NIMRC Resource Highlights

Letter to Members

Save the Date

• Feb. 28 at 2 p.m. CST — Respite Care Providers' Network All Member Meeting 
  All Member Meetings provide an opportunity to join together with other medical respite program providers and administrators to discuss key issues affecting medical respite care. We will provide updates on NIMRC, resource, and policy issues. The discussion for this meeting will center on HUD's 90-day institutional stay rule and the impact it has on medical respite programs. Attendees will have the opportunity to connect with each other, share experiences, and learn insights from other programs. 
• March 13 at 2 p.m. CST — Assessing Health Management in Health Center and Medical Respite Programs 
  This webinar will present recommended approaches for assessing areas of health management that are critical for developing client-centered plans of care within health centers and medical respite programs.
• April 3 from 12-4 p.m. CST — Trauma Informed Design in Medical Respite Care — Virtual Symposium
  More information and registration coming soon!
• May 13-16, 2024 — National Health Care for the Homeless Conference & Policy Symposium
  Registration is open for the 2024 National Health Care for the Homeless Conference and Policy Symposium, slated for May 13-16 in Phoenix. Register before Jan. 31 to receive a 15% Early Bird discount! Use the code EB15 at checkout. The theme for #HCH2024 is “Toward Access and EquaLity: Embracing an Equitable Approach to Health Care.”
  
  CONFERENCE SCHEDULE 
  🌵 May 13: Pre-Conference Institutes 
  A full-day focus on one of three topics: Street Medicine; Justice, Equity, Diversity, and Inclusion; and Medical Respite 
  🌵 May 14-15: Main Conference 
  Two days of concurrent breakout sessions, keynote addresses, poster presentations, access to exhibitors, and networking opportunities  
  🌵 May 16: Learning Labs  A half-day focus on one of six topics: Advanced Care Planning for People Who Use Drugs, Consumer Engagement and Access to Care, Next Steps in Addressing Encampment Sweeps, Research Updates in Homelessness, Nurse-led Care Models, and Indigenous Cultural Safety 
  
  Like last year, the main Conference will include a Medical Respite Care workshop track, and a full-day pre-conference institute on medical respite care, held on May 13.   

