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| 2010 Medical Respite Program Directory Now Available | |
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HEALTH REFORM:
WHAT'S IN IT FOR MEDICAL RESPITE PROGRAMS? | | |
On March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act to expand and improve health care coverage for all Americans. The law includes a number of provisions of interest to medical respite providers.
Beginning fiscal year 2011, federally qualified health centers will receive $11 billion dollars over the course of five years. The Health Resources and Services Administration (HRSA) plans to release a grant announcement later this summer or early fall which will provide guidance on how the first $1 billion of this funding can be used. While the guidance has not yet been released from HRSA, the National Health Care for the Homeless Council will continue to look for opportunities to fund medical respite care through health center grants made available through the Affordable Care Act, and provide updates as information becomes available.
The new law also provides a number of incentives and requirements for hospitals to provide comprehensive discharge programs for patients.
- Beginning January 1, 2015, hospitals with more than 50 beds and receiving reimbursement from a health insurance issuer participating in one of the state-run health insurance exchanges will need to ensure that all patients receive a comprehensive program for hospital discharge. These programs will include patient-centered education and counseling, comprehensive discharge planning, and post discharge reinforcement by an appropriate health care professional.
- Hospital payment structures will encourage hospitals to reduce hospital readmissions by employing comprehensive discharge programs among other strategies.
- States will be able to apply for grants to establish health teams to support patient-centered medical homes. One requirement of health teams is to provide 24-hour care management and support during transitions in care settings.
- A Medicaid demonstration program will pilot bundled payments for the provision of integrated care around a hospitalization for targeted Medicaid beneficiaries. Hospitals participating in the demonstration program must have a robust discharge planning program for targeted patients.
Steps for getting involved in health reform initiatives:
- Meet with hospital administrators to discuss opportunities for partnership in light of new mandates and incentives for providing comprehensive discharge planning programs.
- Meet with administrators at local and state hospital associations to discuss partnerships.
- Invite hospital and hospital association administrators to take a tour of your program.
- Invite your state Medicaid Director to visit your program and discuss opportunities for including medical respite care in any state grants or demonstration programs to provide integrated care.
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| MEDICAL RESPITE CARE INCLUDED IN THE FEDERAL STRATEGIC PLAN TO PREVENT AND END HOMLESSNESS | |
On June 22, 2010, the U.S. Interagency Council on Homelessness released the Federal Strategic Plan to Prevent and End Homelessness. The Plan describes strategies to align federal efforts in housing, health, education, and human services to prevent and end homelessness in America. Among the strategies endorsed in this plan are permanent supportive housing using a housing first approach, co-located housing and health care, and the establishment of medical respite care programs. The recognition of medical respite care in the Federal Strategic Plan to Prevent and End Homelessness provides a good opportunity for providers and consumers to promote medical respite care in local and state efforts to end homelessness.
One way to integrate medical respite care into local and state efforts to end homelessness is through your local Continuum of Care (CoC) plan. The CoC plan is a community plan to organize and deliver housing and services to meet the specific needs of people who are homeless as they move to stable housing and maximum self-sufficiency. It includes action steps to end homelessness and prevent a return to homelessness. CoC plans are funded through HUD networks, which provide competitive grants to carry out specified activities. Medical respite programs that are part of their local CoC network enjoy benefits such as HUD funding, streamlined access to housing, access to the local Homeless Management Information System (HMIS), and improved coordination and continuation of case management services for patients entering and leaving the medical respite programs.
A handful of medical respite programs are also integrated into their local and state Ten-Year Plans to End Homelessness. Ten-year plans are different than CoC plans in that they offer a more comprehensive approach to ending homelessness that may or may not be accounted for in CoC plans. Like the federal plan to end homelessness, local and state ten-year plans align efforts in housing, health, education and human services. In some communities, only government officials are involved in developing ten-year plans, whereas in other communities, stakeholders from every sector may be invited to participate in the planning process. Inclusion in local and state ten-year plans may offer additional funding opportunities for medical respite programs.
With the inclusion of medical respite care in the federal plan to end homelessness, medical respite programs have a distinct opportunity to promote their programs and better integrate with local efforts to end homelessness. Below are some steps that can be taken to promote medical respite programs:
- Look for opportunities to participate in your local Continuum of Care network.
- Provide feedback on your community's Consolidated Plan, your community's plan for spending its HUD grant money.
- Read your local and state Ten-Year Plan to End Homelessness and invite the coordinating entities to visit your program.
- Write letters to the editor or distribute a press release describing your program and tie in the release of the new Federal Strategic Plan to Prevent and End Homelessness which recognizes medical respite care.
