jats:title><jats:p>Prompted by stories of \u201cpatient dumping,\u201d California enacted Senate Bill (SB) 1152, which mandates that hospitals offer patients experiencing homelessness (PEH) a set of resources at discharge to ensure safety and prevent dumping.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>To evaluate interventions to meet the requirements of SB\u00a01152 across three emergency departments (EDs) of a Los Angeles County public hospital system with a combined annual census of 260,000 visits, we used an explanatory sequential mixed methods approach, focusing first on quantitative evaluation and then using information from qualitative interviews to explain the quantitative findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>In total, 2.9% (1,515\/52,607) of encounters involved PEH. Documentation of compliance with the eight required components of SB\u00a01152 was low, ranging from 9.0% to 33.9%. Twenty\u2010five provider interviews confirmed support for providing assistance to PEH in the ED, but the participants described barriers to compliance, including challenges in implementing universal screening for homelessness, incongruity of the requirements with the ED setting, the complexity of the patients, and the limitations of SB\u00a01152 as a health policy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Despite operationalizing universal screening for homelessness, we found poor compliance with SB\u00a01152 and identified multiple barriers to implementation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1468-0009.12563","type":"journal-article","created":{"date-parts":[[2022,3,22]],"date-time":"2022-03-22T15:25:21Z","timestamp":1647962721000},"page":"464-491","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["A Mixed Methods Evaluation of Interventions to Meet the Requirements of California Senate Bill 1152 in the Emergency Departments of a Public Hospital System"],"prefix":"10.1111","volume":"100","author":[{"given":"BREENA R.","family":"TAIRA","sequence":"first","affiliation":[{"name":"Olive View\u2013UCLA Medical Center  Sylmar California"},{"name":"David Geffen UCLA School of Medicine  Los Angeles California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"HYUNG","family":"KIM","sequence":"additional","affiliation":[{"name":"Olive View\u2013UCLA Medical Center  Sylmar California"},{"name":"David Geffen UCLA School of Medicine  Los Angeles California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"KARLA TLATELPA","family":"PRODIGUE","sequence":"additional","affiliation":[{"name":"David Geffen UCLA School of Medicine  Los Angeles California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"LEILANI","family":"GUTIERREZ\u2010PALOMINOS","sequence":"additional","affiliation":[{"name":"David Geffen UCLA School of Medicine  Los Angeles California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"ALEXIS","family":"ALEMAN","sequence":"additional","affiliation":[{"name":"Olive View\u2013UCLA Medical Center  Sylmar California"},{"name":"David Geffen UCLA School of Medicine  Los Angeles California"},{"name":"Charles Drew University  Los Angeles California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"LEORA","family":"STEINBERG","sequence":"additional","affiliation":[{"name":"University of Southern California  Los Angeles California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"GREGORY","family":"TCHAKALIAN","sequence":"additional","affiliation":[{"name":"Harbor\u2010UCLA Medical Center  Torrance California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"KABIR","family":"YADAV","sequence":"additional","affiliation":[{"name":"David Geffen UCLA School of Medicine  Los Angeles California"},{"name":"Harbor\u2010UCLA Medical Center  Torrance California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"REGINALD","family":"TUCKER\u2010SEELEY","sequence":"additional","affiliation":[{"name":"University of Southern California  Los Angeles California"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,3,22]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"United States Interagency Council on Homelessness. California homeless statistics.https:\/\/www.usich.gov\/homelessness\u2010statistics\/ca. Accessed February 11 2022."},{"key":"e_1_2_6_3_1","unstructured":"RegardieJ.The ugly history of downtown patient \u201cdumping.\u201dDowntown News Los Angeles. July 9 2018.http:\/\/www.ladowntownnews.com\/news\/the\u2010ugly\u2010history\u2010of\u2010downtown\u2010patient\u2010dumping\/article_05fa6cea\u20108165\u201011e8\u201096aa\u2010dbaced2025ed.html. Accessed January 24 2022."},{"key":"e_1_2_6_4_1","article-title":"Nevada reach tentative settlement in patient\u2010dumping case","author":"Egelko B. S.F.","year":"2015","journal-title":"SFGate"},{"key":"e_1_2_6_5_1","unstructured":"PatelPR BechmannS.Discharge planning. In: StatPearls [online database]. Updated April 14 2021.https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK557819. Accessed January 24 2022."},{"key":"e_1_2_6_6_1","unstructured":"California Legislative Information. 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