Deaconess Health System in Evansville, Ind., grappled with how to get homeless patients the supportive services that could help them stay healthier in the community and reduce their frequent visits to the emergency department (ED). The solution was to partner on a Homeless Medical Respite Program that has halved 30-day hospital readmission rates and found permanent housing for most of it homeless clients.
The program started nearly three years ago when Deaconess agreed to fund transitional supportive housing on a one-year trial basis for homeless patients once they were discharged from the hospital. The health system partnered with United Caring Services, which operates several shelters and supportive programs for the homeless in Evansville.
United Caring Services and Deaconess opted to continue the program beyond its trial run and expand it.
“As part of Deaconess’ commitment to population health management and delivering value to our community, we identified a vulnerable population with limited resources whose health was in a tailspin,” says Deaconess Health System President James Porter, M.D. “Many of them had medical issues being perpetuated by a lack of safe housing and other unmet social needs. By partnering with United Caring Services, we were able to establish a safe and supportive environment which has reduced 30-day readmissions by 50% for those impacted by the program.”
United Caring Services Director Jason Emmerson calls Deaconess “an incredible ongoing partner … totally committed to this program.” He says the health system’s presence in Evansville is “integral to community outreach and engagement.”
While Emmerson last year expanded the program to receive referrals from other area hospitals as well, he says the bulk of referrals still come from Deaconess.
The program began accepting homeless men in November 2014 at a six-bed facility in downtown Evansville. A four-bed facility opened its doors for women in December.
“It started for men because we had the available space in the men’s shelter, but we’ve always wanted to expand to meet women’s needs,” Emmerson says.
A hospital will refer homeless patients to the program for up to six weeks of transitional housing. The program’s clients generally are people who find themselves on the street or sleeping in shelters, through a situation triggered by an unexpected event, such a job layoff or domestic violence – not those suffering from a serious substance abuse or mental health issue. While in respite, they receive case-management services that are designed to help them find permanent housing and employment.
The program has seen nearly 100 clients and 2,125 overnight stays since its inception – with meals, showers, laundry services and transportation provided, in addition to case management.
“They come to us nearly forgotten and abandoned,” Emmerson says of his clients. “But we are all a part of this continuum of care, and people come out of this program with dignity, a better future, stability and hope.”
He says the program has successfully transitioned 60% of its clients to permanent housing, and another 30% go to some type of safe housing – away from the streets and run-down shanties. He estimates “respite has saved at least $2.55 million in direct costs with the total savings across all emergency, health and social services certainly being much higher.”
But Emmerson says the program’s real value is in how it boosts clients’ self-esteem. “They come from a health crisis on top of all the other crises they are facing and within four to six weeks they have hope and possibilities in front of them,” he says. “That is a heck of a turnaround.”
The stories below look at what other hospitals and health systems are doing to address homelessness in their communities.
Health care safety net for the homeless
Stable housing for elderly residents
Homeless patients’ best prescription is permanent housing, says UI Hospital
Street Medicine makes house calls to the homeless
Housing is health care for homeless
Mount Carmel Street Medicine team brings healing, hope to the homeless