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
April 26, 2024

NIMRC Resource Highlights

Trauma-Informed Design Symposium — Recording and Handouts Now Available! 
In partnership with Shopworks Architecture, this symposium provided attendees with an opportunity to learn in-depth about the importance of trauma-informed design with people experiencing homelessness and strategies to incorporate trauma-informed design principles into all aspects of the program. 
Assessing Health Management Webinar and Publication
Health management skills can be understood as any activities that pertain to developing, managing, and maintaining health and wellness routines – in other words, everything that happens outside of provider interactions. Unhoused individuals experience multiple barriers to managing their health and health conditions, but health centers and medical respite programs have unique opportunities to address and mitigate some of these challenges. To modify health interventions effectively, providers must first engage with consumers to assess their current health management skills and perceptions of their health.
The medical respite team 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

Devora Keller
Greetings, RCPN, happy spring!
The changing of seasons has offered an inspiring backdrop for me to reflect on my first six months as Director of Clinical and Quality Improvement here at the National Health Care for the Homeless Council. Prior to joining the Council, I had the privilege of working with the San Francisco Department of Public Health Medical Respite Program and served as a member of the RCPN Steering Committee. The RCPN, the Clinician's Network, and the NHCHC community have played central roles in my development as a provider and program leader.  I feel both lucky and grateful that my role at the Council has kept me grounded in the mission and work being done by HCH sites across the country. 
My transition from RCPN Steering Committee member to Council staff has enhanced my appreciation for the innovative work happening at respite programs across the country. You are all amazing! Together with NIMRC, your programs are leading by example on a wide range of issues and topics including... 
  • Accessibility 
  • Gender affirming care
  • Behavioral health integration 
  • Support for older adults
  • End of life care for PEH 
  • Reimbursement for previously non-reimbursed services name just a few. These respite efforts are forging the way for HCH programs of all types and helping to set new benchmarks for the HCH movement. 
I am equally excited about the complementary work and advocacy happening across the other teams at NHCHC on a wide range of foci — support and advocacy for individuals living in encampments, enhancing knowledge and comfort with harm reduction practices, integration of JEDI principles into HCH programing, establishing quality metrics relevant and applicable to the HCH population, and diversifying consumers SME representation, to list just a few — that further deepens the work happening in the respite sphere. Special shout out to a series of adapted clinical guidelines about Harm Reduction and Substance Abuse soon to be released — please check them out! 
I am excited to see many of you at our annual conference in Phoenix next month! If we have yet to meet, please say hello! I look forward to supporting you and your teams as I settle further into my new role. 
In partnership, 
Devora Keller, MD, MPH

Respite Kudos and Accomplishments

Medical Respite team member Caitlin and Jack Kline from Hope Has a Home 
Volunteers of America Chesapeake & Carolinas (VOACC) is proud to announce the opening of Hope Has a Home™ for Women, the first residential medical respite program designed to support women experiencing homelessness, mental illness, substance use disorders, and chronic illness in the District of Columbia. A partnership with AmeriHealth Caritas DC, Unity Health Care, Pathways to Housing DC, Developing Families Fund, and The Morris & Gwendolyn Cafritz Foundation, this integrated program will provide care and support to at least 30 women a yearRead the full press release here. 

Activities and Opportunities

HCH2024 NIMRC Networking Reception, Hosted by CommonSpirit 
We’re just a few weeks away from the 2024 National Health Care for the Homeless Conference and Policy Symposium in Phoenix, and we’re excited to see you there! We hope you’ll join us for the NIMRC Networking Reception to meet with fellow medical respite providers, partners, and funders from across the country. The reception will include short remarks from staff regarding the work of the National Institute for Medical Respite Care and the Respite Care Providers’ Network, as well as from CommonSpirit on how they are supporting the field of medical respite care. 
When: May 13 from 5-6:30 p.m. 
On the Oasis Patio of the Arizona Grand Resort and Spa 
Save the Date: Coffee Chat on Navigating Ethical Dilemmas in Medical Respite   
Medical respite care is an incredible opportunity to provide space for healing and recuperation. However, because of the many medical and behavioral health needs resulting from homelessness, combined with the lack of community resources, programs may be faced with challenging decisions and ethical dilemmas. Often in these cases, there is not a clear-cut pathway or decision, but instead requires programs and staff to carefully consider options that manage the safety and health of all medical respite clients and staff. This Coffee Chat presents an opportunity for the medical respite community to come together to discuss ethical dilemmas that can present with programs and identify strategies to support staff in addressing these dilemmas through collaboration.
When: June 26 at 3 p.m. EDT/2 p.m. CDT 
Via Zoom. Registration link coming soon to our webinars page! 

