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Respite News
A Quarterly Newsletter for Members of the Respite Care Providers' Network
August 24, 2022
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| NIMRC Resource Highlights
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NIMRC has several exciting new resources to share:
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Medical Respite Online Course
The National Institute for Medical Respite Care has launched its first Medical Respite Online Course. This resource is available to medical respite programs, providers, and staff as a way to learn more about essential topics related to medical respite care. Each course is 60 minutes and includes an assessment of learning and recommended resources for further learning.
Currently available course topics include:
- Discharge Planning and Processes in Medical Respite Care
- Demonstrating Quality in Medical Respite Care: The Importance of Data
- Harm Reduction
Upcoming course topics include:
- Relationships with Managed Care Organizations
- Trauma Informed Care in Medical Respite
- The Role of Community Health Workers, Case Managers, and Peers
- Addressing Behavior Health and the Role of the Behavioral Health Consultant
- Relationships with Hospitals
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At the end of each course, the user will have an opportunity to share feedback that will be incorporated into additional resources and activities. We encourage all medical respite program staff to use the courses for learning and staff training.
Courses can be accessed here: https://nimrc-nhchc.talentlms.com/
Note: users will be required to create an individual log-in to access the course.
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Promising Practices: Providing Behavioral Health Care in a Medical Respite Setting
Consumers in medical respite care (MRC) programs have complex medical and social needs that are often driven and exacerbated by underlying mental health and substance use (behavioral health) conditions. As MRC programs strive to optimize outcomes and provide whole-person care, they are increasingly exploring innovative approaches to integrate behavioral health care into their service models.
In support of programs’ efforts to meet the behavioral health needs of their consumers, the National Institute for Medical Respite Care (NIMRC) conducted listening sessions, interviews, and a review of relevant research around behavioral health in MRC settings. This resource presents a summary of the findings and highlights promising practices in behavioral health care that are currently being implemented in MRC programs across the country. It outlines strategies and approaches that can be replicated and adapted to other programs’ unique contexts, equipping them to deliver high-quality care that is consistent with the Standards for Medical Respite Care and is responsive to the needs of people experiencing homelessness (PEH) in their communities. These promising practices represent ongoing, dynamic work being done by MRC programs nationwide and demonstrate their commitment to continuously improving outcomes for PEH.
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Now Available: Trauma Informed Environment in Medical Respite Webinar Recording
Medical respite care provides a safe place for healing and recovery from acute health care events for people experiencing homelessness. Within these programs, providing trauma-informed care is essential. A critical element of trauma-informed care is providing a safe and healing environment, one that is accessible, comforting, and promotes recovery.
This webinar provided an overview of on creating a healing environment within your own medical respite program, applicable to all programs with a variety of resources and clients served. The recording and slides are now available.
Have questions about setting up a trauma-informed or accessible environment? Please reach out to Caitlin at CSynovec@nhchc.org.
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Hello, RCPN Members!
If the COVID-19 pandemic brought any silver linings, medical respite care was one of them. Now, there is rapidly growing interest coming from Medicaid systems, health centers, and the broader world of homeless services to partner, invest in programs, and find financial sustainability for programs.
Accordingly, our policy work over the past year has focused in these three areas. As Medicaid systems are increasingly focused on social determinants of health, we’re excited to see California move into the implementation phase of their state-wide recuperative care benefit. Following close behind, Washington State and Utah formally submitted 1115 waiver requests to the Centers for Medicare and Medicaid Services (CMS) that include a medical respite benefit. I was delighted to have contracted with Washington State to host a series of listening sessions with key stakeholders and issue a report to help guide how a statewide benefit might be structured. Going forward, watch for actions coming from Colorado, Illinois, Minnesota, New Mexico, and New York—all of whom are taking concrete steps to evaluate how to include medical respite in their Medicaid plans.
