Bronx Respite Needs Assessment
The Bronx Health & Housing Consortium (“the Consortium”) has undertaken a study of the “medically homeless” population in the Bronx, defined as those whose housing needs are directly related to their health conditions, to explore how a temporary medical respite program may provide an innovative solution to improve people’s health, avoid unnecessary and expensive hospital stays, and move people into stable housing. The Consortium intends to pilot this initiative in the Bronx with the potential of replicating it across New York City. The first step was to conduct a needs assessment to better understand the scope of respite services needed in the Bronx. This study, conducted in June of 2017 and February of 2018, was done in partnership with the Office of the Bronx Borough President, the Bronx Partners for Healthy Communities PPS, and the Bronx Health Access PPS, in association with the Coalition for Housing and Health.
The National Health Care for the Homeless Council defines medical respite as “acute and post-acute medical care for homeless persons who are too ill or frail to recover from a physical illness or injury on the streets but are not ill enough to be in a hospital.” We have learned from experience with patients in the Bronx as well as from experts in the field that there is a Hospital-Homeless cycle of homeless patients. When they are ready for discharge, if they are not provided appropriate shelter they often end up on the street, where their medical condition does not improve. They then go back to the Emergency Department and may be readmitted, which starts the cycle again. Only if we change where they are discharged to—what we sometimes call a respite facility—can we address their medical and social needs to break this vicious and expensive cycle.
This needs assessment was conducted in Bronx hospitals on June 7, 2017 and February 28, 2018. The stakeholders wanted to get data from a warmer and colder month to ensure the samples represented different times of year. All six acute Bronx hospitals–Montefiore Medical Center, BronxCare Health System, St. Barnabas Health System, and New York City Health + Hospitals North Central Bronx, Lincoln and Jacobi–participated in June and all but Lincoln Hospital participated in February. This was a point-in-time study, covering a full day (8:30am to 5pm) at each point in order to avoid duplications. Read a summary of our findings.
The National Health Care for the Homeless Council defines medical respite as “acute and post-acute medical care for homeless persons who are too ill or frail to recover from a physical illness or injury on the streets but are not ill enough to be in a hospital.” We have learned from experience with patients in the Bronx as well as from experts in the field that there is a Hospital-Homeless cycle of homeless patients. When they are ready for discharge, if they are not provided appropriate shelter they often end up on the street, where their medical condition does not improve. They then go back to the Emergency Department and may be readmitted, which starts the cycle again. Only if we change where they are discharged to—what we sometimes call a respite facility—can we address their medical and social needs to break this vicious and expensive cycle.
This needs assessment was conducted in Bronx hospitals on June 7, 2017 and February 28, 2018. The stakeholders wanted to get data from a warmer and colder month to ensure the samples represented different times of year. All six acute Bronx hospitals–Montefiore Medical Center, BronxCare Health System, St. Barnabas Health System, and New York City Health + Hospitals North Central Bronx, Lincoln and Jacobi–participated in June and all but Lincoln Hospital participated in February. This was a point-in-time study, covering a full day (8:30am to 5pm) at each point in order to avoid duplications. Read a summary of our findings.