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Recuperative care offers a safe, clean place to recover for sick homeless

As the number of deaths among Orange County's homeless increases, advocates believe giving homeless people a safe, clean place to recover from injury or illness may slow the uptick in those dying on the streets. 

The "recuperative care" model caught on about a decade ago, when hospitals were caught dumping sick homeless patients on L.A.'s Skid Row. Hospitals contract with non-profits and other organizations that run temporary housing centers with a nursing staff and social services where a homeless person can rest and get better.

Llyod Wayne Brooks, 58, was homeless for about two years living on Skid Row, in Baldwin Hills and other parts of Southern California before he moved into the recuperative care center in Santa Fe Springs run by the non-profit Illumination Foundation. 

“Life just kind of took a different turn for me after my health began to fail,” Brooks said. 

A social worker from the Illumination Foundation found Brooks in a Los Angeles hospital in September fresh from his third knee replacement surgery and with no place to go to recover.

The Illumination Foundation — which runs three recuperative care centers between Los Angeles and Orange counties and the Inland Empire — takes in  homeless patients primarily, who are strong enough to leave the hospital after an illness or injury but are too weak too be back on the streets. 

Brooks spends his day in a wheelchair because his knee has inflamed into a painful swell that has been draining for a year. On top of that, Brooks is now fighting a severe staph infection from a previous knee surgery.

"It hurts all the time," said Brooks. "If I try and get up, I can’t walk. I can’t take a step on it.”

Lloyd Brooks Sr. suffered from cartilage damage in his leg while working as a mover in the 90s. He's spent five months at Illumination Foundation in Santa Fe Springs.
Maya Sugarman/KPCC
Lloyd Brooks Sr. suffered from cartilage damage in his leg while working as a mover in the 90s. He's spent five months at Illumination Foundation in Santa Fe Springs.

While Brooks waits for his fourth knee surgery, he works with the recuperative care center's social workers on how to be self-sufficient in his wheelchair, learning a non-physical job skill, finding permanent housing and understanding how to take care of his basic health needs.

“People experiencing homeless don’t always take care of themselves,” said Aiko Tan, healthcare services director for the Illumination Foundation. “When they do end up in hospital, they have a lot of things happening with them. It’s not just one issue.”

That means conditions worsen and immune systems weaken.

According to data analyzed by KPCC, the number of homeless people dying in Orange County jumped by 53 percent from 2013-2015. Meanwhile, the overall homeless population went up only five percent. Orange County Coroner records indicate many are dying from overdose and compounding health ailments that are treatable, or at the very least, manageable, if having a home wasn’t an every day worry. 

There 428 homeless people who have died in Orange County since January 2013. The most deadly month was September 2015 when 27 homeless people died, followed by December 2015 when 21 people lost their lives. (Data collected from the Orange County's Coroner's Office.)
There 428 homeless people who have died in Orange County since January 2013. The most deadly month was September 2015 when 27 homeless people died, followed by December 2015 when 21 people lost their lives. (Data collected from the Orange County's Coroner's Office.)

Tan and other homeless advocates think recuperative care's model of a warm hand-off for homeless patients discharged from a hospital with healthcare and social services, could keep give homeless people a better chance at living longer.    

“I think that’s what we’re trying to do is eliminate hurdles to healthcare,” she said. 

Hospitals like it, too.

“It has been a very beneficial partnership we’ve had,” said Barry Ross, vice-president of the Healthy Communities program at St. Jude Medical Center in Fullerton.

Ross said the hospital refers an average of six to seven patients a month to recuperative care. 

Yet it's taking a while for the model to catch on in Orange County.

CalOptima, the healthcare insurance program for low-income and disabled people in Orange County, announced January 2015 that it would offer up to $500,000 in reimbursements to hospitals for referring homeless patients to recuperative care. It doubled that funding commitment later that Fall.

So far, 147 patients have been referred by nine out of 18 contracted hospitals with CalOptima. There is still $864,000 left in the reimbursement program.

“Hopefully those numbers will increase,” said CalOptima board chairman Mark Refowitz. “It should be done every community in the United States.”

Los Angeles County opened its third recuperative care center in South L.A. in January with 100 beds. A typical stay is about 45 days, said Cheri Todoroff with the county’s Department of Health Services.

L.A. County contracts with the Illumination Foundation for $150 a night when the 163 beds are full at the county’s three recup centers. The non-profit helps out with about 30 beds per night, said Todoroff.

Part of the attraction for government officials is that the recuperative care centers can provide a bridge to housing.

Jerry Scobee, 47 of Orange, stayed at the recuperative care center in Buena Park with the Illumination Foundation after he was discharged from the psychiatric ward. He’s chronic depression coupled with brain injuries from a serious car crash long ago make him vulnerable to homelessness.

“If this wasn’t here, I don’t know where I’d go,” Scobee said. “I don’t want to be in the streets, you know.”

And he won’t be, at least not for now. After his two-week stay in recuperative care, Scobee moved into transitional housing where the hope is he’ll stay until he can move into permanent housing with some supportive services to help him later.

Illumination Foundation staff member Gillian Elson helped client Jerry Scobee, 47, during his two-week stay at the non-profit's recuperative care center in Orange County and helped him find temporary housing.
Erika Aguilar/KPCC
Illumination Foundation staff member Gillian Elson helped client Jerry Scobee, 47, during his two-week stay at the non-profit's recuperative care center in Orange County and helped him find temporary housing.