August 28, 2011; Source: Los Angeles Times | When you leave the hospital after an acute illness or injury, the nurse will tell you to go home and rest, eat well, keep your wounds clean and take your medications. But what if you don’t have a home to go to?
Generally in this country, hospitals simply release homeless patients back out onto the street, where it is next to impossible to properly take care of one’s self. A patient-dumping scandal among Los Angeles County hospitals spotlighted the problem.
In response, a relatively new model, recuperative care, is gaining traction. In Los Angeles, the nonprofit Illumination Foundation maintains 33 beds in a converted motel, and the JWCH Institute has 53 beds in Bell and in downtown L.A. The centers are staffed with nurses and provide homeless patients with a clean, safe environment in which to get better after brain surgery, a car accident, a drug overdose or even an amputation. But it’s no spa in the countryside. The LA Times reports that the facilities are spartan, with beds separated by cubicle dividers and the smell of bleach in the air. The average stay at the Illumination Foundation’s motel is 10 days. “It’s case management on speed,” Aiko Tan, director of recuperative care for the Illumination Foundation, told the newspaper.
Currently there are 57 recuperative care centers operating nationwide, and the Obama administration wants to see more of them. Studies have shown that they improve health while saving money. A bed in an L.A. recuperative care center costs at most $200 a day, compared with $2,300 a day at a hospital. A 2009 study of homeless patients in Boston found that homeless patients released to recuperative care were half as likely to be readmitted to a hospital within 90 days. And a 2006 study in Chicago found that recuperative care reduced the number of ER visits and shortened hospital stays.
Despite it being such a good deal, funding for recuperative care is hard to come by. Few patients have insurance and Medicaid generally does not reimburse providers. For now, organizations like the Illumination Foundation and the JWCH Institute must rely on grants and on funding from hospitals.—Chris Hartman