Activities and Opportunities

Respite Kudos and Accomplishments

Respite on the Road

Respite in the News

• The first medical respite care facility in West Virgina is being established by a partnership between The United Way of Harrison and Doddridge Counties and WVU Medicine United Hospital Center. The program is a project of Resilience Collaborative, a direct service program of the local United Way. “We believe housing is health care,” said Marissa Russell, director of Resilience Collaborative. Resilience Collaborative is looking to begin operations in a motel setting and then transition to a residential structure should one become available. Also, Marissa Russell did an interview with First at 4 News, which can be viewed here.  
• San Diego County has roughly $80 million in federal pandemic relief funds to be spent by the end of 2026. The County Board of Supervisors is looking at two major proposals, which center on creating more recuperative care beds for homeless San Diegans and increasing the number of behavioral health care workers here in San Diego County. This new proposal, which would prevent a backlog of available beds in full-service hospitals, would essentially double the current number of recuperative beds available countywide. Two allocations totaling $21 million for recuperative beds and workforce wellness were approved by the Board in a 4-0 vote. 
• A recuperative care center for unhoused residents and more training for local behavioral health workers are initiatives under consideration for quick action by the San Diego County Board of Supervisors in early January. This includes a proposal to spend $8 million to build a second facility with about 100 “recuperative care homeless beds,” which could be modeled after the 106-bed Abraham and Lilian Turk Recuperative Care Center operated by Interfaith Community Services in Escondido.
• A meeting was held in San Bernardino, Calif., to focus on issues such as commercial business enforcement, tackling the challenges faced by the unhoused community, and overall city improvements. Th city is constructing a Navigation Center at the former “School of Hope” campus to provide low barrier, noncongregate, interim housing to help address the root causes of homelessness. The campus will connect people to a wide variety of resources, including medical respite. 
• Home Sweet Home Ministries, a homeless shelter in Bloomington, Ill., received a $68,000 planning grant from the Illinois Public Health Institute as part of the Illinois Medical Respite Capacity Building Initiative. The grant will fund training costs and research efforts to work towards implementing their own medical respite care. HSHM staff will network with other grant recipients and entities that already have medical respite programs in place. 
• In Long Beach, Calif., the largely vacant former Community Hospital property is about to get a new tenant that will provide recuperative care, a sobering center, and training for community health workers, with plans to eventually add an urgent care and supportive housing for seniors. Officials from National Healthcare and Housing Advisors (NHHA) will discuss their plans and hear from residents at a community meeting in mid-January. 
• The UW Harborview Medical Respite program, which treats unhoused people who are too sick to be out on the streets but do not require hospital care, currently has 18 beds for all of King County while its building is under construction. It will return back to its full capacity of 34 beds in August 2024. Most shelters are unable to provide health care for older adults, which creates a juggling act of who will serve them. 
• Honolulu Department of Emergency Services has noted a patient surge in the new year. The state has done considerable work to establish medical respite "kauhale"  locations to help the homeless, who have recurrent illnesses and circle back frequently to the ER. 
• This article delves into recent changes in Medicaid expansion and how certain states’ 1115 waivers are being used to negotiate for medical respite services.   
• Connections for the Homeless in Evanston, Ill., is launching a medical respite program to provide greater health care to residents of the Margarita Inn homeless shelter. The program is funded by a $400,000 grant from the Community Investment Fund of Endeavor Health, the health system created by the 2022 merger of NorthShore University HealthSystem and Edward-Elmhurst Health. Connections is one of 43 organizations across the region receiving a grant this year from Endeavor, and one of six operating in Evanston. 
• Senators reconvened in early January to continue introduction of new bills, including LB905 which was introduced by Nebraska state Senator Merv Riepe. This bill would require the state Department of Health and Human Services to submit a waiver or state plan amendment for medical respite care.  
• Sierra Guest Home in Grass Valley, Calif., is planning to expand from 17 to 27 units of groups housing for seniors and veterans. There will be some recuperative care beds available. The project was made possible by a $6 million Community Care Extension grant for housing. 
