Recuperative Care Provides Outpatient Recovery

The Central City Concern's Recuperative Care has provided recovery support and permanent housing for more than 1,000 patients since its inception in 2005.

Central City Concern’s Recuperative Care (RC) is a grantee of SAMHSA’s Services in Supportive Housing (SSH) and Cooperative Agreements to Benefit Homeless Individuals (CABHI) programs. The SSH program funds grantees to provide intensive services to prevent or reduce chronic homelessness. The CABHI program funds grantees to ensure that the most vulnerable individuals who are chronically homeless receive access to sustainable permanent housing, treatment, and recovery supports through mainstream funding sources.

A Place to Go for Hospital Patients in Recovery

A 21-year-old young man had two small children, a 6-month-old and a 2-year-old. He was given one month to live because he was not eligible for a heart transplant. He didn’t have a place to go home to. In the hospital, he had to make a choice about the last month of his life.

Central City Concern’s Recuperative Care (RC) provided him with a place where he could live out his life with his family. He lived for three months. All he wanted to do was to be a dad. “That was a horrible situation, but we were there to see him through. It was just heartbreaking. It is important that when people do die, and many of the people we help do die, [they] know that people care about them. We do a lot of work here on grief and secondary trauma, acknowledging that it is okay to be upset,” says Nic Granum, program manager of Central City Concern’s Recuperative Care Program.

Hospitals had been expressing frustration and that they needed a place for patients to go. “Staff at hospitals have trouble sleeping at night, just as much as we do,” says Granum. “There is a portion of patients, people with infections or fractures, who should be able to go home, if they had a home to go to, but so many have no ideal place to go to. This is happening all over the country.”

Conversations among program staff and several hospitals in 2005 turned into a model that began with 3 beds in 1 housing building. A grant from United Way brought all of the local hospitals into the conversation. Patients who are ready to leave the hospital and have no place to go can go directly to housing at the Recuperative Care Program. Here they are provided with immediate housing, intensive case management, and primary care for post-hospital treatment. Patients are taken to follow-up appointments and can be referred for medical care, addiction, and mental health care services at Central City Concern’s Old Town Clinic, a federally qualified health center (FQHC) and health care for the homeless grantee. “There are four major components to the organization: health and recovery, housing, employment, and peer support,” Granum says. The Recuperative Care Program operates within housing.

People at Various Stages of Recovery Are Welcomed

There are 150 units in the building that house people in the Recuperative Care Program. The program-owned units are “wet,” meaning they are not alcohol and drug free. This is unique to Central City Concern’s comprehensive approach; people are welcome into the program at various stages of recovery. “There is no wrong door. It’s about timing and there is never a dull moment,” says Granum, who was recently named project director for a new project called the Interdisciplinary Community Care Team.

When he talks about what motivates him in this field, he talks about the intersection of many systems. “It is amazing to see people transition from the hospital, the criminal justice system, and outpatient care and to work with social service providers, faith-based groups, advocates, other people in our community who are struggling. I see a lot of people who are treated with dignity because we assume they are capable of succeeding,” says Granum.

Granum recalls one woman who came to Recuperative Care with breast cancer and opted out of cancer treatment. She also lived with schizoaffective disorder and this made it difficult for her to engage in care. “I remember her as fiercely independent, much like my grandmother,” he says. The woman had ended treatment with every doctor in the system but at some point made a connection with one of the doctors at the Old Town Clinic. Personal connection is so essential for people who have lost trust over time. She choose to go off and on her medications and had difficulties staying in one place. The staff at the program recalled that she loved the waterfront and liked to walk there. She was often more receptive to staff members when on walks. She also enjoyed reading. Eventually she chose to move into permanent housing at age 60. For a this woman to have her own home and make her own choices seemed like the greatest gift of life, even towards its end.

Learn more about SAMSHA’s homelessness grant programs and resources and how the Recovery to Practice (RTP) program helps practitioners improve delivery of recovery-oriented services.

Access more behavioral health and homelessness resources.

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Wendy Grace Evans
Last Updated: 04/19/2016