HOSPITALS ARE DUMPING HOMELESS SENIORS WITH SERIOUS MEDICAL CONDITIONS, ADVOCATES FOR HOMELESS REPORT

Advocates describe "crisis," call for state, county and city of San Diego to take action

By Miriam Raftery

Hear our interview aired on KNSJ

April 16, 2023 (San Diego) – Last year, hospitals in San Diego County discharged over 500 vulnerable patients onto the streets late at night in violation of state law, according to Amnie Zamudio and Joanne Standlee, co-founders of Housing 4 The Homeless (H4H).  In an interview with ECM, they described dumping of homeless or indigent patients, many wearing only hospital gowns and booties. Those discharged after midnight included seniors with dementia,  people in wheelchairs,  patients with catheters, and an elderly man with a broken hip. 

Homeless advocates call for action, contend hospitals committing “crimes”

H4H has sent a letter urging the chairs of the Assembly and Senate Human Services committees to hold hearings on the “crisis.” They also held a press conference in late March calling on San Diego Mayor Todd Gloria, the City Council, and the County Board of Supervisors to open the Homeless Resource Center 24 hours a day, 7 days a week to provide vulnerable discharged patients with a safe place to rest, eat, and access wrap-around case management.

“Local area hospitals are committing crimes in plain view every day of the week with no consequences.  While homeless individuals are being held to the letter of the law regarding public habitation violations, hospitals are being given free rein to blatantly break the law which directly endangers lives,” Zamudio stated in a press release.

A state law,SB 1152, took effect in January 2019 and was supposed to prevent hospitals from dumping poor or homeless patients onto the streets, particularly those requiring expensive medical care, instead of placing them with a homeless shelter or keeping in the hospital. The law requires that patients be provided proper clothing, The law requires hospitals to provided screening and stabilizing treatment, and to provide weather-appropriate clothing before releasing such patients.

But the reality is far different.  Zamudio and  Standless say that they are horrified by the reality.  “H4H watches in horror as unsheltered individuals are not offered even the most rudimentary requirements of this bill such as food, weather-appropriate clothing, screening for infectious diseases and vaccinations,” H4H’s release contends.

Advocates detail mistreatment of patients “dumped” onto streets by hospitals regionwide

Standlee (photo, right) told ECM that Zamudio goes out into the night to help those patients dumped onto the streets  between midnight and 5 a.m. and has documented each case with photos, though to protect the privacy of those victimized, they are not releasing the images. “All of them show people dire straits,” says Standless. “They are dragging themselves across the sidewalk to a bus stop,”  sometimes after being given a buss pass, only to wait hours even in cold and rainy weather, since buses aren’t running. “Some have defecated all over themselves…They are in a bathroom desert, so there is no place for them to use the toilet,” Standlee adds.

Zamudio and Standless told ECM that dumping of homeless patients including seniors is being done by both public and private hospitals across our region, including UCSD  Medical Center, Scripps Mercy Hospital, Kaiser Permanente, Sharp Grossmont Hospital, and Alvarado Hospital.

“I’ve gotten calls from people discharged from Grossmont Hospital who are homeless, saying ‘I’ve been discharged, can you guys please provide mewith a hotel room. I’m disabled. I’m in a wheelchair. I have nowhere to go,” Zamudio says.

A veteran with a broken hip was discharged from Alvarado Hospital late at night onto the streets, Zamudio recalled.

“I had video of Scripps Mercy dumping a homeless woman in front of the San Diego Homelessness Response Center before it opened,” she said,adding that H4H called for an ambulance to take her back to the hospital.  The same day, they had to call an ambulance to return an elderly man to a hospital and demand that he be transferred to a skilled nursing facility.

In another case, H4H got a call to help a 72-year-old woman in a wheelchair who had just been discharged. Finding shelter space for seniors is particularly challenging since by law, anyone 55 or older must be placed in a bottom bunk.  But even though a shelter had a bottom bunk available, the facility refused to take this woman, because she couldn’t maneuver her wheelchair to shower unassisted,  according to H4H.  The advocates had to call an ambulance, even though she’d been dumped near a hospital, to get them to readmit her and after advocacy by H4H, agree to refer her into a skilled nursing facility.

She describes another patient as a “wonderful woman” whose “landlord dumped her at Alvarado Hospital and evicte4d her while she was there.” The patient was admitted and discharged by hospitals four times, including UCSD, Scripps Mercy and Alvarado “all while wearing a pink fluffy robe and house slippers.” H4H contacted her sister, who convinced a hospital to administer a cognitive impairment test which showed the woman had dementia.  

“A challenge with seniors is that many suffer from cognitive impairment,” says Standless, noting that many may not understand a discharge plan when agreeing to one. “No one is really tracking or advocating alongside our older adults experiencing homelessness. .This happens all day and all night long.”

