Table 2.

Perceived positive impacts of Senate Bill 1152: examples from key informant interviews.

Perceived positive impacts of SB 1152 on hospital processes
Increased accountability and consistency in documentation and service delivery	“I feel as if there has been a difference between before SB 1152 and now. In that there’s much more accountability in terms of all individuals that are touching a patient throughout their stay. Whether it’s the doctor, the nurse, the licensed vocational nurse or certified nurse assistant. Then social work and case management. There’s definitely more accountability.” – Clinical Social Work Supervisor, non-profit, LA County “I think our biggest learning curve was just how we were tracking and documenting the individuals that were presenting into the hospital, where before that was kind of hit or miss if we even asked them if they were homeless.” – Manager of Care Transitions, non-profit, Humboldt County “I don’t want to be super critical of SB 1152, because I think it gives guidance and I think it helps. And I like the collaborative effort that it really does pull different services responsible to make sure that they have clothing and they have some food and they have their immunizations that they need. I think these types of bills are very necessary to make sure that there’s some accountability. But at the same time, we need to work with the community as well.” – Clinical Social Work Supervisor, county, LA County “[SB 1152] probably put [discharge planning] more to the forefront and kind of forced us to evaluate every one of our discharges for homeless [patients] to make sure they’re safe. So, I can’t say that that’s a bad thing.” – Director of EM and Trauma Services, non-profit, Humboldt County “We’re proud of the fact that we’re very consistent. If we do it once, we do it 100 times and everybody gets the same” – ICU/ED Nurse Manager, for profit, Humboldt County
Improved quality of resources	“We also wanted to make sure that everyone had an identified place for their clothing… we actually ordered clothing from a local vendor who offered it at a discounted price. What ended up happening is we were able to provide that vendor’s contact information to all of the other ministries. Now that is our contact for all six to eight ministries to order their clothing. It’s weather appropriate clothing. T-shirts, sweatshirts, sweatpants, sweat shorts, socks, shoes. We also have ponchos and underwear. The essentials basically.” – Clinical Social Work Supervisor, non-profit, LA County “Another change for us is that we provide more cab rides. We always provide bus tickets, but now we will provide a cab ride just depending on their situation. If [patients] are having a difficult time with accessing the bus, then we provide cab rides, and we meet the [SB1152] criteria [of providing transportation] within a 30-mile distance.” – Social Worker and Nurse Case Manager, for profit, Humboldt County “SB 1152 made us more responsible for making sure the patient gets their medication. So when the pharmacy is open, we’ll fill them and make sure that the patient has them in hand when they leave, … even after hours now…rather than just [giving] them a prescription and say[ing], ‘Go to the next free clinic and go get it filled.’. [Instead], what patients are being told is, come back to the emergency room in the morning, the social worker will help you get it filled… So that was one thing that SB 1152 did for us, made us make sure that our patients have the proper treatment and prescriptions filled.” – ED Social Worker, university, LA County
Streamlined processes	“I think what’s changed is there’s a lot more tracking and a more streamlined approach to it, and also now it’s the hospital or the nursing staff or physician initiation [to provide services], rather than patient requesting for services.” – Nurse Manager, non-profit, Humboldt County “And the Box…setting up this resource system for everybody that’s much more friendly to navigate and we’re updating it always in real time has really helped to streamline resources and update resources.” – Associate Chief of Clinical Social Work, university, LA County
Improved awareness of homelessness	“Through this law, we realize more that there’s people that live in their cars, that are couch surfing. When they come to the hospital they might look like a normal patient, they have proper clothes…like there’s nothing wrong with them. But then when we look into their story, then we find out they’re living in their car, they’re just bouncing between friends…it brought the spotlight into this population, and even if [people like hospital security guards] don’t know the specifics of the law, people [at the hospital] know that someone’s required to do something.” – ED Social Worker and Homeless Care Coordinator, university, LA County
Respect and funding for social care staff	“It made it to where we have more support to do our job from our own organization…I think that we have more professional respect in what we do.” – Clinical Social Work Supervisor, non-profit, LA County “I think it was the pressure of SB 1152 that came that made [our hospital administrators] say, okay, we really should look at this [request for hiring homeless care coordinators], and…get on board with that.” – ED Social Worker, university, LA County

SB 1152: California Senate Bill 1152; LA: Los Angeles; ED: emergency department.