Through its Medical Respite Care Program, Catholic Charities of East Tennessee (CCETN) provides short-term residential care for unhoused individuals recovering from illness or injury. The program offers a safe place to rest, transportation to medical appointments, and trauma-informed wraparound case management, including post-discharge aftercare.
While local homecare agencies provide medical care, the medical respite program focuses solely on social services. After referral from a partner hospital, clients are connected with a primary care physician, prescription drug coverage, disability application support, and trauma-informed wraparound case management. They also receive meals, access to a fully stocked pantry, toiletries, linens, and a room designed to feel like home. Tailored medical supplies may be purchased on their behalf, up to $1,500.
Ultimately, the program helps turn recovery into renewal, healing into hope, and a bed into a future.
Challenge or Need
The program was developed to address increasing hospitalizations among unhoused individuals and the need for a safe place to heal. Because many unhoused people rely on emergency departments for primary care, this demand can lengthen wait times for patients with urgent needs.
The Medical Respite Care Program supports recovery in a safe, home-like environment; reduces hospital readmissions; and helps improve long-term health outcomes. The program serves individuals who are too ill or frail to recover on the streets but lack a stable setting where they can receive homecare services.
Why It’s Innovative
We offer a comprehensive program that supports patients for a full year. While many programs discharge patients back to the street, our approach goes further. We recognized that meeting an immediate need was not enough. When individuals leave the emergency room without a safe place to recover, they often lack access to medications and follow-up care, which can lead to another emergency room visit and a worsening medical condition. Our goal is to help clients avoid returning to the streets and move toward lasting stability.
During the program, each client is paired with a SOAR-certified (SSI/SSDI Outreach, Access and Recovery) case manager who helps them apply for disability benefits, obtain state identification, and complete other steps needed to secure housing. Graduated levels of care guide clients through recovery while keeping them engaged in daily living activities. We provide transportation for physical and mental health appointments and accompany clients when needed. After clients move into housing, or even if they return to the streets, our 12-month aftercare program continues to check in, provide services, and offer supportive advocacy.
Program Impact
This program began on March 10, 2025 and has a maximum occupancy of two patients at a time, with a second room under construction. In 16 months, we have walked alongside eight patients for a total of 363 bed nights. Additionally, five of these eight patients have continued their care through our After Care Program, and four are still participating.
Clients are met with compassion, and their dignity is upheld through this thorough journey of healing.
Additionally, the impact our program has on the hospital is a direct savings of over $900,000 (approximately $2,500 per bed night).
Lessons Learned
Program expectations, roles, procedures, and responsibilities should be clearly defined and documented in a memorandum of understanding (MOU) before accepting the first patient. All participating partners must understand the plan, agree to the requirements and funding structure, and be fully aligned from the start.
Strong hospital partnerships and medical staff committed to making referrals are essential. Hospitals provide medical care and financial support, while CCETN provides social services. Together, this partnership can save hospitals millions of dollars by freeing beds, reducing readmissions, helping avoid insurance-related penalties, and giving clients a safe place to heal.