Get the latest news from the Respite Care Providers' Network!
Get the latest news from the Respite Care Providers' Network!

Respite News


A Quarterly Newsletter for Members of the Respite Care Providers' Network
July 20, 2023

NIMRC Resource Highlights

Over the past year, the medical respite team has been developing foundational resources for the field of medical respite, which defines medical respite care and its role within the continuum of health and housing services. These resources also identify essential aspects of medical respite programs, building on the work of the RCPN which developed and updated the Standards for Medical Respite Care. In addition to the Standards, NIMRC introduced the Models of Medical Respite Care (December 2022) and the Guiding Principles for Medical Respite Care (May 2023). The relationship of these different foundational resources is captured and described in the Framework for Medical Respite Care (May 2023).
As conceptual documents, there was also a need to develop additional resources to assist programs in implementing the Guiding Principles, Standards, and Models of Care into practice. Additional tools have been developed and published in order to assist programs in defining their Model of Care, determining needed staffing based on their Model of Care, and identifying a sustainable budget for their programs. 
All of these resources are available from the NIMRC website, and a comprehensive list is included below:
Foundational Resources
Supplemental Resources
Additional new resources
NIMRC remains open to the needs and ideas of medical respite programs! If you have questions or ideas for new resources, please contact us!

Letter to Members

Bobby Watts, CEO of NHCHC
The National Institute for Medical Respite Care (NIMRC) was born three years ago near the beginning of the COVID pandemic, a year ahead of the timeline in the National Health Care for the Homeless Council’s strategic plan. The reason for the early start was that we knew that Medical Respite was an important part of the answer to the question that many localities and states were asking: How can we protect the health of our homeless neighbors in a global pandemic? That is what Medical Respite programs had been doing for more than 30 years throughout our nation’s shameful homelessness epidemic. We knew that we needed to elevate the deep experience and expertise of the Respite Care Providers Network at that time of great need where lives were hanging in the balance. So, we established NIMRC on July 15, 2020.
In the past three years, this special initiative of the Council has taken steps beyond what we could have expected. Thanks to the guidance of an initial Advisory Panel, the ongoing and continual guidance of the Respite Care Provider’s Network, and generous foundation and corporate partners, we have been able to re-grant more than $6.5 million and combine those funds with customized technical assistance to help more than 50 Medical Respite programs begin, expand, and/or improve their services and physical facilities. 
Our goal is simple, but powerful: to expand and advance the practice of Medical Respite programs throughout the country. We have been invited to give guidance to states that are considering or are implementing Medical Respite in their state Medicaid plans, which has the potential to solidify Medical Respite on an ongoing basis in a growing number of states. We have advanced Medical Respite Care by creating tools to help programs implement the Standards that RCPN helped create a few years ago that will improve services and operations. Based on input from the RCPN, we’ve focused on helping medical respite programs increase the effective provision of behavioral health in their programs. Finally, we are grateful for generous partners that have allowed us to be on the ground in California to aid medical respite (also called recuperative care) programs, hospital systems, managed care plans, and governments as they implement the ambitious 1115 waiver that now includes medical respite/recuperative care as a community benefit in the largest Medicaid program in the country.
In short, NIMRC, over the last three years, has helped us elevate the knowledge of the RCPN to the health system and secure resources to advance solutions to some of the problems you have identified as most pressing. As any proud parent of a three-year old, when looking back over the last three years, we marvel at how much growth and development has occurred so quickly. And more growth to advance Medical Respite is coming.  Stay tuned ...
Bobby Watts
CEO, National Health Care for the Homeless Council

Activities & Opportunities

Membership Updates

Thank you for your continual support of NHCHC & NIMRC. For organizational members of the Council, please note we are changing our membership model to run on a fiscal year, July 1 to June 30. Our hope is to make it easier for your organization to remember when it’s time to renew! Already have an active membership with the Council? Our Membership Manager, Chelsea Hardin Hensley, will reach out to you when it expires with a plan to get your organization on to this new fiscal year schedule. Unsure if your organization is a current member? Check out our new membership directory that is updated daily!
If your organization is not yet a member and wishes to join, take a look at all the benefits available to your organization! Medical respite programs fall under Tier 2 of our membership structure, based on your homeless health budget. Thank you for the amazing work you do day in and day out. We appreciate you being a part of this community. Questions? Reach out to membership@nhchc.org!
Connect with us on social media for ongoing updates and news!

Facebook: National Institute for Medical Respite Care
Instagram:
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LinkedIn:
National Institute for Medical Respite Care
Twitter:
NatlInstMRCare

Save the Date

This Coffee Chat is an opportunity for medical respite program staff to share their experiences in providing harm reduction services and to learn from each other, both to navigate challenges and implement new strategies within their programs. This Coffee Chat is open to programs that are exploring harm reduction and to those who are more experienced, creating an opportunity for sharing and learning within the field of medical respite care.
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, plus resource and policy issues.