- Invite local and state government officials to visit your program, particulary those who participate in housing and health related committees/commissions.
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| SUCCESS STORY: SAL SALAS | |
 Sal Salas studied at the University of California in Berkeley, lived in a large house, and had a beautiful wife and daughter. He looks back at his seemingly picture perfect life and wonders if given the chance if he would walk out on it all again. Though everything looked good from the outside, Sal was dealing with an addiction that caused him to plummet to some very dark places. "I was clear enough to know that my addiction was not good for my family," says Sal, "so, one day I packed my bags and left." Within 6 months, Sal found himself living on the streets. Within 2 years, he found himself in jail. Sal had been homeless and dealing with addiction for 20 years when he was hit by a car and rushed to the hospital last year. The accident left him with a crushed knee, trauma to his kidney, and a strangulated hernia. He had two surgeries and was told that he needed to be in a wheel chair for three months. In need of a safe and clean place to recuperate from the surgeries, the hospital social worker offered him the option of going to a hotel or participating in a medical respite program. After learning about the benefits of the medical respite program, Sal felt that this was the place where he needed to go if he was going to change his life. Sal wanted to use his time at the program to get some perspective on his life and address his addiction. By the time he left, Sal's wounds had healed, he had quit drinking, and his case worker was able to get him connected to SSI benefits, general assistance, and placement into housing. Sal confesses that he had become addicted to pain killers during his recuperation and resumed drinking once he ran out of his medication. His drinking led to another arrest after which he enrolled in a program at Friendship House, a non-profit organization that provides residential substance abuse treatment for American Indians. After completing the program, he went back to the medical respite facility where the staff helped him get back into housing. Sal has maintained his housing for 8 months now. He sees his case manager once a week and has entered a vocational program that is helping him finance the remainder of his education at UC Berkeley. Sal participates in speaking engagements and is in discussion with a videographer about an upcoming documentary film where he hopes to share his story. Sal is also a member of the RCPN Steering Committee where he champions proper treatment of co-occurring pain and addiction in a medical respite setting. |
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NEW PROGRAM:
CONTRA COSTA COUNTY MEDICAL RESPITE PROGRAM | | |
Last year, shelters in Contra Costa County received nearly 150 calls from hospital discharge planners in need of a place to discharge convalescing patients. Seeing a need for a medical respite program, the Contra Costa Health Services Homeless Program worked with the Hospital Council of Northern California and its member hospitals and raised over $1.6 million for the endeavor. Much of the funding came from the state's Housing and Community Development Fund and the county's Community Development Block Grant.
The new 24-bed medical respite program opened its doors in June this year. Patients who participate in the program will receive case management, medical and psychiatric care, access to substance abuse detoxification and treatment services, meals, and help finding permanent housing. Cynthia Belon, Director of the Contra Costa Health Services Homeless Program, estimates that the program will serve as many as 380 adults per year.
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OPPORTUNITY TO PARTICIPATE IN RCPN TASK FORCES | |
The National Health Care for the Homeless Council depends on teams of dedicated providers and consumers to plan and develop quality products and activities to improve the delivery of care for people experiencing homelessness. Participation in a task force is a wonderful way to network with leaders in medical respite care and receive recognition for your work. The RCPN Steering Committee, a standing committee of the National Health Care for the Homeless Council, is inviting RCPN members to participate in the following task forces: Medical Respite Program Development Task Force
This task force will meet monthly beginning in September to develop a work book to supplement the publication, Medical Respite Care for People Experiencing Homelessness: Practical Planning. The workbook will inlcude activities and templates for administrators who wish to develop a medical respite program. The workbook will also ensure readiness for on-site technical assistance visits offered by the National Health Care for the Homeless Council. Medical Respite Clinical Guidance Task Force
This task force will meet monthly beginning in September to develop guidance for providing clinical care in the respite setting. Please send all inquiries by August 13 to Sabrina Edgington, RCPN Coordinator, at 615-226-2292 or sedgington@nhchc.org. |
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2010 NATIONAL HCH CONFERENCE & POLICY SYMPOSIUM MATERIALS AVAILABLE ONLINE
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Materials from the 2010 National Health Care for the Homeless Conference & Policy Symposium are now available online. Presentations, audio recordings, and other conference material related to medical respite care are consolidated on the RCPN Training page. Quick survey: What topics would you like to see covered at the 2011 Medical Respite Pre-conference Institute? Submit your answer. |
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| Sabrina Edgington, MSSW | Respite News Editor
Respite Care Providers' Network Coordinator
National Health Care for the Homeless Council, Inc.
sedgington@nhchc.org | 615/226-2292 | www.nhchc.org
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