Likewise, health centers are also expanding to include medical respite programs. Most recently, the Colorado Coalition for the Homeless in Denver opened its program, as did one at Hennepin Health in Minneapolis. To that end, our most recent policy brief illustrates how health centers can fulfill mission and enhance value to their community by adding a medical respite care program, outlines both the advantages and challenges to such an expansion, and offers steps for health centers to consider. Over the next few years, we’d like to support more health centers to add medical respite care to their scope of service.
Finally, let’s not overlook our partners in homeless services. NIMRC conducted listening sessions with medical respite and HUD-funded Continuum of Care (CoC) staff respectively, and published an issue brief that illustrates how they can effectively partner to improve systems of care and better meet the health care needs of people experiencing homelessness. [Bonus: it includes a spotlight on the great partnership in Yakima, Washington!]
Yes, there are many policy issues of great concern that are impacting the HCH community—such as increasing criminalization of homelessness, rising housing costs, and a lack of additional federal resources—but good things are happening too! Your steadfast advocacy has advanced the field of medical respite care, improved public policy, and directly benefited vulnerable people needing care. That’s simply fantastic.
Onward we go!
Barbara DiPietro, PhD
Senior Director of Policy
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| Activities & Opportunities
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Save the Date
Coffee Chat: Medical Respite and Addressing Monkeypox
Thursday, September 8th - 1:30 p.m. ET
Monkeypox has been recently declared a public health emergency by federal officials. Medical respite programs may have or will be asked to support individuals with monkeypox. However, this presents as a challenge as monkeypox is an infectious disease with specific guidelines to prevent transmission and infection; unfortunately, those within congregate settings are more at risk.
Please join our coffee chat to share in discussion around how monkeypox is currently affecting your community, protocols you have implemented, and concerns and challenges you are facing. As a community, we can learn from each other to put forward practices that keep our clients and staff safe, while increasing the health and well-being of those we serve. For initial guidance on monkeypox in people experiencing homelessness, please read the Council’s newest fact sheet, and join us on September 8th. Register here.
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RCPN All Member MeetingWednesday, September 28th at 2:00 PM ET
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. This will be followed by a large group discussion on current issues affecting the field, where attendees have the opportunity to connect with each other, share experiences, and learn insights from other programs. Register here.
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| | Respite Kudos & Accomplishments
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Congratulations to Gargi Cooper, who received the 2022 Beacon of Hope Award from the Lynn Continuum of Care, in Lynn, MA. The Beacon of Hope Awardee “embodies the mission of the CoC by displaying in their daily work the mission of ending homelessness; does more than what is required and makes a visible difference in the life of the people being served; and always demonstrates dignity and respect while engaging with everyone.” Gargi is a Family Nurse Practitioner with the Deborah Smith Walsh Recuperative Care Center and Lynn Community Health Center. Read more about Gargi and her award here.
If you would like to highlight a medical respite program or provider in the next RCPN newsletter, please send your “kudos” to Caitlin at csynovec@nhchc.org
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| | From the Medical Respite Community
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Twenty, one-dollar items to take your medical respite program to the next level By Julia Gaines
“It’s the little details that are vital. Little things make big things happen.”
– Coach John Wooden, Creator of “The Pyramid of Success”
When a patient arrives in your medical respite, they may be feeling confused, overwhelmed, maybe even scared. They still may be experiencing physical pain and discomfort. And most likely the incident that landed them in the hospital was traumatic, and maybe left their affairs in disarray and their next steps shrouded in uncertainty.
This is where the little things can make a big difference in their recovery. Sure, respite care programs need medical supplies, bedding, socks and basic personal care items, but what makes residents feel comfortable and welcomed? What makes their space feel safe and organized? What gives them hope, and the feeling that they matter?
With the client experience in mind, for the last few years I’ve trying out items at our local Dollar Tree for our shelter’s Recuperative Care unit. Some are practical, some are fun, but all these seemingly simple and insignificant accessories have made a huge impact on our respite program, improving safety, cleanliness, roommate relations, self-sufficiency, and the resident’s overall sense of contentment and dignity.