Respite Kudos and Accomplishments

We’d like to extend a huge thank you to Brooks Ann McKinney who has served as Chair of the RCPN Steering Committee for the last two years. Brooks Ann has completed her term as Chair but will continue to serve on the RCPN Steering Committee. Congratulations to Susannah King and Laurel Nelson who we welcome as the RCPN Steering Committee’s new Chair and Vice Chair for the 2023-2024 fiscal year. 
We’d also like to extend our sincere gratitude to Jordan Wilhelms and Devora Keller who are both ending their time on the RCPN Steering Committee. Jordan and Devora have been incredibly generous with their time and expertise while serving on the Steering Committee and they will be missed. We are so appreciative of their contributions to the field of medical respite and the National Health Care for the Homeless Council & NIMRC!

Respite on the Road

Photos from the 2023 NHCHC Conference in Baltimore.
Photo 1: Laurie Nelson and Brooks Ann McKinney
Photo 2: Jesse Gelwicks, Ashley Brand, and Julia Dobbins
Photo 3: The Medical Respite Team: Tarryn Bieloh, Caitlin Synovec, Julia Dobbins, Samantha Marco, Christa Signor, Stephen Wilder
Photo 4: Medical Respite PCI Attendees
Photo 5: Conference Attendees 

Respite in the News

The awareness of medical respite care and medical respite programs across communities has grown! Many of our respite programs have been featured in the news, in addition to articles that identify medical respite care as a key intervention for people experiencing homelessness.
  • Throughout 2021 and 2022, states have been seeking to include, or have successfully included, medical respite to Medicaid 1115 waivers. These experimental Medicaid-reimbursed programs are reviewed and approved by the Secretary of Health and Human Services to promote the objectives of Medicaid. Much of the funding has historically come from the not-for-profit sector. However, government funding has recently started to increase. Much of the growth and interest can be tied to the January 7, 2021, guidance issued by the Centers for Medicare and Medicaid Services (CMS) for the purpose of driving states to adopt strategies to address social determinants of health, such as access to housing.
  • USICH Executive Director Jeff Olivet delivered remarks at the National Health Care for the Homeless Conference and Policy Symposium. “One thing we know from decades of HCH work is that homelessness is deadly. Every year, far too many of our brothers and sisters die without homes. And every year, far too many of us read their names and light candles to remember them on the longest night of the year. I would like to commend you all for the lifesaving work you do every day, and I would like to commend the council (HCH) and NCAB for your great leadership in shining a light on the mortality associated with homelessness.” 
  • Bakersfield’s Brundage Lane Navigation Center has started accepting patients for a new recuperative care dorm. It takes in unsheltered individuals, who are ready to be released from local hospitals but have after-care needs, such as nursing wounds, broken bones, and IV treatments. The facility has nineteen beds, plus bathrooms, showers, isolation rooms and exam rooms.
  • Louisville's unsheltered population has risen significantly in the past year, advocates warn. Medical respite included as part of the solution. the Coalition for the Homeless released a report outlining steps the city could take to push back against "an acute homelessness crisis," including putting money toward funding 45 medical respite beds – 30 new, 15 existing – for unhoused people who have medical needs when they exit hospitals, by using state and federal funding and Medicaid reimbursement while working with local hospitals and health centers.
  • The city of Albuquerque received more than $100 million in funding from the state legislative session. $10 million is headed for the development of a medical respite facility, a sobering center, and a first responder drop-off area at the Gateway Center.
  • Central City Concern (CCC) is relocating its Recuperative Care Program (RCP) to the former Comfort Inn Hotel. From this new location, staff will provide ongoing medical and housing support for people recently discharged from the hospital but needing continued recovery assistance. CCC is purchasing the 66-unit former hotel to host the RCP program, where they often run at their capacity of 51 participants. The program’s relocation will allow it to expand to address the 25 to 35 patient referral waitlist. Beyond the added space, the new facility offers centrally located access to transportation through the adjacent Max station and the 72 Bus line.
  • The Rhode Island Senate passed legislation sponsored by Senate Health and Human Services Committee Chairman Joshua Miller (D-Dist. 28, Cranston, Providence) for Medicaid Homeless help – funds for one-time transitional costs to get Rhode Island’s homeless into housing. The Medicaid homeless help bill also creates a pilot program of restorative and recuperative care for those experiencing homelessness to recover from illness, injury or medical treatment.
  • Boulder Community Health announced it has launched a new health care program whose goal is to increase access to services and reduce health inequities for vulnerable patients. The new program, called Project HEALS (Health Equity in Achieving Long-term Solutions), is designed to provide continuity of care services for complex case patients who face social and economic barriers to accessing health care, including patients experiencing homelessness, behavioral health conditions, traumatic brain injuries, dementia and substance use disorders. One pillar of the program will include partnering with the Colorado Coalition for the Homeless to offer post-acute care at the Coalition’s new respite facility in Denver for patients with insecure housing who are leaving BCH.