• Springfield (Mo.) City Council is considering a bill to decide whether to award two nonprofits funding to improve or build new homeless shelters. The funding comes from American Rescue Plan Act (ARPA) funds that the city received. The two organizations selected are the Salvation Army and Women’s Medical Respite. They would each receive part of the nearly $2 million that’s allotted for this funding. “We put out a request for proposals for folks to apply for agencies that do homeless shelter work to apply for ARPA. There’s a staff of five at the planning department that evaluated the proposals based on evaluation criteria, scored them, and then made a recommendation on funding,” said Bob Jones, grants administrator for the planning and development department. The goal is to provide more resources for unhoused people in Springfield. 
• The push for the recuperative care center in San Diego comes as a response to the delayed implementation of Senate Bill 43 (SB 43), which has been postponed for one year due to concerns from hospital administrators about potential overloads in emergency departments. The new center, estimated to cost $8 million and house approximately 100 beds, is a strategic move to reduce pressures on hospitals. Supervisor Terra Lawson-Remer is at the forefront of this initiative, advocating for swift action. 
• CalAIM involves the use of state contracted managed care plans to offer members enhanced care management and community supports. Recuperative care is now considered one of the 14 offered community supports under CalAIM. 
• Blessing Health in Quincy, Ill., has been awarded a planning grant on behalf of itself and 10 community agencies to develop a medical respite care program that could be implemented in Quincy if long-term funding, a location for a facility and staffing can be identified. Medical respite care is short-term housing combined with health services that allows people experiencing homelessness the opportunity to rest, recover and heal in a safe environment while accessing medical care and other supportive services. Planning grants were recently awarded to 16 organizations, including Blessing Health, by the Illinois Public Health Institute. The funds came from the Illinois Department of Human Services as part of Home Illinois: Illinois’ Plan to Prevent and End Homelessness, which identified medical respite care as a key activity. 
• A former Super 8 hotel in Goleta, Calif., was acquired and renovated with funds from the State of California’s Homekey program, and the Housing Authority of the County of Santa Barbara owns and manages it. Eight studio apartments are reserved for graduates of the Cottage Hospital Recuperative Care program, who are recovering from health issues.  
• “Illinois urgently needs legislation to ensure safe hospital discharges for people experiencing homelessness. In Chicago, emergency shelters are at or beyond capacity, so people are waiting several days and longer for shelter bed placements. Homeless patients who are discharged from hospitals sometimes wait on the street for many days before a shelter bed becomes available. While waiting for a shelter bed assignment, they don’t have access to food or medicine. When homeless patients are sick and hospitalized, many require restorative care upon discharge, ideally from a medical respite shelter program. But in Chicago, we lack medical respite shelter programs for unsheltered people who require extra time to recover from surgery, a serious illness or who may need outpatient treatment for cancer, for example.” 
• There are five respite beds in Clark County for its estimated 9,032 people who are living unsheltered. Local advocates point to a program in Northeast Portland that provides a model of what respite care could be in Clark County. Central City Concern’s Evergreen Crossing has 90 beds and combines a primary care clinic and shelter where workers tend to clients’ medical needs and help them get housed. Nonprofit Share partnered with PeaceHealth Southwest Medical Center to dedicate the five beds mentioned earlier for people coming out of the hospital. Occasionally PeaceHealth can send a nurse or other health care professional to provide medical care, but typically that responsibility falls to a Share staff member, who has dozens of other people to see after, plus lacks the necessary medical certification. Share and PeaceHealth have a tentative plan to expand the respite program.
• Unity Housing is a coalition of service providers and other stakeholders whose mission is to address homelessness in East Tennessee through innovative and collaborative solutions, based on proven methodologies. Board members Opal Frye-Clark and Amanda Moorhouse are hoping to create a medical respite facility in the Johnson City, Tenn., area. Instead of returning to the streets after a hospital stay, people could experience a post-discharge journey that gives them a much better shot at not being right back in the hospital. 
• St Joseph’s Mercy Care Services, Inc. is a medical respite provider in Atlanta, Ga. Kaiser Permanente provided $150,000 to assist Mercy Care in the administration of their “Strengthening the Medical Respite Ecosystem in Metro Atlanta, Georgia” project. The project provides recuperative care needs for homeless, medically fragile men and women in metro Atlanta. “Mercy Care is thankful for the support of Kaiser Permanente, which will allow us to fully assess the recuperative care needs of adults experiencing homelessness throughout Atlanta and build a sustainable model for meeting those needs,” said Kathryn Lawler, Chief Executive Officer of Mercy Care. “Mercy Care’s medical respite programs for men and women serve over 130 of the most vulnerable people in our community every year, helping them to stabilize their health conditions and secure the permanent housing they need to fully recover. Kaiser Permanente’s generous financial and technical assistance support will enable Mercy Care to build the programming needed to serve even more individuals in need.” 
