Recuperative Care Demonstration Project

Brief Description
Homeless persons needing further recovery from physical injuries or illnesses after hospitalization (i.e., those who are not sick enough to remain in hospitals, but are too sick for the streets) need recuperative care beds where they can recover with medical oversight. With a homeless population estimated at 88,000, LA County has only 45 recuperative care beds, all located in Central City East (Skid Row). In 2006, hospitals in LA County discharged an estimated 7,500 homeless inpatients, of which 12% or 900 needed recuperative care. It is estimated that these patients were, on average, kept up to four extra days in hospital inpatient settings because, in most cases, there were insufficient, appropriate beds to which they could be discharged. Given this situation, the Recuperative Care Coalition Steering Committee proposed a two year demonstration project to double the number of recuperative beds in LA County from 45 to 90.

Measured or Anticipated Outcomes
  • Improved access to recuperative care for homeless individuals
  • A 100% expansion in capacity of the current recuperative care system
  • That the proposed model(s) can be self sustaining at the conclusion of the demonstration period
  • A potential of being replicated nationally

Policy Implications
  • The project seeks to both expand recuperative care capacity while assessing the feasibility of an innovative fiscal approach combining foundation dollars with private hospital funding.
  • Not only does recuperative care provide basic medical care and oversight in a clean, safe environment for homeless patients transitioning out of an acute care hospital but the project also reduces unnecessary hospital stay days and associated costs for hospitals.
  • The need for recuperative care services expands beyond Los Angeles County and the Southern California area where recently discharged homeless patients have no place to recover, facing worsening health conditions which require more immediate, and often more costly medical treatment.

This project has been generously supported by Kaiser Permanente, QueensCare Foundation and LA Care.

Key Partners
The Recuperative Care Coalition Steering Committee includes LA County Department of Health Services, the Hospital Association of Southern California, JWCH, Inc., Kaiser Permanente, LA Health Action, and Neighborhood Legal Services. Another key partner is Salvation Army Bell Shelter.

Kelly Bruno, Vice President, Programs at