There Is No Wrong Door
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Description:
In a cost benefit review of a single typical patient, Care Oregon documented that Central City Concern’s Recuperative Care Program reduced annual hospitalization and medical costs by more than $80,000 per patient. The Recuperative Care Program has provided care and housing for more than 1,000 patients since the program’s inception in 2005. Nic Granum, Program Manager, talks about the important transitions people make from hospitals to homes with the support, services, and compassion of their staff.
Content:
Central City Concern’s Recuperative Care Program is a grantee of the Services in Supportive Housing (SSH) and Cooperative Agreements to Benefit Homeless Individuals (CABHI) program of SAMHSA’s Center for Mental Health Services (CMHS). The SSH program funds grantees to provide intensive services to prevent or reduce chronic homelessness, and the CABHI program funds grantees to ensure that the most vulnerable individuals who are chronically homeless receive access to sustainable permanent housing, treatment, and recovery supports through mainstream funding sources.
A twenty-one-year-old young man had two small children, six months old and two years old. He was given one month to live because he was not eligible for a heart transplant. He didn’t have a place to go home to. In the hospital, he had to make a choice about the last month of his life.
Central City Concern’s Recuperative Care Program provided him with a place where he could live his last month with his family. He lived for three months. All he wanted to do was to be a dad. “That was a horrible situation, but we were there to see him through it; it was just heartbreaking. It is important that when people do die, and many of the people we help do die, [they] know that people care about them. We do a lot of work here on grief and secondary trauma, acknowledging that it is okay to be upset,” says Nic Granum, Program Manager of Central City Concern’s Recuperative Care Program.
Hospitals had been expressing frustration and that they needed a place for patients to go: “Staff at hospitals have trouble sleeping at night, just as much as we do,” says Nic. “There is a portion of patients, people with infections or fractures, who should be able to go home, if they had a home to go to, but so many have no ideal place to go to. This is happening all over the country.”
What started with conversations among several hospitals in 2005 turned into a model that began with three beds in one housing building owned by Central City Concern. A grant from United Way brought all of the local hospitals into the conversation. Patients who are ready to leave the hospital and have no place to go can go directly to housing at the Recuperative Care Program. Here they are provided with immediate housing, intensive case management, and primary care for post-hospital treatment. Patients are taken to follow-up appointments and can be referred for medical care, addiction, and mental health care services at Central City Concern’s Old Town Clinic, a Federally Qualified Health Center (FQHC) and Health Care for the Homeless grantee. “There are four major components to the organization: health and recovery, housing, employment, and peer support.” The Recuperative Care Program operates within housing.
There are one hundred and fifty units in the building that house those in the Recuperative Care Program. The units are “wet;” they are not alcohol and drug free, which is unique to Central City Concern’s comprehensive approach that people are welcome into the program at various stages of recovery. “There is no wrong door. It’s about timing and there is never a dull moment,” says Nic, who was recently named Project Director for a new project called the Interdisciplinary Community Care Team. When he talks about what motivates him in this field, he talks about the intersection of many systems: “It is amazing to see people transition from the hospital, the criminal justice system, and outpatient care and to work with social service providers, faith-based groups, advocates, other people in our community who are struggling. I see a lot of people who are treated with dignity because we assume they are capable of succeeding.”
Nic recalls one woman who came to Recuperative Care with breast cancer and opted out of cancer treatment. She also lived with schizoaffective disorder and this made it difficult for her to engage in care. “I remember her as fiercely independent, much like my grandmother.” She had fired every doctor in the system but at some point made a connection with one of the doctors at the Old Town Clinic. Personal connection is so essential for people who have lost trust over time. Eventually she chose to move into permanent housing at age 60. She selected to go off and on her medications and had difficulties staying in one place. The staff at the program recalls that she loved the waterfront and liked to walk there. She was often more receptive to staff members when on walks. She also enjoyed reading. For a fiercely independent woman to have her own home and make her own choices seemed like the greatest gift of life, even towards its fiercely independent end.
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Type of Resource:
HRC Resource
Publication Date:
2012
Location:
Rockville, MD
Phone:
617-467-6014