Providence program offering respite for the homeless earns CHA's highest honor


Achievement CitationSPOKANE, Wash. — The Transitional Respite Care for the Homeless Program of Providence Health Care helps extremely vulnerable patients to prevent complications of illness and injury by giving them a warm and safe place to rest and recover.

On June 6, at the Catholic Health Assembly in Orlando, Fla., CHA awarded the program its 2016 Achievement Citation. The recognition, CHA's highest honor, is given for innovative programming that changes lives for the better.

Providence Health Care's emergency department at Sacred Heart Medical Center sees about 80,000 people each year; about 5 percent of those patients are homeless. Many of the homeless men and women accessing care at the emergency department are seeking primary care, but others seek treatment for deep and intractable wounds, infections such as cellulitis, broken bones, and uncontrolled diabetes or other serious, chronic health concerns.

Fragile of mind, body and soul, and often with varying degrees of mental illness and addiction, these homeless patients are more likely to return to the emergency department or be readmitted to the hospital.

The respite program's goal is to stop the revolving door of emergency department treatment by providing a supervised facility with a level of care from an on-site nurse similar to what a patient might receive from an attentive family member.

Providence partnered with Catholic Charities of Spokane to create the respite program at Catholic Charities' House of Charity, which is a homeless service center by day and a shelter for homeless males at night. (Providence Health Care, a subsidiary of Providence Health & Services, runs the only completely free clinic in Spokane at the shelter.)

Providence started the respite program in November 2013 with just one bed in the shelter, now there are beds for 24 recuperating patients. (Providence also has four respite beds for women at Hope House, a women's shelter in Spokane.)The men in the respite program can stay inside the House of Charity 24 hours a day; others using the shelter must go elsewhere in the afternoon. The respite patients receive three meals a day, the non-intensive nursing care, and instruction to help them take charge of their health and medication management. Participants can remain in the respite program until they are medically ready to be out on the street again.

A case manager helps respite program participants access ongoing primary care and behavioral health services, and can link participants to housing and other social service resources.

The program saves lives and reduces suffering. And, according to Elaine Couture, it also significantly reduces health care spending. Couture is chief executive of Providence Health Care. The Henry J. Kaiser Family Foundation estimates that, in 2014, a Washington state hospital would have spent $3,189 per day to care for an inpatient. The respite program provided about 3,500 nights of care in 2014. In the absence of the respite alternative, some of those patients likely would have stayed in the hospital longer to ensure a safe discharge. Others, who had returned to the streets would have been at high risk for rehospitalization.