Cook County Medical Respite Network
What is Medical Respite?
According to the National Institute for Medical Respite Care (NIMRC), medical respite is post-acute care for people experiencing homelessness who are too ill or frail to recover from an illness or injury on the street or in a shelter, but who do not require hospital level care. Medical respite provides short-term residential care that allows people an opportunity to remain near their community, rest, recover, and heal in a safe environment while also accessing clinical care and support services.
Core component of medical respite programs include:
24-hour access to a bed
3 meals per day
Transportation to medical appointments
Access to a phone for telehealth and/or communications related to medical needs
Safe space to store personal items
Wellness check at least 1x every 24 hours by medical respite staff
Common Referral Guidelines
Please see Network Guide profiles for unique features of each program. Some common eligibility requirements for Medical Respite include:
Ineligibility/Contraindicators
Self-referral
Active homicidal or suicidal ideation
Stable chronic medical conditions or absence of medical need
Eligibility Requirements
Experiencing homelessness
Primary diagnosis is medical – secondary diagnoses may be mental health or substance use if conditions are stable
Experiencing acute medical need including associated with chronic condition
Independence with Activities of Daily Living (ADLs)
Four Models of Medical Respite
The location, intensity, and delivery of services is variable by each program. The model informs the acuity and types of conditions that can safely be served within the medical respite. National Health Care for the Homeless Council (NIMRC) categorizes the bundle of services offered by Medical Respite programs into four models of care. Each Medical Respite program in this Network Guide adopted and implemented a model under the NIMRC standards. Referring partners may benefit from understanding the models and associated programs to inform the outreach and referral process based on patient need. The distinguishing features of the integrated and complex care are specific to onsite access or on-call medical and behavioral healthcare.
| Coordinated Care Model | Coordinated Clinical Care Model | Integrated Clinical Care Model | Comprehensive Clinical Care Model | ||||
|---|---|---|---|---|---|---|---|
 |
Case management/care coordination for medical needs | |
Case management/care coordination for medical needs | |
Case management/care coordination for medical needs | |
Case management/care coordination for medical needs |
 |
Case management/care coordination for social needs | |
Case management/care coordination for social needs | |
Case management/care coordination for social needs | |
Case management/care coordination for social needs |
 |
Medical needs addressed through community-based or externally located medical services | |
Provision of basic onsite medical/ clinical services and coordination with community-based providers | |
Integrated onsite clinical services such as condition monitoring, and coordination with community-based provider | |
Comprehensive onsite clinical services such as daily condition monitoring, and coordination with community-based providers |
 |
Medication support, clients self-manage medication | |
Medication management, by clients and licensed clinical staff (review and education) | |
Medication management, by clients and licensed clinical staff (education, reconciliation and prescribing) | |
Medication management, by clients and licensed clinical staff (education, reconciliation, prescribing, and administration) |
 |
Identification of need for and connection to community behavioral health services | |
Identification of need for and connection to community behavioral health services |  |
Connection and transition to primary care provider/health home before discharge if medical needs are managed by onsite clinical staff | |
Connection and transition to primary care provider/health home before discharge if medical needs are managed by onsite clinical staff |
|
Behavioral health services through screening, onsite care, and referrals to community partners | |
Behavioral health services through screening, onsite care, medication prescribing, and referrals to community partners | ||||
 |
24-hour program staffing | |
24-hour program staffing with ability to monitor high level medical needs | ||||
 |
On-call medical support | |
On-call medical support |
.
About the Network Guide
This Network Guide is a tool for referring-hospitals and health centers to find Medical Respite programs across Cook County for people experiencing homelessness. This is a product of the Illinois Medical Respite Capacity Building Initiative made possible by the Illinois Office to Prevent and End Homelessness.
The Network Guide creates a central platform for information about programs and will be updated as new programs open. It is also a place to access links to websites and referral forms and locate contact information. Programs have differences in facility size, space sharing, and physical accessibility. The goal of this Network Guide is to expand awareness of the range and number of Medical Respite providers across Cook County, and future iterations will expand the tool statewide.
While all Medical Respite programs are for recovery from acute illness or injury, programs differ in the level of onsite medical or behavioral health staffing, as well as physical accessibility features such as elevator and bathroom accommodations. Programs indicate “Common Medical Conditions,” as examples of trends in service needs but does not indicate an exclusive specialty or eligibility criteria. The data collected across existing programs show the most common reasons for a denial into Medical Respite are:
no acute health need
too high of health needs
poorly managed mental health
Bed capacity is also a reason for denial but is not one of the primary reasons. However, referrals that are accepted may still result in pending admission based on bed availability within the timeline needed to accommodate the hospital discharge plan. Medical Respite providers encourage appropriate referrals despite potential capacity limitations to coordinate patient care for people experiencing homelessness.
The Boulevard of Chicago
Address: 3456 W. Franklin Blvd, Chicago, IL 60605 (West Humboldt Park)
Geographic Service Area: Chicago, Suburban Cook County
Bed Count: 64
PGM Respite
Address: 1458 S Canal St, Chicago, IL 60607
Geographic Service Area: Chicago South Side and West Side neighborhoods
Bed Count: 7
RISE Center
Address: 211 N Oak Park Ave, Oak Park, IL 60302
Geographic Service Area: Suburban Cook County, Chicago residents patients of Cook County Health or County Care
Bed Count: 19
Sojourner House
Address: 324 N. Austin Ave, Oak Park, IL
Geographic Service Area: Suburban Cook County, Chicago
Bed Count: 5
Summit Service Center
Address: 7666 W 63rd Street, Summit, IL 60501
Geographic Service Area: West and Southern Suburban Cook County
Bed Count: 18