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Check out how far a dollar can go with these must-have discount store items for your respite!
- Earbuds: If your residents share a dorm-style room, then no doubt there are often movies or music playing on multiple devices at any given time. But when night owls keep their roommates up with the sounds of Hollywood car chases and dance numbers, tensions may flare. Supplying a pair of earbuds to every streaming enthusiast allows them to stay quietly entertained without interrupting their neighbor’s zzz’s.
- Flip flops: aka “shower shoes” are a must for those bathing in highly utilized bathrooms to keep infections at bay. But remember: if a client has mobility issues, they may want to avoid walking to and from the bathroom in flip flops, as they are not stable shoes for walking.
- Notebooks: Whether it’s a mini spiral-bound notebook to jot down phone numbers and to-do lists or a hardcover journal to doodle or process their journey through recovery, every resident could find a use for this tool!
- Laundry bags: Garbage bags seems to be the #1 mode of transporting clothing, but these drawstring laundry bags give the resident a little more dignity and security when transporting their clothes.
- Phone chargers: Cell phones are our lifeline to practically everything, and they are even more vital to our unsheltered, for whom their phone may be the main link to the world around them. Since many of our respite residents arrive with dead cell batteries, it’s always handy to have a couple types of phone chargers on hand to help keep them connected to those who matter.
- Small disposable cups: I don’t think we’ve ever had a resident who didn’t have at least one medication to take regularly, so it’s smart to keep small cups accessible with a water pitcher so they’re able to take their meds independently 24/7 (you can also purchase reusable water bottles for $1, but if residents are on a restricted-liquid diet or have night time incontinence, you may want to avoid a large bedside bottle of water).
- Hot and cold packs: From lower back pain to hand cramps from arthritis, when pain meds don’t quite do the trick, these items provide an additional level of comfort. I also recommend a couple tubes of tooth numbing gel to keep clients comfortable until they can get to the dentist for that toothache (yes, clients have said the dollar store brand works!).
- Picture frames: Frame your respite’s mission and values, important phone numbers, program guidelines or the weekly group activity schedule to keep information at your client’s fingertips. It also reinforces their purpose in your program and hopefully encourages engagement in social activities!
- Whiteboards: Our Recuperative Care program is mad-serious about lining up those doctor appointments, diagnostic tests and home health visits, but this healthcare-heavy schedule can be difficult for the resident to remember. So, each bed has its own 8x11 dry-erase whiteboard Velcroed to the wall so staff can write these reminders in a place easy for the resident to see. This is especially useful for residents with dementia, for whom we can write the date and their location to help them feel grounded. Another great whiteboard investment is a large one for the common area that has a row for each resident by bed #. Here they can see their entry and exit date and a list of their upcoming appointments all in one place.
- Plastic storage bins with snap lids: Safe storage can be a challenge, so a shoebox-sized bin with a secure lid helps keep a resident’s prescriptions all in one place and not piled up and exposed on their nightstand. If your clinical staff distributes medications to clients, these bins could be labeled and locked in a cupboard only accessible to staff.
- Peel n’ stick hooks: Keep the floors clutter-free! With hooks in various sizes, residents can hang towels, washcloths, and sponges in shower, or hang their earbuds, jacket, or favorite picture next to their beds without damaging the walls. And the hooks can be moved to accommodate each resident’s accessibility needs.
- Calendars: Whether it’s for their medication schedule, medical appointments or to keep track of their case management tasks, a simple wall or pocket calendar can help residents remain goal-focused, organized and their brains clutter-free.
- Disposable washcloths: Let’s get real, showering isn’t always the easiest (or safest) activity for our respite folks. Sometimes they also have a healing wound and bandaging that can’t get wet. So, when a shower isn’t in the cards, access to disposable washcloths can help a resident feel clean and fresh even if they rarely leave their bed.
