Ronald Lee, a 67-year-old man, had been struggling with mental health issues following the tragic death of his teenage son a few years prior. Before being admitted to Bellevue Hospital in New York for psychiatric care, he had been staying between family members’ couches and a veterans shelter, facing the struggle of not feeling mentally ready to return to shelter life after being discharged.
While in the hospital, Bellevue staff offered him an alternative: care at a 26-bed facility, called a medical respite, in Harlem. Medical respites provide a place for individuals who are no longer sick enough to remain hospitalized but still require follow-up care that they can’t access in shelters or on the street. The Harlem program offered services like wound care, physical therapy, and social services, along with help in finding stable, long-term housing upon leaving the program.
The Harlem program has been met with success, and the model is gaining traction elsewhere in the United States. Medical respite care has the potential to not only improve patient outcomes but also to reduce overall healthcare costs. New York recently received permission to bill Medicaid for the service, providing a new funding stream for it.
While medical respite care offers hope for homeless and mentally ill individuals like Lee, it is not without its challenges. Undocumented patients face particular hurdles, as Medicaid won’t cover their care under the new funding model. Additionally, organizations implementing this type of care are uncertain about the level of Medicaid payments and the sufficiency of state-offered start-up grants.
Despite these challenges, programs like the one in Harlem have demonstrated significant success in connecting homeless individuals to more stable housing and reducing their reliance on costly hospital care. In the long term, medical respite programs like these offer the potential for both improving patient outcomes and reducing healthcare spending, provided that the appropriate funding and support are in place.
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