NIMRC Resource Highlights

• The webinar, initially presented on 3/13/24, provides recommended approaches for assessing areas of health management that are critical for developing client-centered plans of care. 
• A supplemental publication, Assessing Health Management Skills, goes into greater depth on the process and strategies for assessing health management.     

Letter to Members

Respite Kudos and Accomplishments

Activities and Opportunities

Respite on the Road

Respite in the News

• 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. 

• 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.
  
  

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.