Join NIMRC for the Inaugural California Recuperative Care Symposium  
The National Institute for Medical Respite Care (NIMRC), a special program of the National Health Care for the Homeless Council (NHCHC), hosts the inaugural California Recuperative Care Symposium, September 12-13, 2024, at the Hilton Arden West in Sacramento, Calif. Embracing the theme Cross-Organizational Solutions for a Seamless System of Care, NIMRC elevates the growing practice of Recuperative Care (also knows as Medical Respite Care) as an integral component of our mission to build an equitable, high-quality health care system. We are excited to showcase many of these promising practices, models, and examples of leadership at this groundbreaking event. Early-Bird Discounted Registration will open May 9. More details are available on our website. 

Respite on the Road

Above and below: Medical Respite Team member Samantha at a site visit to The INN Between in Salt Lake City, Utah. 
Above: Medical Respite Team Member Brandon at a site visit to The Guest House in Chicago.  
Above: Medical Respite Team site visit at Pico-Union in Los Angeles. 
Group picture of Los Angeles Recuperative Care Learning Network Forum attendees. 
On March 28, the L.A. Recuperative Care Learning Network welcomed more than 75 attendees to the 2nd annual Forum event at the Garland Hotel in Hollywood, Calif. A lively gathering of recuperative care providers, health plans, hospitals, and other community partners, the Forum celebrated the Network’s two years of building partnerships, collaborating on solutions, establishing protocol around CalAIM reimbursements for Recuperative Care services, and improving the system of care for people experiencing homelessness in Los Angeles County.  
The Forum, and the monthly meetings of the L.A. Recuperative Care Learning Network, are funded by Kaiser Permanente, supported by the Hospital Association of Southern California HASC), and facilitated by the National Institute for Medical Respite Care (NIMRC). 

