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Respite News
A Quarterly Newsletter for Members of the Respite Care Providers' Network
April 25, 2023
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| NIMRC Resource Highlights
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Medical Respite Fidelity Measure – Participation Needed!
The National Institute for Medical Respite Care is in the process of developing a Fidelity Measure for Medical Respite Care Programs.
The goal of the Fidelity Measure is to help identify a program’s fidelity to the mission and values of medical respite care. Having a structured, standardized Fidelity Measure helps to ensure people experiencing homelessness have access to, and are receiving, quality care while in a medical respite program.
As part of developing a standardized measure that reflects the variety and diversity of medical respite programs across the country, we are soliciting participation of medical respite providers in the testing process.
Who: Any/all medical respite program staff
What: Complete the online form, which will take approximately 20 minutes
When: By Sunday, April 30
We welcome participation from any staff working within a medical respite program and are also interested in having multiple staff from the same program complete the form.
If you have any questions or feedback about the Fidelity Measure, please email Caitlin at CSynovec@nhchc.org.
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Clinical Guidelines for Medical Respite Care Programs
One of the challenges of providing care to people experiencing homelessness is that many medical guidelines and interventions are not developed with consideration of housing status. General recommendations for addressing acute and chronic conditions are often based on the assumption that a person has stable housing, economic resources, or available support systems. In response to this challenge, the National Health Care for the Homeless Council (NHCHC) and the National Institute for Medical Respite Care (NIMRC) have developed adapted clinical guidelines for providers working with this population.
The Clinical Guidelines for Medical Respite Care are a series of publications intended to guide practitioners within the MRC setting for clinical decision-making for various medical conditions, symptoms, and needs. All published Clinical Guidelines are located within the Medical Respite Toolkit. Conditions covered within the new Guidelines include:
NIMRC remains open to the needs and ideas of medical respite programs! If you have questions or ideas for new resources, please contact us!
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Hey there, RCPN Members!
For those of you who I have not had the privilege to meet yet, my name is Christa Signor and I am a Program Manager on the Medical Respite team. In January, I celebrated my one-year work anniversary with the Council and NIMRC. Prior to joining NIMRC, I started my journey right out of college working with our unhoused community members as a Recreation Specialist on an integrated care team in Permanent Supportive Housing (PSH). During my time in PSH, I immediately fell in love with the work, and more importantly, the people. I had the privilege of seeing firsthand the power of meeting basic human rights, like housing and healthcare, and what it can do for health outcomes and quality of life. After, I went on to earn my Master's of Science in Recreation and Leisure Services (MSRLS), and then became a Recreation Therapist (CTRS). Post graduate school, I worked simultaneously at an Inpatient Behavioral Health Hospital as a Recreation Therapist and at the CoC in Austin, Texas, as the Healthcare System Liaison on the Housing for Health Team. In these roles, I worked directly within the intersection of housing and healthcare, at the system and provider levels, during the initial years of the pandemic.
All this to say, within my almost decade in Homeless Services I have experienced a wide range of emotions. I have experienced immense joy helping community members move into their housing and seeing the light in their eyes when they knew they could close the door to their home for the first time in years. I have experienced immense frustration with the system seeing the significant gaps and injustices that exist. I have also experienced immense grief from community members passing away too young, too soon, from being unsheltered during winter storms, and from services that came far too late. I say this not to be a total downer, but to acknowledge the emotions and scars, moral injury, and secondary trauma that seems to come as a package deal with the work. I consistently hear the range of emotions providers are living with, and I just want to take the opportunity to name the fight to end homelessness truly is an emotional fight, and you are not alone.
As a collective, we are quick to focus on what we can do for others and how we can help our community, managing consistent crisis after crisis, and silently shouldering our feelings because there’s still work to be done. However, if we intend to stay in the fight for as long as it takes to end homelessness, we must take care of ourselves. So, let’s talk about self-care! Recently I read a piece that highlighted the difference between self-care and self-comfort that I would love to share and remind us of. Spoiler alert: as you may know, they’re not the same, and this is important! Self-care is the process of engaging in practices that are truly restorative. This is a combination of exercise, eating healthy, and restful sleep. This also looks like connecting with others, being in nature, drawing, participating in sports, and practicing meditation. Alternatively, self-comfort (aka self-soothing) is doing something that makes you feel good in the short term, but is not fundamentally refreshing to you (I.e., binge watching TV or eating a feel-good snack). The true test of whether a practice is self-care is the outcome: does the action provide genuine restoration?
