A respite from the street: Easing homeless from hospital to shelter improves lives, saves money
FARGO — Bryan Luer's life took a downward spiral that resulted in homelessness, being hospitalized for a case of bronchial pneumonia and getting diagnosed with leukemia.
It started when the 59-year-old Fargo man was working a rigorous schedule as a custodian that proved to be too taxing on his health.
"Seven days a week all year long, no vacation, no nothing," he said. "Got to be too much after awhile. You just get run down."
So Luer quit his job. He also lost his room at a small downtown lodging motel after the building was sold and slated for remodeling. He was unable to find affordable housing, and found himself homeless for four months, residing at the New Life Center.
But Luer's luck took a turn for the better when he was enrolled in a medical respite program, which helps homeless people address their health problems and provides stable housing. A hospital nurse referred him to the medical respite program.
"When I got out of the hospital I felt great," Luer said. "I was sleeping better, eating better."
The program, started two years ago, is a collaboration involving multiple local agencies and organizations, including the Fargo Housing and Redevelopment Authority, YWCA, New Life Center, Family HealthCare and Sanford Health, which contributed $100,000 to launch the project.
The respite program fills a major void for homeless persons who are well enough to be discharged from the hospital but not well enough to return to the streets.
Five respite beds are available at the New Life Center and two beds at the YWCA shelter.
So far, the program has saved an estimated $500,000 by providing 2,084 days of care in shelters instead of hospitals. For less than $100 a day, the program provides a bed, three meals a day, as well as a case manager.
"We sometimes had patients 38 to 40 days in the hospital because we had no place to go, especially in the winter," said Lois Ustanko, Sanford's director of faith community nursing, who works with the program.
Complex health problems
The medical respite program has served 58 homeless persons, almost three of every four of them men, ages 21 to 67. Most have complex health conditions, including substance abuse, mental health issues and chronic diseases such as diabetes and heart disease.
"It's still a small program," Ustanko said. But early results are encouraging. In comparing the year before the program was established to the first year the respite program was available, she said, several improvements were documented: a 59 percent reduction in hospital admissions, a 66 percent reduction in the number of total hospital days, and a 40 percent reduction in emergency room visits.
Luer now has an apartment in the Fargo High Rise Senior Center, 101 2nd St. S., and assistance from Monnie Knapp, a coordinator with Community Living Services. Knapp visits Luer and takes him on some errands, although he is provided transportation for his medical appointments.
A six-month transition period with a case manager is typical in the program, and Luer is approaching the end of his.
"Bryan's got himself figured out pretty good," Knapp said.
"These people help me out greatly," Luer said, referring to Knapp and the medical respite program. His contacts have helped connect him to other programs and services. "They know the right people to talk to."
Luer is among the 26 percent of patients served by the respite program who have made it into permanent housing. Up to 70 percent would be eligible for affordable housing options, if they were available; the Fargo housing authority's waiting list has 2,000 families.
He finds his rent-subsidized apartment at the High Rise much more spacious and comfortable than the room he had before. "It was a dump," he said. His apartment is furnished with used furniture donated by the New Life Center.
"For what I need, it's perfect," Luer said. "The organization's done a lot for me."
The idea for the medical respite program evolved out of graduate studies for Alicia Hauff, a nurse practitioner at the homeless health clinic operated by Family HealthCare. She was studying the unmet health needs of the local homeless population, and a social worker identified respite care as a major need.
Housing is critical for maintaining health, she said. Lack of housing, and the stresses that go with it, take a toll on one's health.
"They need more than just a shelter bed," Hauff said. "We like to say housing is health care."