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.
  • The Servant Center, a nonprofit in Greensboro NC, is acquiring and renovating a building to provide 43 beds for the community, some of which will be for medical respite. The Greensboro nonprofit helps the unhoused and disabled, and in particular veterans, to become independent. More information can be found here as well. 
  • The Fresh Start program, a resource center and emergency shelter for homeless families operated by Lebanon County Christian Ministries in Pennsylvania, will become a partner with WellSpan Health's Arches to Wellness program, a recuperative care medical respite program providing those facing health challenges and lack of housing with a place to stay while they receive medical support. 
  • Fifty people in need of not just shelter but clinical support, care coordination and a sense of community will now have a place to call home with the official opening of Hookahi Leo, Hawaii’s third kauhale respite village, in Kalihi HI. The new kauhale’s name means “a community with one voice” and will be operated by the Hawaii Health and Harm Reduction Center 
  • Project Hope and Adventist Health/Rideout are working on a two-phase project in the Yuba-Sutter area of California. Phase one will focus on renovating a property in Yuba City and repurposing it as a medical recuperative care and sobering center. The second phase will transform the former Fremont Hospital into a comprehensive medical campus. 
  • WVU Medicine United Hospital Health Center is partnering with the United Way of Harrison and Doddridge Counties to establish the first medical respite care center in the state of West Virginia. A medical respite care facility would provide better continuity of care, along with access to integrated medical care and support services. 
  • In November 2023, the city of Vancouver, WA declared a civil emergency in response to increasing homelessness. “It’s one of the reasons we declared the emergency, to be able to respond more rapidly,” said Jamie Spinelli, the city’s homeless response manager. She added the city is working on establishing a so-called  bridge shelter which would provide 150 beds, as well as services such as medical respite beds, on-site substance use disorder services, a medication-assisted treatment clinic and peer support. 
  • A highly-anticipated medical respite shelter with 53 permanent supportive housing beds and 65 medical respite beds might open by the end of 2024 in Tacoma, WA. The Low-Income Housing Institute has received $3.85 million for a contract that is expected to be executed this summer and the shelter will be at a former Clarion Inn. 
  • Preble Street in Portland, ME had a few lovely successes with moving two chronically homeless clients into permanent housing. One worked with Preble Street’s rapid re-housing program, and the other client was a medical respite patient before transitioning into housing.  
  • The city of Santa Cruz, CA plans to open a new 34 bed facility by the end of 2024. The shelter will be considered a navigation center and will provide more intensive services for clients, who will be able to stay for about 6 months. “This will be the first of its kind referral-based facility in Santa Cruz County and will provide a service-rich environment with on-site interim housing so that individuals with psychiatric health and substance use disorder needs are not discharged back to the streets,” said Robert Ratner, Housing for Health Director. 
  • Shepherd’s House Ministries in Bend, Ore., recently hired a part-time residential nurse into their medical respite program, who “has made an immediate impact by helping coordinate medical care, engaging in wound care, improving communication with medical providers, and overseeing hospice at home”. Funding was received via a two-year grant from PacificSource Community Solutions, further bolstered by a matching contribution from the Central Oregon Health Council. 
  • A new medical respite program for women just opened in D.C., Hope Has a Home. Operated by Volunteers of America, their 8-bed home will provide 24-hour assistance for those staying there, and support for physical and mental health challenges. 
  • The Max-Well Respite Center in Pensacola, FL is a transitional housing program under the non-profit organization Re-entry Alliance Pensacola. The pilot program provides homeless patients with a place to heal when they need care after leaving the hospital. “We want to be sure they have a safe plan of care once we discharge them so that they can continue to heal at home and that's challenging when home is outside,” explained Christie Jandora, nurse and director of emergency services at Ascension Sacred Heart. “This program will provide them a bed to go for up to 90 days. 
  • In Fullerton, CA, the city council approved the purchase of a homeless shelter using legislative money, an earmark of about $9.5 million. Also, an operating agreement was made between the Illumination Foundation and the Navigation center. The city plans to pay for 40 beds at $80 per bed. Previous conversations have included ideas to incorporate recuperative care beds as well. 
  • In Santa Maria, CA, Hope Village Interim Supportive Community recently opened. Hope Village aims to provide temporary housing for unhoused people in North County. Thirty rooms are reserved for unhoused individuals who require recuperative care after being discharged from hospitals. Good Samaritan Shelter will provide 24/7 care. 
  • New Beginnings, a transitional housing community in Fayetteville, AR plans to provide medical respite units for unhoused residents discharged from the hospital. The program, called A Place to Heal, is a partnership with Washington Regional Medical Center and Blue & You Foundation. 
  • St. Mary’s Community Services in the process of building and establishing Project Pathways, a new shelter in Stockton, CA. The emergency shelter will offer 288 beds and include 46 recuperative care units. The shelter will accept clients’ partners and pets. “We expect to be able to open by the end of the year,” said Petra Linden, CEO of St. Mary’s Community Services. 
  • The Inn Between in Salt Lake City, UT provides medical respite and end-of-life care to those experiencing homelessness. The group provides a home environment that enables adults experiencing homelessness to gain access to professional hospice care from state licensed hospice agencies, undergo life-saving medical treatment, stabilize in preparation for surgery, or recuperate from serious injury. One of our medical respite managers, Samantha Marco, visited last month. 
  • Depaul USA Daybreak has partnered with the Macon Housing Authority in Macon, GA to open 82 units of mixed income housing and a twelve medical respite beds. 
  • In Eureka, CA, the Mother Bernard House recently opened and will be providing 48 units for people experiencing homelessness, and six of these units are dedicated to recuperative care. 
Policy News
  • While medical respite care has so far been limited in New York, it’s on the verge of expanding. In January, the Biden administration gave New York permission to bill Medicaid for the service, opening up a new funding stream. There are currently two respites in Harlem that have about 100 beds between them, and at least another two upstate. The state health department is offering nonprofits $50,000 grants to open another eight. 
  • This article discusses budgetary changes made by New York City Mayor Eric Adams, including an update on recent medical respite activities in New York City. NYC Health + Hospitals has served over 1,100 respite patients as part of its Housing for Health initiative. Seventy-five percent of patients completed their medical respite stay, and over 300 people were exited from respite into more stable housing.  
  • Legislative Bill 905 passed unanimously in Nebraska, which requires the state Department of Health and Human Services to apply for a Medicaid waiver or state plan amendment with the federal Centers for Medicare and Medicaid Services by Oct. 1, 2025, to designate two medical respite facilities for homeless individuals in the state. The facilities will be reimbursed for services to qualified individuals. The bill also provides the department with authority to license adult respite care facilities and authorizes funding for the program from the Medicaid Managed Care Excess Profit Fund. 
  • A new law passed that will qualify Nebraska’s hospitals for approximately $1 billion of additional federal Medicaid funds each year. “LB1087 is one of the most impactful and transformative pieces of legislation that we passed this session," said Sen. Jacobson. “This program allows our state to dramatically increase reimbursement rates to hospitals without costing our state general fund any additional dollars. It will have a dramatic impact on reimbursement rates, hospital services, and ultimately on the availability of health care across the state." 
  • As of February 2024, the Biden administration has approved eight 1115 demonstrations under the new health-related social needs waiver framework. These waivers authorize evidence-based housing and nutrition services for specific high-need populations. Several approvals build on prior 1115 waiver initiatives (including California’s CalAIM transformation). This article provides state-specific information on how 1115 waivers can be used to cover medical respite care.  
  • Section 1115 Medicaid waivers can help states reduce health inequities by covering housing costs and providing meal support for vulnerable pupulations. This article gives an overview of what states are working on, and how medical respite services fit into the waiver’s coverage. 
  • This article explores an exclusion which prohibits Medicaid funds from covering an individual’s care at an institution of mental disease (IMD), defined as a facility with more than 16 beds with the primary function to diagnose or treat people with behavioral health disorders. This policy limits a county's ability to build healthcare systems that have the capacity to adequately serve their communities, while also perpetuating patient inequities by limiting access to services in the most appropriate settings. It includes a case study of the Los Angeles County Department of Mental Health and shows the cost savings benefits of recuperative care centers.

If you have a news story recognizing a medical respite/recuperative care program, please share it with us by emailing Beau at   

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

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Facebook: National Institute for Medical Respite Care
National Institute for Medical Respite Care

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