No doubt that many of the 55,000 plus homeless in L.A. County would concur that living on the streets will make a person sick.  Among 20,000 homeless people surveyed nationally, more than one in five lives with a chronic health condition alongside a substance addiction and mental illness. These co-occurring conditions are then exacerbated by the harsh realities of life on the streets. Medical respite care – known locally as recuperative care – is a critical component of the continuum of health care for people experiencing homelessness. 

In addition to providing short term clinical oversight for individuals recuperating from an acute illness or injury, these programs facilitate care transitions from hospitals to a primary care provider and when possible to a home. Recuperative care lends the opportunity for homeless individuals to connect with case managers and begin developing a pathway off the streets. 

The Affordable Care Act (ACA) places large emphasis on coordinated care and lowered hospital readmissions; and recuperative care provides a therapeutic intervention with the power to prevent unnecessary hospitalizations of homeless people in crisis.  While the ACA does not increase the supply of affordable housing it will help hospitals and clinicians provide more comprehensive and effective care for homeless patients. Medi-Cal expansion and enrolling all that are eligible will improve access to care and in-turn stabilize their health needs. Recuperative care, though not the cure for homelessness, provides a great opportunity for hospitals to engage in a productive effort to impact homelessness while reducing unnecessary emergency room visits, readmissions and costs. This small amount of extra support can stave off costlier and more severe health emergencies while linking homeless individuals to much needed ongoing support. 

The National Health Foundation (NHF) in partnership with the Hospital Association of Southern California (HASC) began developing a recuperative care program in 2007 in response to local outcries against hospitals’ alleged inappropriate discharging of homeless patients. Prior to this program, private hospitals lacked appropriate discharge options for their homeless patients and as a result reported keeping homeless patients up to four days longer than medically necessary. The NHF “pod” model of recuperative care better serves the homeless patient discharged from the hospital to a non-shelter setting. NHF operates its program at two locations in Los Angeles County (Mid-City and La Puente in the San Gabriel Valley); and is looking to expand. Recuperative care patients participating in NHF programs benefit from compassionate and caring staff seven days a week to ease with transition and recovery; daily nutritious hot meals (in partnership with Meals on Wheels); reliable transportation to follow-up appointments; coordinated community wellness activities and education; and specialized care provided by the American Cancer Society for patients with a cancer diagnosis. Visit http://www.nhfca.org/ to learn more. 

Hospitals across Southern California remain committed to serving our most vulnerable; and will continue to look for opportunities to collaborate on productive meaningful ways of impacting homelessness.