The Neighborhood Service Organization (NSO) has launched a collaboration project with health systems and community-based agencies to establish a Recuperative Housing Center to help care for the homeless or those who need a place to stay after hospital stays.

The center will provide 50 beds of temporary housing and continued care for patients who are experiencing homelessness or housing insecurity and need a safe place to continue their recovery, immediately following a hospital discharge.

Partners include Ascension Michigan, Henry Ford Health System, Authority Health, CHASS Center, Coalition on Temporary Shelter (COTS) and Detroit Area Agency on Aging, with NSO serving as the lead agency. This collaboration is the first of its kind in Michigan.

The collaborative 90-day pilot project looks to promote wellness, prevent avoidable rehospitalization, and allow more efficient use of hospital beds, especially in light of COVID-19. Historically, housing insecure individuals are returned to shelters following discharge because they do not have a permanent residence and their recovery is disrupted.

“While this project has launched during this crisis, NSO and our collaboration partners aim to continue developing long-term solutions for the healthcare delivery system in the space of housing, because we believe housing is healthcare,” says Linda Little, president and CEO of Neighborhood Service Organization, which is operating the center located in Detroit.

The strength of the collaboration is the unprecedented engagement of health systems and community-based agencies – all working together to address the issue of housing on the healthcare delivery system. The experiential knowledge and outcomes from this pilot will inform long-term, sustainable solutions for this unmet need that the collaborative intends to address in the community.

The Recuperative Housing Center offers a solution to participating hospitals in metro Detroit’s tri-county area. The challenge of safe discharge planning for this high-risk population has only been amplified during the COVID-19 crisis.

Patients who are medically cleared and meet a defined set of criteria, are referred into the recuperative housing center by Ascension Michigan and Henry Ford Health System. Health plans will benefit from this solution, as a recuperative housing center is a lower cost alternative to acute and sub-acute care. However, the greatest impact will be on the individuals served.

While at the Recuperative Housing Center, patients will receive personalized case management to safely transition to a shelter or another housing solution for which they qualify. They will also receive care coordination support to assist with follow-up care and medication management, as well as access to telehealth services. Home care can also be provided, if indicated.

The center is funded by United Way for Southeastern Michigan and the McGregor Fund, and supported by the City of Detroit.

“COVID-19 has had a devastating effect on all of us, especially the homeless and most vulnerable in our community,” says Dr. Darienne Hudson, president and CEO of United Way for Southeastern Michigan. “We are glad to provide support for such an important, first of its kind project.”

The impact of homelessness on healthcare costs and services is far-reaching.

According to the National Institutes for Health, 33 percent of all visits to hospital emergency departments are made by chronically homeless people. Most emergency departments are not purposed to address the psychosocial needs of homeless patients.

• Homeless people visit the emergency department an average of five times annually, and the most frequent users of them on a weekly basis. Each visit costs an average of $3,700, amounting to $18,500 spent annually for the average user and up to an average $44,400 in emergency department costs for the most frequent users.
• On average, homeless people spend three nights per visit in the hospital, which can cost more than $90,000.
• According to University of California researchers, homeless people have higher rates of chronic health problems than the general or poverty population.
• 80 percent of emergency department visits by people struggling with homelessness are for conditions that could have been addressed through preventive care.
• The provision of housing for the homeless decreases emergency department visits by 61 percent.
• Housing the homeless reduces healthcare costs by 59 percent; emergency department costs reduced by 61 percent; and inpatient hospitalizations reduced by 77 percent.

  Ascension Michigan, Authority Health, CHASS Center, City of Detroit, Coalition on Temporary Shelter (COTS), Detroit Area Agency on Aging, Henry Ford Health System, Neighborhood Service Organization, NSO, the McGregor Fund, United Way for Southeastern Michigan