Some shelters have started partnering with health organizations to provide follow-up care while offering housing to people who are unsheltered after a hospital stay.

M Health Fairview and Our Saviour’s Community Services, located in Minneapolis’ Phillips neighborhood, piloted this idea – known as a medical respite program, last February. The pilot was slated to end in June 2022 but was extended through June 2023 because of its success.

The idea came after providers at the M Health Fairview University of Minnesota Medical Center noticed a pattern where many unhoused patients would get treatment, get discharged and then end up in the emergency department. The need became even more apparent with the added pressure on emergency departments during the pandemic and a low number of available beds, said Larry Hiscock, a community liaison for M Health Fairview.

The respite program between M Health Fairview and Our Saviour’s Shelter aims to reduce the number of people re-admitted to the emergency department. M Health Fairview realized many of their unhoused patients weren’t receiving the proper after-care once discharged.

“If you’ve ever had to recover from a procedure or something, that’s tough in general. But to do that without the basics of shelter really makes it difficult,” Hiscock said.

Hiscock says respite programs are just one way of addressing the issue. He said affordable and stable quality housing is the most crucial approach to resolving these outcomes on a bigger and long-term scale.

Many existing clients at Our Saviour’s Shelter also expressed a need for housing after leaving the hospital.

“We were able to see what kind of needs the clients had once they were discharged from the hospital and then incorporate that into the planning and development of the medical respite program,” said La’Quadra Neal, the director of Our Saviour’s Housing and manager of the medical respite program. “The biggest thing that people were looking for is a safe place to recover at night, as well as making sure that they had their supplies.”

During the pilot 20, people stayed at the shelter following their stay at various M Health Fairview locations. The program offered an in-house nurse who would educate patients on their conditions. Aside from that, the shelter’s regular services, like having case managers to assist with looking for housing, and signing up for benefits, were also beneficial to the clients, Neal said.

Ten of the shelter’s 21 available beds are reserved for the respite program. Stays are typically 30 days, although individuals with unresolved medical issues can receive an extension from M Health Fairview, Neal said.

Measuring success

Hiscock said the program did a great job of connecting resources to the patients.

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

During the pilot, 11 of the 20 patients remained out of the emergency department and began receiving care in a primary care setting. Eleven of the program’s 45 participants from February 2022 to January 2023 have moved into other housing, Neal said. Since then, the program has had 16 more participants.

“(That) is a pretty big step because otherwise, people were in that cycle of returning to the emergency department for care,” Hiscock said. “That is a notable success.”

“The thing about medical respite that I’m hoping helps in the long term is that life expectancy goes up. People who experience homelessness, their life expectancy is a lot shorter,” Neal said. “We’re hoping by using this model and changing the way that we do shelters, these are better outcomes and better health initiatives for clients.”

There’s a possibility that the program will extend past June 2023, although the decision depends on several factors, Hiscock said. M Health Fairview is in the process of reviewing the patient outcomes – to determine the program’s health benefits and whether it’ll be sustainable.

Minnesota has four other medical respite locations, according to the National Institute for Medical Respite Care.