Homelessness is a widespread problem, particularly of urban environments, and has been growing over the last two decades nationally. It is estimated that between 2.5 to 3.5 million people, including 1.35 million children, are homeless in the United States in a given year and the likelihood of becoming homeless is 7.5% over an individual's lifetime. Much of the homeless population reports physical health, mental health, alcohol and substance abuse, and social problems. New London Homeless Hospitality Center (NLHHC) has recently opened a respite care facility to help coordinate care and provide basic medical attention. This report will examine the premise and progress of this effort.
A literature review was developed to provide the national and local facts and trends on homelessness and respite care. Several key informant interviews were conducted to provide qualitative data on program specific respite services in the New London community. Additionally, a model for cost-effectiveness was proposed, based upon the unit-costing approach for health care.
The median length of stay at the respite was found to be 10 days. The unit-costing is based on inputs from the interviews and existing respite records. When data were missing, assumptions were made to estimate the unit costs for each distinct output recognized. Such assumptions are disclosed herein. Semi-structured key informant interviews with guests revealed that the respite program is their only and last opportunity for shelter and recuperation in times of injury and illness. Moreover, we found that the respite feature of NLHHC's services is in general satisfactory to them in fulfilling their human service needs, although the shelter's facilitation of interaction between guests and social service agencies could be improved to assure the continuum of care following respite stay. Interviews with Lawrence and Memorial (L&M) Hospital and NLHHC staff demonstrated accord that the respite program is effective and serves a vital need in the community, although communication and coordination between NLHHC and L&M could be improved, especially apropos of enhancing homelessness detection (and thus respite guest referral) via the hospital's intake process.
The NLHHC respite center is new, but has already demonstrated positive impact. Respite guests and staff give anecdotal evidence that this is a needed community resource. The humanitarian and social benefit is substantial. Quantitative evaluation has not yet been applied, but in other locales respite care has been successful at reducing costs. We recommend continued research and monitoring of this innovative program for fiscal effectiveness and excellence in guest services.
Yale School of Public Health
New Haven, CT
van Diepen-Hedayat, Anandi; Keene, Doug; Baysol, Tara; and Gankindi, Vamshidher, "Building a Case for Community Respite: A New London Homeless Hospitality Center Project" (2014). Practice Based Community Health Research Reports. 4.