United Way of the Cape Fear Area and the 10 Year Plan to End Homelessness will hold the 7th Annual Pajama Party on March 11 at Bluewater Grill to benefit the Medical Respite Care Program. Wear your favorite pajamas and help call attention to the fact that not everyone has cozy PJs or a warm bed to come home to after being discharged from the hospital. Visit uwcfa.org for information and tickets.
The Cape Fear Homeless Medical Respite Program is coordinated by United Way of the Cape Fear Area. It is one of several programs launched between 2008 and 2015 by the 10 Year Plan to End Chronic Homelessness, and is currently managed by United Way and the 10 Year Plan Legacy Program.
This program provides brief, recuperative hotel stays for homeless people being discharged from the hospital who are too ill to recuperate on the streets or at a homeless shelter but no longer need in-patient hospital care. Homeless medical respite care is a non-medical best practice endorsed by the National Health Care for the Homeless Council because it reduces health care costs and improves recovery outcomes for a highly vulnerable population.
Until July 2014, the Cape Fear area lacked an alternative to costly hospitalization for sick, injured or post-surgical homeless people. Accordingly, many people with conditions that required bed rest were discharged to local shelters or to the streets. The lack of a safe, clean place to recuperate was adversely affecting health outcomes. Many of those discharged returned quickly to the hospital’s emergency department (ED) or were readmitted. And quite predictably, that unproductive cycle only served to increase total medical costs per homeless patient, many of whom lacked health insurance.
To illustrate, New Hanover Regional Medical Center (NHRMC) identified 411 homeless patients, who on average visited the ED seven times between 2010 and 2011. The enormous cost of their health care was largely written off by the hospital as indigent care. Unfortunately, within the overall health care system, those types of costs are rarely recouped.
In 2013, United Way partnered with the disAbility Resource Center (dRC), NHRMC, Good Shepherd Center and others. Using money raised at the 10 Year Plan’s Annual Pajama Party, representatives from these groups conducted a four-week homeless medical respite care pilot. Based on that pilot, four clients were successfully served and none returned to the hospital within 90 days. The dRC was then able to apply for and received $30,000 in grant funding from the Cape Fear Memorial Foundation to start a full-time program. Additional partners, as well as proceeds from the PJ Party, helped launch the first homeless Medical Respite Care Program in the summer of 2014.
The first year proved to be very successful. The program served 37 clients with an average length of stay of eight days. The average cost was $1,027 and included shelter, food, case management and transportation. The cost was less than a single day in the hospital.
The dRC reapplied for grant funding and in 2015, the Cape Fear Memorial Foundation renewed for a second year at the same amount.
As it became obvious that having the respite care option saved the hospital significant dollars in indigent care costs and created better recovery outcomes, NHRMC announced it would donate $12,000 to help fund program operations. As a result, the second-year Cape Fear Homeless Medical Respite Care Program is currently operating on a nearly $50,000 budget for the 2015-2016 fiscal year.
At present, the program provides limited, hotel-based stays to eligible homeless as they recuperate from acute medical conditions. The maximum stay is two weeks in one of two hotel rooms currently available. Casework is managed by the dRC, an officially designated Center for Independent Living in Wilmington. Because of scarce resources, client referrals are made to the dRC by NHRMC discharge staff, Cape Fear Clinic, and New Hanover Community Health Clinic, the Good Shepherd Center’s medical staff, or by New Hanover County Department of Social Services’ Adult Protective Service caseworkers. Since July 1, 2015, the program has served an additional 26 clients, providing 184 recuperative days.
The dRC staff determines eligibility and coordinates hotel stays, meals, transportation, appropriate income assessment and housing resources, and volunteer services for each participant. NHRMC and Cape Fear Health Net assist in connecting clients with additional health care resources, and NHRMC coordinates charity care applications and provides free or low-cost home health care if requested by the referring physician. Good Shepherd Center staff and volunteers provide food to clients during their stays.
United Way convenes the program’s strategy team, provides project oversight, and ensures its alignment with best practices. The ultimate goal of the program is to achieve sustainable annual funding to provide services from a permanent non-hotel facility.
Please join us for our annual Pajama Party fundraiser on March 11, 2016, at Bluewater Grill, in Wrightsville Beach.
Christopher L. Nelson is president of the United Way of the Cape Fear Area, a local nonprofit organization. Since 1941, the United Way of the Cape Fear Area has worked alongside local agencies in Brunswick, Columbus, New Hanover and Pender counties to assist them in providing substantial and sustainable change within the Cape Fear area. To learn more about the United Way of the Cape Fear Region, go to https://uwcfa.org/ or call (910) 798-3900.
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