  • Massachusetts Senator Ed Markey announced a $450,000 federal grant awarded to Boston Healthcare for the Homeless to support its medical respite unit the Barbara McInnis House.
  • Santa Barbara County officials, local nonprofit leaders, and DignityMoves held a groundbreaking ceremony for a new homeless facility on May 9. Known as Hope Village, it will have 94 units right across from county offices. Of the 94 units, 10 will be dedicated to 18- to 24-year-olds exiting the foster care system and experiencing homelessness, 30 to recuperative care after a hospital stay, and 54 to community members in general. 
  • The Clearlake (California) City Council approved updates to a contract with Adventist Health for the operation of the Hope Center, a facility to transition individuals out of homelessness. CalAIM will allow them to bill for the services offered at Hope Center, such as recuperative care, housing navigation and sustainability.
  • The Iwilei Resource Center opened in June to provide 24-hour services to Honolulu’s homeless population including hygiene and medical care and helping with obtaining documentation and medical insurance. Honolulu Emergency Services Director Jim Ireland said the decision to open up a medical respite center was made after coming across patients who were living on the streets and were too sick to go to IHS and HONU, but not sick enough to be admitted into the hospital.
  • Aetna’s Medicaid plan in Michigan has granted $250,000 to 10 community-based organizations, aiming to address social determinants of health (SDOH) needs and advance health equity throughout the state. The third grant recipient, Neighborhood Service Organization's Medical Respite Program (Detroit), aims to assist homeless individuals in need of ongoing care.
  • Governor Josh Green, M.D., recently celebrated the arrival of units for Hawaii's first medical respite kauhale, or village, on Oʻahu. The 10-unit village is being constructed by nonprofit HomeAid Hawaii in the mauka-most section of the Department of Health parking lot, will be completely fenced and will have 24-hour private security. The medical respite facility will serve homeless individuals just released from hospital inpatient beds, as well as people without homes who are discharged from the emergency room and have nowhere to go.
  • Unhoused Americans have few places to turn when death is near. Welcome Home, a facility offering long-term medical respite and end-of-life care for unhoused adults, is one of a small number of places in the United States that offers unhoused people a comfortable and dignified option when they are terminally ill.
  • CalOptima Health wants to create a facility to better serve OC’s unhoused, aging population. The proposed $49 million facility will bring recuperative care and elder care services under one roof. The recuperative care center will take care of 119 unhoused older adults working toward a permanent housing placement, and the center will not provide housing to individuals who do not need medical assistance or rehabilitation services. All guests will be allowed to stay until they find stable, permanent housing, the agency said. CalOptima Health anticipates the average length of stay will be one year.
  • A Bay Area health coalition is bringing equity to Black patients seeking respite care. Brenda Goldstein, an independent health care consultant at LifeLong, believes that the connection between respite services and homelessness is critical. She argues that homeless individuals — especially Black people — often suffer from higher rates of chronic illnesses and mental health issues worsened by living on the streets.
  • The Gathering Inn, located in Placer County, CA, was awarded $6.4 million to acquire and renovate an existing property in Lincoln to create a medical respite and licensed Residential Care Facility for the Elderly. The project is expected to add nearly 100 beds.
  • Lessons from the Field: How an Ad Hoc Stakeholder Network Is Helping Redefine Medical Respite Care in Los Angeles, provides a case study of how one local network of providers, hospitals, and plans — the Los Angeles Recuperative Care Learning Network, or LARC — is finding a way forward. Participants are working together to identify and overcome barriers to effectively provide health services through CalAIM to people in the region who are unhoused. LARC first coalesced in 2021 to help as many recuperative care providers as possible begin contracting with managed care plans in anticipation of CalAIM’s launch the next year.
  • The Women’s Medical Respite in Springfield, MO recently purchased a new facility: a four-bedroom house in east Springfield. The WMR program will soon have eight beds, with four of those on the first floor where there will be a wheelchair-accessible bathroom. Since the WMR program started in 2015, 275 women have stayed there as they recovered from medical procedures.
If you have a news story recognizing a medical respite/recuperative care program, please share it with us by emailing Samantha at smarco@nhchc.org.

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 Julia, Caitlin, Stephen, Christa or Tarryn 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.
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