• The Los Angeles County Board of Supervisors took the next steps in a planned overhaul of the historic General Hospital building, with the ultimate goal of providing hundreds of units of affordable housing. Hilda Solis is spearheading the creation of a Restorative Care Village on the campus, which will provide a comprehensive continuum of care to address the physical health, behavioral health, and substance use needs of the county’s most vulnerable residents. Already in operation on the campus are 96 recuperative care beds, providing long-term care and support for those with chronic health needs, including residents experiencing homelessness. 
• Providence Hospital has helped Central City Concern in Portland, Ore., by designing and funding the Recuperative Care Program, an innovative approach to treating those who are discharged from the hospital but have no home to return to, helping them not become homeless again. The program expanded a month ago from 55 to 90 beds by purchasing a Comfort Inn on 82nd Avenue. 
• Women’s Medical Respite of Springfield, Mo., is a non-profit organization committed to providing respite care to ill homeless women who do not meet the criteria necessary to be hospitalized. They are a recent recipient of part of the Jerry Redfern Grants to support operating expenses. 
• Maine Medical Center, a complete health care resource for the people of Maine, partnered with Greater Portland Health to open a new recuperative care facility. This short-term communal medical space will allow unhoused clients an opportunity to rest and heal in a safe, supportive environment. 
• Louisville Metro Government announced that the new Community Care Campus will include a medical respite center for individuals who are homeless and discharged from local hospitals. The goal is to transition people into supportive housing that still provides them with medical care. The respite center will be able to house 30 patients at a time. Additionally, the Campus will provide shelter and services for families and individuals dealing with homelessness, and Volunteer of America officials said they expect the new shelter to serve over 400 families annually. 
• Construction has begun on a $15M medical respite facility at the Gateway Center in Albuquerque, N.M. The facility will offer medical care and short-term residential care to homeless people who are too ill to recover on the street, but not sick enough to warrant hospital-level treatment.  
• In 2012, Circle the City opened the doors of Arizona’s first respite center, the Midtown Medical Respite Center — a 50-bed recuperative care facility for men and women facing homelessness to rest, heal, and recover. Patients also receive daily medical care, meals, case management, and other necessities. Today, Circle the City operates two medical respite centers, two outpatient healthcare clinics, and five mobile medical units that provide care to shelters, transitional living centers, and hard to reach areas. The founder of Circle the City, Sister Adele’s new role is as the Director of Mission Engagement and to support and assist the Development and Human Resources departments at the organization. Services are provided at their Medical Respite Centers, and health centers as well as out in the field with mobile and street medicine teams. 
• Listen to a conversation on Cincinnati radio news Cincinnati Edition about what medical respite centers offer, why they’re needed, and what happens when those in respite care are discharged. Dr. Bob Donovan, co-founder and chief of medical operations, The Center for Respite Care, Julia Dobbins, director of medical respite care, National Health Care for the Homeless Council, and Caitlin Synovec, assistant director of medical respite care, National Health Care for the Homeless Council were featured in the segment. 
• One couple faced multiple medical emergencies that landed them homeless and living in their car until a helping hand came along to change the narrative. Helping Hands of the Cape Fear helps provide medical respite for those who need post-hospitalization care and are faced with homelessness. In addition, they also supported the couple in finding stable housing. The couple lived in the transition home for seven months and moved into a place of their own after the medical respite stay. 
• Homeless people recovering from hospitalizations in Tucson, Ariz., now have a temporary home to heal in. Catholic Community Services of Southern Arizona (CCS) cut the ribbon to respite center Casa de Respiro in December. Casa can hold up to 48 people at one time, and the organization projects it can help at least 500 people each year. Dogs are also welcome too because the CCS team says they know that pets are sometimes the only thing people have to call their own.
• Waterfront Rescue Mission helps fill healthcare gaps for unhoused people in Pensacola, Fla. The mission's respite care program offers a safe environment with hospital beds for ill or injured homeless men to recuperate.
