Medical respite program assisting unhoused populations following hospital stays

Some shelters have begun partnering with health organizations to provide follow-up care while housing homeless people after a hospital stay.

M Health Fairview and Our Savior’s Community Services, located in the Phillips neighborhood of Minneapolis, piloted this idea — known as the Medical Convenience Program, this past February. The pilot was scheduled to finish in June 2022 but has been extended to June 2023 due to its success.

The idea came about after providers at M Health Fairview University of Minnesota Medical Center noticed a pattern where many patients who were not sedated received treatment, were discharged from the hospital and then ended up in the emergency department. Larry Hiscock, community liaison at M Health Fairview, said the need is becoming more apparent with the added pressure on emergency departments during the pandemic and the low number of available beds.

The rest program between Fairview and Our Savior’s Shelter aims to reduce the number of people readmitted to the emergency department. Fairview realized that many of their unsedated patients did not receive appropriate care after discharge.

“If you have to recover from a procedure or something, it’s generally hard. Doing it without the basics of a shelter makes it really difficult,” Hiscock said.

Temporary programs, Hiscock says, are just one way to address this problem. Quality, affordable and stable housing, he said, is the most important approach to resolving these outcomes on a larger, longer-term scale.

Many of the current clients of the Redeemer’s Refuge have also expressed a need for housing after leaving the hospital.

said La’Quadra Neal, who runs the medical comfort program at Our Lifesaver Shelter. “The most important thing people were looking for was a safe place to recover at night, as well as making sure they had their supplies.”

During pilot 20, people stayed at the shelter after staying at various Fairview locations. The program introduced an in-house nurse to educate patients about their conditions. Aside from that, the shelter’s regular services, such as having case managers help with housing searches and signing up for benefits, have also been beneficial to clients, Neal said.

Ten of the 21 available beds in the shelter are reserved for the comfort programme. Usually stays are 30 days, Neal said, though individuals with unresolved medical issues can get an extension from Fairview.

measure success

Hiscock said the program has done a great job connecting resources to patients.

“Not only do people have this opportunity to receive extended support while they are recovering physically, but they are in a safe place where they have that social worker, case management support; helping the individual complete their paperwork so that they are insured, which makes it easier to access care,” Hiscock said. It helps them qualify and connect with different programs so that they can obtain more stable housing in the long term.”

During the trial, 11 of the 20 patients remained outside the emergency department and began receiving care in a primary care setting. From February 2022 to January 2023, 11 of the 45 participants in the program moved to other residences, Neal said. Since then, the program has had 16 additional participants.

“(This is) a very big step because otherwise, people were in that cycle of going back to the emergency department for care,” Hiscock said. “This is a remarkable success.”

“The thing that I hope medical respite will help with in the long term is that life expectancy goes up. People who experience homelessness, they have a much shorter life expectancy,” Neal said. “Hopefully by using this model and changing the way we do shelters, these are better outcomes and better health initiatives for clients.”

There is a possibility that the program could extend beyond June 2023, Hiscock said, though the decision depends on several factors. Fairview is in the process of reviewing patient outcomes – to determine the health benefits of the program and whether it will be sustainable.

Minnesota has four other medical rest sites, according to the National Institute for Interim Medicare.