Moving forward, the Recreation Therapist in me would like to challenge you with these questions:
- In what ways are you practicing self-care?
- How can you improve your self-care practices this week?
- In what ways are we supporting staff with their self-care practice?
I am so grateful and could not be more honored to be in this fight every day with all of you. Please make sure you’re caring for yourself, and if you need help coming up with some self-care ideas, or just want someone to hold space, the NIMRC team is always here.
As always, thank you for all you do in the fight to end homelessness!
Together,
Christa Signor, MSRLS CTRS
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Register now for the 2023 Health Care for the Homeless Conference & Policy Symposium in Baltimore Registration is now open for the 2023 National Health Care for the Homeless Conference & Policy Symposium! This year’s conference will be held May 15-18 in Baltimore. For the first time ever, this year’s conference will include a Medical Respite Care workshop track. We’ve curated a Medical Respite workshop track that addresses a broad range of complex topics including financing, building partnerships, harm reduction, connections to housing, and engaging with clients post-medical respite care. In addition to the excellent medical respite content that will be provided during the conference, NIMRC is hosting a Networking Reception for medical respite providers, supporters, and funders. All conference attendees are invited to join this reception which will be held at the conference hotel on Monday, May 15, from 5 p.m.-6:30 p.m. Attendees will have the opportunity to hear from three foundations about their investment in medical respite care and how programs can partner with local foundations. Attendees will also get to network with other providers from across the country. We hope to see you there!
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| Respite Kudos & Accomplishments
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Congratulations to Monte Hanks, who is the 2023 Willie J. Mackey National Medical Respite Award recipient!
Monte is the Assisted Living Facility Administrator at The INN Between in Salt Lake City, Utah. Monte began his work in this field with Wasatch Homeless Healthcare, Inc. (Fourth Street Clinic), where he stayed for more than 25 years as the Client Services Director, Case Management Supervisor, and Clinic Liaison. While at Fourth Street Clinic, he created and developed Case Management, a Recuperative Care Program, a Dental Referral Project, and a TEAM approach to potentially violent situations.
In 2005, Monte published a study titled “It Takes a Village: A Multidisciplinary Model for the Acute Illness Aftercare of Individuals Experiencing Homelessness” alongside eight individuals from across the state of Utah. This study focused on the effects of early medical respite programs for individuals exiting the hospital, yet still needing care. Though he didn’t realize it, this study, and his involvement in the early development of a local “Hospice for Homeless” program, became the building blocks for what would become the INN Between. The INN Between officially opened its doors in August 2015 and has since provided a safe home environment for 114 unsheltered individuals to pass away with dignity, as well as a clean space for more than 500 unsheltered individuals to receive their medical recuperative care.
Congratulations to the Center for Respite Care in Cincinnati, Ohio, which is celebrating 20 years of operations. The Center is the region’s only organization that cares for people experiencing homelessness once they are released from the hospital. Much of their success has been credited to partnerships with community organizations and relocation to a new facility that increased capacity by 40%. Read more about the impact on the community and follow along as the Center celebrates 20 years by acknowledging 20 contributors that have been instrumental in their success.
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| Activities & Opportunities
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Participate in the testing of the Medical Respite Fidelity Measure by completing this survey.
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(Left) The NIMRC Team traveled to Birmingham, AL to tour the Firehouse Respite Program. Pictured here: Abby Poole (Firehouse) and NIMRC team members Tarryn Bieloh, Caitlin Synovec, Christa Signor, Samantha Marco and Stephen Wilder.
(Right) The LA Recuperative Care Network hosted a forum in Burbank, CA. Pictured here: Julia Dobbins (NIMRC/NHCHC), Ana Reza (VP of the Hospital Association of Southern California), Jacey Cooper (California State Medicaid Director), Pamela Mokler (Pamela Mokler & Associates), and Bobby Watts (NHCHC).
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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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- A new pilot program will help unhoused Rhode Islanders with medical needs. The Medical Respite Care pilot will serve community members statewide experiencing homelessness or housing insecurity who are preparing for or recovering from medical procedures, hospitalization, or generally are in need of a safe place to heal from an acute illness or injury.
