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Homeless Housing

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Sacramento hospitals provide beds to the homeless--without taking hospital space.

Until two years ago, Sutter Medical Center in Sacramento, CA, treated its homeless patients like most other hospitals in the United States do: treat, discharge, repeat. Homeless patients would be admitted to the hospital, undergo treatment and be discharged--but without a consistent way to properly wash their hands or fill a prescription, they'd often be readmitted with an infection. Like many hospitals, Sutter tried to reduce the likelihood for readmittance by keeping patients a few days longer, filling much-needed beds and often only prolonging the inevitable.

Today, homeless patients ready to be discharged have another option: a bed and follow-up care in a respite shelter until they're ready to transition to more permanent housing. The respite shelter is part of the Interim Care Program, a four-hospital partnership with the county of Sacramento, the Salvation Army and The Effort, a community-based primary-care and mental health provider. Through the ICP, Sutter places homeless patients in need of short-term (less than six weeks) follow-up care in one of 18 beds owned and manned by the Salvation Army.

The Salvation Army provides space and management for the 24-hour center, which is overseen by the county of Sacramento. The four participating hospitals (Sutter, Kaiser Permanente Sacramento, Catholic Healthcare West and UC Davis Medical Center) each commit $50,000 a year to the program, as well as beds and equipment.

More than 250 patients have been treated at the shelter so far--75 of them Sutter patients. All shelter patients have enrolled in some sort of healthcare coverage, and 80 percent have moved to more permanent housing, says Keri Thomas, manager of Sutter's community benefits program. Only 8 percent of participating patients have been readmitted to the hospital.

"From a purely business perspective, it's cheaper for us to do this than it is to have them come back into the hospital with an infection that we're going to be treating for many days," says Sutter Medical Center CEO Tom Gagen.

Phase II of the ICP--The T3 Continuum Program--began pilot testing at Sutter in early 2007. The program will place some of Sutter's frequent ER users (homeless and underinsured patients averaging more than eight ER visits in six months) in a housing and primary-care treatment program run by The Effort. The program will roll out to the three other hospitals in 2008.

-Molly Rowe

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