• A grant of $5.2 million was announced by the Healey-Driscoll Administration in Massachusetts to provide individuals experiencing homelessness a safe space to recover after a hospital visit. The Medical Respite Pilot Program is a partnership between healthcare agencies and community-based organizations that will offer 40 beds of temporary housing with clinical support while program participants receive assistance in finding suitable long-term housing. The program will help reduce healthcare costs and utilization, hospital capacity, and housing outcomes. These locations are appropriately equipped with 40 semi-permanent shelter beds and clinical support staff. 
• Jaynell Assmann, the founder of Care Beyond the Boulevard, a nonprofit that provides medical care to the homeless community, recently established what’s currently the only homeless medical respite program in Kansas City, Mo. It’s funded solely by her nonprofit. In late September, the City Council approved a plan to invest nearly $5 million in a program that would include a form of medical respite for community members struggling with addiction, many of whom are also homeless. 
• The Alameda (Calif.) Point Collaborative has begun abatement and demolition work in order to construct a medical respite and clinic facility to serve patients experiencing homelessness. The project will consist of a two-story facility with 50 beds for medical respite and hospice, a medical clinic, and a drop-in center where Alamedans at risk of becoming homeless can get assistance. This building is one part of a holistic campus, which when completed will also include a 100-bed permanent supportive housing facility for homeless elders with medical needs.   
• The first medical respite program in Omaha, Neb., served 17 people in its first year. The Siena Francis House shelter is part of a 2-year medical respite pilot program with Charles Drew Health Center. Ultimately, the goal is to reduce re-admission rates, which could lower costs and wait times in the healthcare system as a whole.
• The City of Savannah, Ga., is looking to invest over half a million dollars to create housing for medically fragile individuals experiencing homelessness. The Director of the Chatham Savannah Authority for the Homeless, Jennifer Dulong, said those who are deemed 'medically fragile' are often not in a good enough condition to share a shelter space with others and lack things like transportation to follow-up appointments and access to prescriptions to help them recover. The apartments on Florance Street would be transitional housing, providing things like case management, access to transportation, and ensuring nutritional needs are met. 
• In an effort to combat homelessness and provide crucial support to unhoused individuals and families, the City of Victorville, Calif., is preparing to open its groundbreaking Wellness Center. The Victorville Wellness Center will be a first-of-its-kind low-barrier emergency shelter, offering interim housing and comprehensive wraparound support services. Notably, it will also house a medical and recuperative care clinic. Local hospitals will be able to discharge Victorville’s unhoused directly to the Wellness Center medical clinic to receive the recuperative care required to recover while freeing much-needed hospital beds. 
• A shelter for seniors and medically vulnerable homeless in Sandy, Utah, will provide privacy and specialized care. The Medically Vulnerable People Program Facility is housed in a former EconoLodge motel. It is designed to serve 165 people requiring specialized care; residents will either have their own rooms or share a room with one other person, depending on their condition. A full-time behavioral health medical nurse will work in the facility, and at least once a week Fourth Street Clinic will bring in three or four providers for more specialized care. If patients need care beyond what the clinic offers in-house — such as cancer or cardiology treatment — the staff work to get them to their appointments. 
• With COVID-19 cases in decline, Washington County (Ore.) has repurposed 10 private rooms in an EconoLodge in Hillsboro that had been used to quarantine people during the pandemic. The rooms will now be a clean and safe place for people who are homeless to recover from an injury or illness with help from a visiting nurse. It’s a model known as recuperative care. 
• A new navigation center in Lakewood, Co., is helping unhoused people get back on their feet. RecoveryWorks, a nonprofit that helps people get back on their feet and into permanent housing, held an open house Thursday for its new navigation center, located at 8000 West Colfax Avenue in Lakewood. For nearly three years, the nonprofit ran "a smaller version" of the center roughly 10 blocks from its new center. Ginsburg said the smaller facility is now a medical respite center for unhoused people who’ve recently been hospitalized. 
  

Respite Care Providers' Network Information

• If you are not already a member, please join the Respite Care Providers Network (RCPN). The mission of RCPN is to improve the health status of individuals who are homeless by supporting programs that provide medical respite and related services. Follow this link for more information and to join the RCPN.
• Is your medical respite program profile in the NIMRC directory up to date? Complete this program profile form to update your information and view the directory here.
• Does your program need technical assistance? Please contact us to request a TA meeting to help address your program’s needs! 
  
• Additional resources for medical respite/recuperative care can be found at www.NIMRC.org.