The opportunity
Homelessness can take a number of different forms — from living on the streets, in encampments and shelters, to traditional housing or staying with family and friends. While the federal government reports 1.5 million people a year experience homelessness, other estimates find twice this number of people lack adequate housing in any given year. In the wake of the COVID-19 pandemic and the potential eviction crisis, homelessness numbers are expected to grow even higher.
If someone experiencing homelessness spends time in the hospital for a surgery or injury, where they will go after they are discharged becomes a significant and potentially dangerous situation.
Medical respite care, also known as recuperative care, works to help those experiencing homelessness recover in a safe place to heal after a hospital stay. It includes acute and post-acute care for those who are too ill or frail to recover from illness or injury on the street or in a shelter, but not sick enough to warrant hospital level care. In other cases, it works as short-term residential care that allows people the opportunity to rest, recover, and heal in a safe environment while accessing medical care and supportive services.
The innovation
UnitedHealthcare partners with organizations such as the National Healthcare for the Homeless Council (NHCHC) to make respite care a more readily available part of the solution to ending homelessness. Together they work to offer a safe hospital discharge option in the form of medical respite, to deliver needed services in a medically appropriate environment, reduce hospital lengths of stay, and lower overall costs of care. Prior to the COVID-19 pandemic, UnitedHealthcare partnered with the NHCHC to implement a series of nationwide approaches for financing medical respite care, as well as co-authored the review of best practices for funding, particularly via managed Medicaid.
The need for medical respite care became even more acute for this vulnerable population with the onset of COVID-19, as it brought new attention to the fact that these individuals need access to medical and mental health services and supportive services in a safe, therapeutic setting. The situation prompted the United Heath Foundation, as part of a $5 million grant to assist people who are experiencing homelessness, to deploy $2.5 million of the grant to NHCHC to support both urgent, immediate needs at local health care for homeless programs, as well as longer-term needs to expand capacity.
This grant is slated to impact 10-15 communities nationwide, and started in cities such as Detroit, Memphis, New Orleans, Houston and Las Vegas. The funds provide medical care to individuals experiencing homelessness and to help purchase necessary supplies to fight the pandemic. The NHCHC also helped allocate the funds to expand and develop medical respite programs, providing temporary housing for individuals experiencing homelessness who do not need hospital-level care, but do have health care needs that cannot be met in a shelter. In addition, UnitedHealthcare is actively working with the NHCHC to explore how medical respite can be used to isolate individuals who test positive for COVID-19, or to help people who are not infected isolate to slow the spread of the virus.
Helping people heal
Medical respite care can help people experiencing homelessness by providing them a place to heal after a hospital stay. The need for this type of stable housing not only provides privacy and safety, it is also a place to rest and recuperate, as well as to allow individuals to obtain additional health care and social services easier. COVID-19 brought new attention to the fact that these individuals need access to medical and mental health services and supportive services in a safe, therapeutic setting.
