Discharge Planning

Healing Hands Newsletters

Tools to Help Clinicians Achieve Effective Discharge Planning | Too many people without financial resources and social supports cycle among hospitals, mental health facilities, foster care or group homes, correctional institutions, shelters, and the streets. These insidious “revolving doors” exacerbate homelessness and call for clinicians and communities to find coordinated solutions that are humane and cost effective. First steps often involve creative adaptation of existing interventions. These articles discuss discharge planning strategies and focus on individuals who are leaving health care institutions, jails and prisons, protective youth services, or the armed forces.
Healing Hands | October 2008| Vol. 12, No. 5

Preventing Homelessness through Discharge Planning

The Role of Effective Discharge Planning in Preventing Homelessness looks at discharge planning and its role in the continuum of care. Assessment and treatment, planning for discharge, and service coordination and integration are the three primary strategies outlined to help prevent homelessness among those with special needs leaving an institutional setting and returning to the community. This study also looks at innovative strategies used in various ten-year plans and provides recommendations for future discharge planning strategies.

New Guidance on Discharging Homeless Hospital Patients

Guidance On Discharging Homeless Hospital Patients is issued jointly by the Department for Communities and Local Government and the Department of Health. They represent recommended practice for organizations involved in hospital admission and meeting the needs of people who are homeless or living in temporary or insecure accommodation, and were drawn up by an expert steering group consisting of representatives from Homeless Link, the London Network for Nurses and Midwives, and the Health Inclusion Project Advisory Group. Homeless Link has also produced four fact sheets (Developing integrated care pathways for homeless people, The Housing Act, Housing Status, and Resource/Intranet Book) to accompany the guidelines. These resources  are available on the Homeless Link website.

Essentials Tools for Discharge Planning

Various public and private institutions contribute to homelessness by discharging their wards to the streets or shelters. Ending such practices is an important, current tactic in the struggle to end homelessness itself. We encourage health care providers and other advocates for homeless people to examine the impact of ineffective institutional discharges on homelessness in your own communities and to advocate for policies that will help prevent homelessness. To that end, we provide these resources that have been compiled by the Massachusetts Housing and Shelter Alliance.

Institutional Discharge and Homelessness

A growing body of information documents the large number of people who become homeless upon discharge from hospitals and treatment facilities, jails and prisons, and the foster care system. The role of ineffective discharges from institutions in generating homelessness has been widely recognized at least since the publication of Priority: Home! The Federal Plan to Break the Cycle of Homelessness (U.S Department of Housing and Urban Development, Washington, DC, March 1994). Each such case represents a failure of publicly operated or regulated institutions to fulfill their responsibilities to persons in their care. Each case also reveals the paucity of community resources to meet the housing, health care, and other needs of individuals without personal resources, and demonstrates the responsibility of institutions to work to increase community resources.

  • Prohibit discharges into homelessness from all publicly funded institutions such as hospitals, treatment facilities, prisons and jails, and the foster care system. Invest in recuperative care facilities for patients without homes who require supervised medical care but are not ill enough to remain hospitalized.
  • Require all publicly funded institutions providing residential care, treatment or custody to secure all available entitlements for residents prior to discharge and to provide staff persons trained in housing placement assessment and assistance.
  • Establish assisted living type recuperative care facilities for homeless individuals who require medical, mental health and/or addiction services over a period of time in order to sustain their housing stability while they recuperate, recover, and prepare to enter permanent housing.
  • Support legislation, such as the Public Safety Ex-Offender Self-Sufficiency Act of 2003 and the Bringing America Home Act, to encourage better planning and services for individuals being discharge from correctional institutions into the community.
  • Create sufficient jobs and incomes, affordable permanent housing, universal health insurance, accessible health care, and other community services to meet the needs of all persons at risk of homelessness, consistent with other National Health Care for the Homeless Council positions.