Gregory Sovick lived on the streets of Redding for 10 years after experiencing family deaths and financial losses.
Eventually, he met Dr. Kyle Patton, the medical director of the HOPE (Health Outreach for People Everywhere) program at Shasta Community Health Center and a street medicine doctor.
"I met Dr. Patton in the bush. I had respect for him because he was out in the bush," Sovick said. "It takes a lot of guts to do that."
At the time, Sovick, 64, had a growth on his nose that Patton thought should be removed. But Sovick’s camp was swept soon after that, and Patton couldn’t follow up.
When he finally saw Sovick again, months later, the cancer had grown a lot.
"It started to get into my eye and on my upper lip," Sovick said. "I went into radiation treatment, and that's where I lost my right eye."
Sovick needed a place to rest and recover while receiving radiation therapy.
Enter medical respite: a quiet place for homeless people to heal from an acute issue, like an infection or a wound — something that could put them in the hospital or would be hard to heal on the streets.
Patton sees it as a stopgap.
"We're the safe discharge plan for the hospital," he said.
Medical respite is for people who need more care than a traditional homeless shelter provides. They don’t have a home for a health aide to visit, and they might not have insurance. Even if they do, it might not cover long-term stays in a facility.
"I call it the 'you can't go home, but you can't stay here' type situation," Patton said. "I don't have anywhere else to send them, but I can't just leave this patient here in this situation."
A 2022 study found that many community-based caregiving programs aren’t designed to meet the needs of people without stable housing. The research also noted that with the high cost of long-term and skilled nursing care — as much as $100,000 per person annually — new strategies are needed to help cut those costs.
Medical respite at Hartman House
The HOPE program’s medical respite served 133 people last year, both in hotels, like Sovick, and in its Hartman House, run by the Shasta Community Health Center and the nonprofit Pathways to Housing.
Walking into the house, on a quiet residential street in Redding, gives the impression of walking into both a home and a doctor’s office.
There’s a medical clinic with weekly visits from a nurse. People usually stay for two to three months and receive case management while here.
Not having access to things like medical respite can lead to further medical issues and additional costs.
Jo Weaver, professor of global studies at the University of Oregon, told the story of an older woman in a wheelchair living in her car.
"She has diabetes, and that's what led to the loss of her limb, and she isn't able to get to public toilets, which are generally port-a-potties, easily," Weaver said.
She explained that while the woman needs medication to manage her diabetes, she avoids taking it because of its gastrointestinal side effects — side effects that are hard to manage without reliable access to a bathroom or shower.
Statewide recommendations for medical respite
There’s a need for more places offering medical respite care.
"There's a major gap here, and a lot of people are falling into that gap," said Jimmy Jones, executive director of the Mid-Willamette Valley Community Action Agency.
Jones chaired a task force on hospital discharge challenges in Oregon. The goal was to figure out how to prevent patients from languishing in hospitals.
Patton said some patients remain in the hospital simply because there’s no safe place for them to go — a common issue in communities without medical respite care.
"You're not supposed to discharge them to the streets or the shelter,” he said. “And then what do you do? They stay in a hospital bed for a period of time, which is a high cost to that health system."
Both Providence and Asante declined requests for an interview about whether this is happening in their hospitals.
One of the hospital discharge task force’s recommendations was expanding medical respite statewide.
There have been similar recommendations in California.
Participants in a 2023 study by the UCSF Benioff Homelessness and Housing Initiative told researchers about how they were discharged onto the streets or into shelters that couldn’t support their recovery. The study recommended increasing the availability of medical respite to decrease the length of hospital stays and improve health outcomes.
Jones’s agency runs a program like that.
"That model is very successful in keeping people alive because a lot of times the homeless population that goes through a hospital system, they may have quite pronounced chronic ailments that trying to fully recover outside from, especially when it's wet and cold, is just not plausible," he said.
Jones said the current siloed system isn’t built to cover the overlap between health care and housing.
"When we have this kind of wide gaps and chasms between the scope of the state agencies, then when you get a complex problem that has many facets to it, like this one, they frequently just fall right in the middle," he said. "That's what's happened here."
Medical respite also means using funding creatively. The HOPE program gets money through Medi-Cal and the federal government.
But Patton said this funding model can be uncertain, making it hard for new medical respite centers to open.
"Historically, they just haven't really been reimbursed," he said. "There hasn't been a reliable funding stream for medical respite. The places that you've seen do it have done it well, but it hasn't been like a broad sort of policy initiative, like we're going to fund all medical respite programs across the country."
So there’s still more need for this type of service.
A bill in the Oregon legislature would direct the Department of Human Services and the Health Authority to study options to expand medical respite.
But Jones said not much has happened since the task force’s report came out in December.
"I don't think that concept has advanced very far yet," he said.
Even if there’s the political will and the funding, it will take time for agencies to create more facilities to fill this gap.
And even once homeless people leave medical respite, they still face the next obstacle: finding permanent housing.
