Gateway Center aims to fill gap in health care for homeless - Albuquerque Journal

Gateway Center aims to fill gap in health care for homeless

The city of Albuquerque plans to establish its first Gateway Center in the former Lovelace hospital. In addition to shelter beds, the facility could be the first in the city to feature “medical respite” care — a service that would give individuals without homes a place to recover from acute illness and injury. (Jim Thompson/Albuquerque Journal)

Copyright © 2021 Albuquerque Journal

What many might consider a minor injury could spiral into a health crisis for those living on the streets.

An everyday cut, for example, can advance to a bacterial infection without proper washing and wound care, said Rachel Biggs, policy director at Albuquerque Health Care for the Homeless. Even common viruses can be more difficult to beat without a safe place to rest and recover.

“What happens, especially with this population we’re talking about, is if you have an acute illness that’s not treated quickly and effectively with a home in place, it’s going to turn into a really long-term illness and could lead to death,” Biggs said during a new city webinar focused on local homeless service providers.

But advocates and city officials say Albuquerque’s new Gateway Center could provide a solution.

The city’s vision for its first Gateway Center – which it will create inside the old Lovelace hospital on Gibson – includes 25 to 50 medical respite beds. The beds would be in addition to, and separate from, the estimated 150 to 175 regular shelter beds, according to city officials.

Medical respite provides people without homes a place to recover from short-term illness and injury. It can be the next stop after a hospital discharge or an alternative for those who might otherwise seek treatment in the emergency room.

Biggs said a needs assessment identified medical respite as a gap in the local homeless services landscape. While there are more than 100 such programs around the country today, she said, there are none in Albuquerque.

And while that needs assessment was last updated in 2019, the ongoing pandemic further revealed the demand.

Quinn Donnay, the city’s Gateway project coordinator, said hospitals strained to handle both COVID-19 surges and the ordinary emergency room load.

“It was very clear that (medical respite) was a higher need than we probably knew before the pandemic. I think service providers knew, but we didn’t really understand the total scale until hospitals were getting a lot of COVID patients and they couldn’t actually see the folks who would normally end up in the ER because that’s the only place we have right now,” she said.

The safety nets currently available in Albuquerque are not enough, experts say.

If someone comes to AHCH today with an acute health issue that is not severe enough for hospital admission, the organization typically puts the person in a motel with a short-term voucher. But Biggs said that means limited medical attention.

Another option is the “social” model recuperation programs available at a few area shelters. They offer a place to sleep, get regular meals and access some medical care.

The Albuquerque Opportunity Center men’s shelter, for example, has 30 of those beds. The facility helps clients get to and from medical appointments, has two exam rooms for providers making on-site visits and, before COVID-19, hosted weekly clinics with University of New Mexico medical students.

But medical respite is at least one step above that. It would include 24/7 supervision and regular medical oversight.

“Sometimes that’s just a daily check-in with a medical provider; sometimes that’s wound care,” Biggs said in an interview with the Journal. “It depends on the needs of the individual.”

Unlike congregate shelter settings, the Gateway Center’s medical respite program would likely place just two people in the same room with their own bathroom.

“It would be truly quiet and comforting,” Donnay said.

Advocates say medical respite offers multiple benefits. Providing a safe, medically supervised setting can help clients stave off more serious health problems, which can in turn alleviate pressure on local hospitals and emergency rooms.

And because clients tend to stay about 30 days, service providers have a big window to tackle housing needs. They can assist patients signing up for benefits like Social Security, Medicaid and food stamps and identify more stable living situations.

The Albuquerque Opportunity Center has noticed that opportunity in its recuperative program; officials say case managers capitalize on the time they have with the recovering clients.

“It’s not that they’re just laying there recuperating; we’re in there saying, ‘OK, let’s work on your housing plan,’ ” said Dennis Plummer, CEO of Heading Home, which manages the facility. “We see a pretty good success rate of exits into housing because they don’t have anything else to do (during their stay).”

AOC started as a standard overnight men’s shelter and still has that component. But Plummer said management was spurred to start a recuperative program while housing a client who had just undergone hernia surgery and was unfit to leave during the shelter’s daytime closure.

“He had almost passed out trying to get on the bus (coming to the shelter),” Plummer recalled. “In the morning, we were like, ‘You can’t go back out. Let’s figure this out.'”

AOC now has contracts with local hospitals to provide a 24/7 step-down facility. But it has no medical personnel on staff and does not, for example, provide in-house wound care, which is a major need.

Biggs said Albuquerque Health Care for the Homeless uses more of its motel vouchers for clients recovering from skin infections than any other malady.

But other top reasons it refers people to the motels are acute illnesses, like the flu, acute pain, and recovery from assault and trauma.

“We’re excited to see the movement on medical respite, and we’re really happy to hear that medical respite will be included in the city’s plans moving forward,” Biggs said.

Donnay said the city is still working out many details of its planned medical respite program and for the Gateway Center in general.

The city’s purchase of the Gibson facility closes April 1, and many steps remain before the city can open it as a Gateway Center, including design work and a permitting process. It is unclear exactly when the planned shelter and medical respite elements would launch.

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