- A collaborative effort by Three Oaks Center, MedStar St. Mary’s Hospital, and St. Mary’s County Health Department (SMCHD) is providing medical respite services to residents who are homeless in Maryland.
- Victorville begins installing modular units at $28 million Wellness Center for the homeless. The campus will have a low-barrier emergency shelter, recuperative care facility, medical clinic, interim housing, and wraparound support services.
- Clallam County Health & Human Services has launched a pilot program designed to provide shelter and medical services to Clallam County residents who are homeless and in need of a safe place to recover from illness or injury.
- Brundage Lane Navigation Center expands beds, adds medical services. The expansion, funded by the Biden administration's American Rescue Plan Act, not only increased the number of beds in the center, but it also includes a new pet kennel that can hold 50 animals, additional outdoor recreational space, and a recuperative care dorm run by Kern Medical.
- Respite program addresses many needs of Omaha’s homeless. The 24-month pilot program, which began in August, stems from an area Health & Housing Coalition that charted how well-being is adversely affected by unstable housing, making follow-up care problematic and resulting in high re-admissions.
- Ka Hale A Ke Ola Homeless Resource Centers and the Pacific Cancer Foundation are working together to help homeless cancer patients on Maui get safe, clean housing for vitally needed, life-saving medical treatment.
- The Salvation Army received $4 million in federal funding to help build its new emergency shelter and community center in Madison. The new buildings will be part of a $50 million, two-building campus that includes a multi-family apartment complex with affordable housing units called The Shield. The Shield and shelter are meant to provide emergency housing to homeless families and single women, medical respite, mental health programs and housing services.
- By early May, 74 new shelter and transitional housing units will be ready for veterans and medically fragile people experiencing homelessness in Salem, Oregon. With recent and ongoing renovations, including the conversion of up to 10 rooms into ADA-accessible units, the facility is suited for medical respite and allows for a trauma-informed approach to services that meets the Veterans Administration standards, agency leaders said.
- Louisville's Coalition for the Homeless released a new 4-step plan to end homelessness. Step three includes funding 45 medical respite beds for newly discharged unhoused patients. The coalition plans to leverage state, federal funding and Medicaid reimbursement while also working with Norton and UofL Hospital and Family Health Centers.
- Rocky Mountain Refuge helps unhoused Coloradans find peace in the face of death. They offer end of life care for those experiencing homelessness regardless of race, age, gender, gender expression, age, nationality, disability or marital status.
- Formerly homeless woman moves into new apartment with help from local organization & state program. PATH San Diego and CalAIM helped woman get into Chula Vista apartment.
- Personal View: Funding needed for medical respite care for homeless adults. Today, Joseph & Mary's Home is Northeast Ohio's sole provider of medical respite care for medically fragile people experiencing homelessness.
- The Alameda Alliance for Health (AAH) awarded Alameda Point Collaborative (APC) $4 million in funding for the development of the medical respite center at the future Alameda Wellness Campus. The 50-bed high acuity medical respite program will serve 400 unhoused Alameda County residents annually, according to its website. This recuperative care will support clients to resolve acute medical conditions, stabilize chronic conditions and receive dignified end-of-life care.
- Drexel House, a program of Catholic Community Services of Western Washington, located in Olympia, opened two medical respite beds. Drexel House has 86 units of permanent supportive housing for men and women coming out of homelessness, along with an emergency shelter for 16 men. Residents are provided case management, referrals, transportation, and supportive services, with the goal of breaking the homelessness cycle.
- New Facilities Increase Access at Sojourner House Medical Respite Program. With the installation of lifts both inside and outside the house, Sojourner House is now able to more easily accommodate patients.
- A proposed medical complex in northeast Austin could bring healthcare services closer to low-income patients and people experiencing homelessness, Central Health announced last week. Central Health said the new complex “will fill critical gaps in care.” It will include clinical space, pharmacy services, a short-term detoxification center for substance-use and alcohol-use disorders, and 50 respite care beds for people experiencing homelessness and recovering from previous hospital visits.
- An independent study funded by the National Institutes of Health found that the emergency hotels provided to homeless people during the height of the pandemic led to increased doctor visits and reduced high-cost emergency-room visits. The study, which tracked 346 homeless people who used San Francisco’s Shelter-in-Place Hotel Program from April 2020 to October 2022, found that the average emergency-room visits decreased by more than half, while the proportion of residents seeking outpatient care almost doubled.
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.
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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, 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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