In yet another troubling case, an elderly person discharged by Scripps was aided by H4H after a concerned community member called for help.  During the intake process atH4H, she wandered off, so advocates called police.  They learned that there was already a silver alert reporting her as a missing person, filed around two weeks earlier. It’s unclear whether the hospital didn’t realize she was a missing person, or perhaps didn’t reveal this due to privacy law concerns.

“We are specifically speaking about people who were discharged—not those who left against medical advice,”  Standlee points out.

Despite the dangerous conditions under which many patients have been discharged, based on their observations, Standlee and Zamudio don’t believe the blame lies primarily on hospitals, which are overwhelmed. “The hospitals are essentially being forced to break the law,” says Standlee,who faults city officials and Supervisors for “patting themselves on the back for their solutions to homelessness, but they are gravely failing older adults.”

Instead, they believe the responsibility lies primarily with politicians at all levels of government to take action to help homeless patients in San Diego, which has one of the nation’s highest homeless populations.

“They’ve already declared this(homelessness) a crisis,” Standlee says. “Where are the FEMA trailers to put people in, and medical personnel parachuting in?”

Shelter space is inadequate. According to the Housing Commission, Standlee notes, of every 100 people who agree to accept shelter, only 37 are admitted.

“The Mayor and the City Council, they know what’s happening, but not only are they not taking action, they are further criminalizing homelessness,”  she says. What’s needed is to offer ”human dignity to these people instead of leaving them on the streets.”

But at the H4H press conference, not a single politician showed up, though several medical professionals spoke out to affirm the problem.

As of our interview, the state officials contacted had not yet offered to hold the hearings that H4H requested.  Civil rights leader Shane Harris helped H4H draft its letter, which was sent on March 14, about two weeks before the press conference.

Advocates at H4H have reached out to Assemblymember Akilah Weber, whose staff agreed to set up a meeting. “I’m very hopeful about that,” Standlee said.

H4H advocates want an investigation into the deaths of unhoused people on local streets.

In 2022, according to the County Medical Examiner’s data, 572 homeless people died on the streets in San Diego County.  It’s unknown how many may have been patients discharged prematurely. Data is hard to access and some such deaths may not be recorded as such. For example,H4H describges an elderly woman who passed away near the Sports Arena, but after her body was taken away and police had left, her belongings were left behind—including evidence that she had been recently discharged from a hospital. 

Zamudio gets emotional when talking about the ordeal facing homeless senior patients she has seen.  “I don’t know how to communicate to the general population,” she told ECM, her voice breaking,”the alarming rate that we have of elderly women just wandering our streets.”  She said that earlier this year, a 72-year-old woman was sexually assaulted on the streets.

Zamudio recalls  that back in the late ‘80s and ‘90s, a crisis dubbed “granny dumping” was occurring. Now with hospitals dumping homeless seniors, she observes, “We are there again, in 2023.”

Hospitals deny wrongdoing, but acknowledge challenges

Hospitals have not admitted to violating the law, but contend the situation is overwhelming.

In a statement to media, Scripps Mercy Hospital noted that it had more than 10,500 homeless patient visits last year. NBC  quotes Scripps Health as stating in part, “We ensure all patients are safe to leave the hospital before being discharged. We work with each patient to develop a discharge plan, which includes giving them discharge instructions, follow-up for medical or behavioral healthcare needs they may have and providing them with information about community resources so they can access food, clothing, shelter and transportation for their chosen destination, as applicable.Hospitals cannot directly secure homeless shelter beds for patients.”

Bruce Hartman, director of marketing and communications at Sharp Grossmont Hospital, told ECM in an email, “Discharge planning at Sharp hospitals is focused on ensuring our patients are prepared to care for themselves after they leave one of our medical facilities. Of paramount importance is confirming they understand their discharge instructions and know to contact us or other health care providers if they have health concerns after discharge.”

But he acknowledged, “ The homeless population unquestionably provides unique challenges. We attempt to transition these individuals to supportive housing facilities, but many choose not to take advantage of these resources. As the largest local provider of care for the un- and underinsured, we are committed to providing quality care for all San Diegans and assuring our patients are safely discharged. “

How you can help

Housing 4 the Homeless seeks volunteers and donations, as well as angel investors to help them purchase a hotel to house vulnerable homeless seniors.  They’ve identified a property, but need $10 to buy it.

Run by four women volunteers with just one staffer, the nonprofit organization does have a business plan and for the past three years. has been leasing hotel rooms to vulnerable homeless people.

Despite the daunting challenges, the group has had support from some in the community who want to help out.

“I’m so grateful that people are starting to care about this issue,” Zamudio concludes, “and starting to care about our seniors on the streets in San Diego.”

If you would like to help by volunteering or donating, or if you know a homeless individual in need of help, you can visit the H4H website at

https://housing4thehomeless.org/  or call (619)992-9152.

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