- Rugs: Be wary of slipping and tripping, of course, but a thin bedside rug with good traction and that’s secured to the floor provides a comfortable landing for bare feet in the morning. It also adds some color and a cozy “home” feeling to an otherwise institutional-like environment.
- Nightlights: Another roommate-relations saver, another nighttime complaint is about people turning on the lights to walk to the bathroom. Nightlights provide a safely illuminated walkway to the bathroom without disturbing others’ slumber. A small tap light next to the bed is also good for those who need to take medications in the middle of the night or for avid readers who just want to read one more chapter.
- Pocket folders: Our Recuperative Care’s intensive case management program results in the accumulation of numerous documents during a resident’s stay. To keep it all organized and accessible, put their care plan, worksheets, med list and hospital discharge summary in one pocket folder labeled with their initials. Their next case manager will thank you for it!
- Cube storage containers: Coming to Recuperative Care with excessive belongings is a common issue for residents who travel with everything they own. But messy beds and walkways pose a trip hazard, and the uncleanliness can create garbage and pests. Fabric storage cubes, which come in various sizes and patterns, make it possible to utilize under-bed space for things like socks andunderwear, toiletries, and other trinkets because they are flexible enough to adjust to even the tightest spaces.
- Puzzle books: It’s said that idle time is the Devil’s playground, and the long days of recovery can wear on the resident’s mental and emotional state. To help with restlessness and to avoid behaviors unhelpful to recovery, a good crossword or Sudoku puzzle can keep their brains stimulated while their body rests. And who says this has to be a solo activity? Add a deck of cards, dice cup, coloring books, and board games for a full-on entertainment cupboard so residents can enjoy activities together! (Don’t forget religious and recovery books, too!)
- Inspirational decor: The Dollar Tree has a ton of colorful canvas signs, shiny floral wall decals, and wooden, metal and porcelain tabletop decor that say inspirational things like “Attitude of Gratitude” and “You’re Amazing!” It helps keep the mood light and hopeful at a time when residents may be experiencing some seriously heavy health issues. Also, don’t forget to check out the seasonal DIY decor that residents can custom craft themselves!
- ‘Happy Birthday’ banner: On occasion, a resident celebrates a birthday during their respite stay. While birthdays can stir mixed feelings, our Recuperative Care staff never miss an opportunity to celebrate a resident and show them that they are among friends. So, we keep a birthday banner on hand to hang on the wall over the resident’s bed on their special day. Pair the banner with a heartfelt card secretly signed by staff and other residents the week prior, and you’re likely to see their face light up in surprise over the thoughtful acknowledgement of their special day.
Note: This list is by no means exhaustive. Dollar stores carry all sorts of solutions for respite care that are affordable on our limited budgets. But if your program has a few extra bucks, I highly recommend the additional items available online for under $10: alarm clocks, so residents wake up independently and on-time for their appointments, metal mesh gloves so staff stay safe from sharps when packing up residents’ belongings, grabber tools for those residents who risk falling out of their wheelchair when reaching to pick things up from the floor, and simple combination locks (preferably with resettable 4-letter word combos rather than numbers) so residents can secure their valuables in a locker with a lock that’s easy to operate (and there’s no key to misplace!)
Julia Gaines is the Senior Supportive Programs Manager for the Committee on the Shelterless (COTS). She joined COTS in January 2020 to open the Recuperative Care program at Mary Isaak Center, located in Petaluma, CA. Julia has worked as a sub-acute care CNA, a nonprofit development coordinator, and journalist.
What items can your medical respite not live without? Julia would love to hear from you! jgaines@cots.org
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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.
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If you have a news story recognizing a medical respite/recuperative care program, please share it with us by emailing Caitlin at csynovec@nhchc.org.
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| | Respite Care Providers' Network Information
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- 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, or Christa 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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