The Health Resources and Services Administration (HRSA) plans to announce the availability of expansion grants before the end of the year. These grants will give existing Federally Qualified Health Centers (FQHCs) the opportunity to expand behavioral health, oral health, pharmacy, and enabling services.

Enabling services, the non-clinical services that increase access to primary health care and improve health outcomes, are core to most medical respite programs. Enabling services such as health education, patient navigation, case management, referrals, and benefits acquisition can be quite effective when provided in a medical respite setting given the amount of time that patients stay in the program and the focus on wellbeing. FQHC administrators should start planning for upcoming expansion grants and determining how they might use this grant opportunity to grow their medical respite programs. The National Health Care for the Homeless Council is available to provide technical assistance on using HRSA funding to support medical respite programs. Please direct any questions to Juli Hishida, TA Program Assistant, jhishida@nhchc.org,

People who are experiencing homelessness are among the most frequent users of hospital emergency services. In a 2008 study of frequent hospital admissions for Medicaid patients in New York, patients who were homeless or precariously housed were over six times more likely to name the emergency department as their usual source of care (Raven et al., 2008). Another New York-based study found that homeless patients were four times more likely to utilize emergency department services than their housed counterparts (D'Amore et al., 2001).

For people who are unstably housed, disease management is often secondary to meeting basic needs such as shelter and food. With this in mind, Common Ground of New York launched the 100,000 Homes campaign, which is based on existing innovative strategies implemented across the country that have resulted in significant and measurable progress toward ending homelessness. Through the Campaign, community change agents such as health care and housing providers come together to share best practices in easing the transition from hospital to home for the most frequent users of hospital services. 

The Campaign aims to house 100,000 of the most vulnerable individuals and families in the next three years through the combined efforts of communities across the nation.  Presently 53 communities are actively working towards this goal with many more communities joining monthly.  Collectively, over 5,800 individuals have been housed through the best practice models implemented and promoted through the Campaign. 

Medical respite programs can complement the 100,000 Homes Campaign by providing medical respite beds to patients who require recuperation time or additional medical assistance prior to housing placement. Medical respite care providers can also participate in the campaign by attending local stakeholder meetings, assisting in Registry Week to identify individuals who are most vulnerable, and by locating permanent housing, social service supports, and a medical home for vulnerable individuals.

The 100,000 Homes Campaign hosts a variety of opportunities to learn best practices, including monthly "Innovations Calls," a time-limited call series to foster local engagement, and many web-based resources and connection opportunities.  On December 14, the Campaign will host an Innovations Call highlighting the role of medical respite programs in addressing vulnerabilities, improving health and housing retention, and reducing unnecessary healthcare costs. The Respite Care Providers' Network will issue more information about the call when it's available.

To learn more about the 100,000 Homes Campaign, please visit www.100khomes.org or contact Catherine Craig, Director of Health Integration, National Programs, (212).471.0846, ccraig@commonground.org. 

Raven, M.C., Billings, J.C., Goldfrank, L.R., Manheimer, E.D., Gourevitch, M.N.. (March 2009). Medicaid patients at high risk for frequent hospital admission: real-time identification and remediable risks. Journal of Urban Health, 86(2):230-41.

D'Amore, J., Hung, O., Chiang, W., Goldfrank, L. (November 2001). The epidemiology of the homeless population and its impact on an urban emergency department. Academic Emergency Medicine, 8(11):1051-5.