2018 Family Medicine Cares Resident Service Award

Finding Respite for Duluth's Homeless

Becky Davies, MD and Jesse Susa, MD, both second-year residents with the University of Minnesota, Duluth Family Medicine Residency, will collaborate with First Covenant Church and the Churches United in Ministry (CHUM) and Loaves & Fishes to implement a year-long medical respite in the hopes to ultimately improve quality of life for Duluth’s underserved. The project’s goal is to ultimately improve quality of life for Duluth’s underserved by demonstrating not only the financial benefit of medical respite care, but also stewardship in use of community sources.

Health disparities disproportionately affect people who are homeless as shown by higher numbers of hospitalizations, lower life expectancy, and higher rate of homelessness for patients with mental illness and disabilities.  It is not uncommon for medical residents and faculty from Duluth Family Medicine Residency (DFMC) to discharge patients from the hospital to the streets of Duluth.   

Arrangements have been made to occupy a 3-bedroom parsonage that stands in the parking lot of the First Covenant Church.  Admission criteria for these respite beds include the patient is:

  • Over 18;
  • Homeless or at risk for homelessness;
  • Is showing the potential for improvement or transition to long term housing if not medically fit for CHUM or Loaves & Fishes;
  • Not requiring more than minimal assistance with activities of daily living (ADL);
  • Mentally stable to live alone;
  • Not requiring ongoing drug/alcohol treatment;
  • Willing to come to the Medical Respite Center;
  • Following program rules and can participate in their own care.

Discharge Criteria includes the patient has:

  • Finished the course of treatment that was initiated in the hospital (i.e. antibiotics, wound healing, steroids, nebulizer treatments);
  • Recovered the energy and strength to navigate the streets of Duluth to attend appointments;
  • Become enrolled in supportive housing network;
  • Established health insurance and social support programs.  

Residents will track data on the number of hospital re-admissions, subsequent ER visits, primary care visits, establishment of permanent housing for patients who were accepted into the respite. Program. The data will be compared with the same stats from patients who qualified but were not accepted to the respite care beds due to lack of space. Currently, Duluth’s largest health care system is planning a 5-year expansion project called “Vision Northland”, which includes building a new hospital complex, expanding services and repurposing old buildings. The data collected from this project will be presented to hospital leaders as a model of a large-scale respite program for Vision Northland.

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