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A new skid facility where homeless women can try to ‘recover and heal’


Before ending up in hospital, “I felt like I was invincible,” said Jillian, 58, who suffered from liver failure. “But I wasn’t.”

Alcohol had derailed his life. She struggled to keep a job and had strained ties with family and friends. When she walked out of the hospital to attend a program in a queue, it was not the life any little girl dreams of, said Jillian, who asked to be identified only by her first name to protect the intimacy with his family.

But she ended up “ending up in the right place with the right people” – a clean, quiet site dotted with palm trees that can feel like a world away from the stampede.

It’s called the Oasis, a 40-bed site operated by Wesley Health Centers and created through a joint effort by the City and County of Los Angeles.

“It’s a good place,” Jillian said, “for women to recover and heal.”

This skid facility provides “recovery care,” which includes medical follow-up, counseling, and case management, for homeless people who are medically vulnerable. These sites have traditionally served homeless people fresh out of hospitals, providing the kind of basic care other Angelenos might receive from family or friends back home while they recover.

Without this care, “if they have a healing wound, it cannot be cleaned. They don’t have a refrigerator to put their medications in,” said Libby Boyce, senior program director for the Housing for Health Division of the LA County Department of Health Services. “Like anyone coming out of a hospital, he goes home and someone is watching to make sure he’s okay.”

The programs aim to end the revolving door between the emergency room and the street for the homeless.

An analysis of urban hospitals in Connecticut and Florida calculated that such programs, also known as “medical respite,” shorten the typical length of hospital stays for unhoused patients by two days and reduce future hospital trips, saving $1.81 for every $1. invested. In LA County, researchers also found an increase in the number of patients using primary care – essential medical services that can prevent future crises.

The aim is to stabilize people so they can recover mentally and physically and hopefully move into accommodation, supporters say.

“We are often asked the question: “Does this solve a health problem or a housing problem? said Julia Dobbins, director of medical respite for the National Health Care Council for the Homeless. “And the answer is yes. It’s both.

Cynthia Taylor-Davis, 72, said she has been a resident of the Oasis for three months, where she is recovering from hip replacement surgery and the loss of her daughter to cancer.

(Irfan Khan/Los Angeles Times)

In addition to people being discharged from hospitals, recovery care has also been used by county health departments as an option for homeless people whose medical or psychiatric conditions prevent them from living in a typical shelter.

They must be independent enough to handle day-to-day activities, but may struggle with schizophrenia, live with amputated limbs, use colostomy bags or manage chronic conditions like diabetes, staffers said.

The Oasis is the first such facility under the Housing for Health program which specifically targets homeless women, many of whom have histories of trauma and abuse.

In an assessment three years ago, the Downtown Women’s Center found that 44% of homeless women surveyed in Los Angeles had been the victim of a crime in the previous year, 36% had experienced domestic violence and 27% had been sexually assaulted during this period. . Nearly 60% rated their mental health as fair or poor. Over 40% reported having an ambulatory disability.

“It was the best place, closest to home, to be able to be myself and feel a little bit human, and get back to where I was,” said Cynthia Taylor-Davis, 72, who said that she had been in the institution for three years. month. “I want to be able to go back to work. Walk normally. And above all, to overcome my depression following the loss of my daughter.

Taylor-Davis said she’s been struggling since losing her daughter to esophageal cancer. She thinks the disease should have had it, she said, before it hit her daughter. She is also trying to regain her mobility after hip replacement surgery. She remembers, with nostalgia, that it has been years since she was able to ride a bike.

“It gives me confidence to take a step without falling. I had a love affair with cement a few times,” Taylor-Davis said. “I can laugh about it now…but it wasn’t a laughing matter.”

Inside the Oasis, the walls are painted in serene shades of sage and aqua and adorned with glossy photographs of the woods. Dorms are structured with cabin-like segments that have sliding doors to provide some privacy.

Edenia Jones, associate director of recovery care and enriched service programs at Wesley Health Centers, is still fixing up the community room, where she plans to have computers and an exercise area. The women recently celebrated a ‘spring adventure’ in the backyard with a DJ, catered food and ice cream, where some stood up and sang karaoke.

“I want them to feel at home,” Jones said.

Jillian, who worked as a veterinary nurse, recalls coming to another recovery care program run by Wesley Health Centers for the first time and trying to hand in her food stamps and general relief payments to the admissions coordinator, who turned them down. “Don’t I have to give you this so I can stay here?” she remembers asking him. “He said, ‘No, no, we provide everything for you. “”

After the lights come on each morning and she gets up, she often goes to medical appointments offsite. “You find out that after not taking good care of yourself for a few years, there are a lot of things wrong with you,” she said. “Especially with my age group.”

She sees a hepatologist. A cardiologist. A neurologist. An ophthalmologist. She began attending a relapse prevention program for alcohol use. Her hepatitis C disappeared, she said, and she did not return to the hospital for liver failure. In the courtyard of the Oasis, an employee took care of her hair in the shade of an umbrella.

She wants to start working with animals again, maybe volunteering. And her ultimate goal is to get closer to her grandson.

“I’ve missed so much already,” Jillian said. “He’s going to be 3 years old.”

Maria Todd, 87, has her vital signs checked at the Oasis.

Maria Todd, 87, has her vitals checked at the Oasis, where she says she is getting “everything I need”.

(Irfan Khan/Los Angeles Times)

In Los Angeles County, “demand for recuperative care beds currently far exceeds supply due to record levels of homelessness, deep shortages in all forms of housing” and the demands of a project state law intended to stop patient dumping, a report prepared for the UniHealth Foundation found two years ago.

Although the programs cost much less than keeping a homeless patient in a hospital, they were generally not covered by Medi-Cal in the past. That meant many hospitals were “essentially paying for it out of their own funds,” said Paul Young, senior vice president of public policy and reimbursement for the Hospital Assn. from southern California.

The UniHealth report found that as a result, private hospitals rarely paid for stays beyond one month. Health officials hope changes to Medi-Cal can help: Starting in January, recovery care can be covered for a few months under CalAIM, a new plan to overhaul the Medi-Cal system.

Even before this change, LA County was funding longer stays in recuperative care through its Housing for Health program, which secured funding through a pilot program for Medi-Cal beneficiaries called Whole Person Care. Housing for Health now has more than 700 beds for recuperative care across the county, with more on the way.

The day-to-day operations of the Oasis are funded by the city through the Los Angeles Homeless Services Authority and the county through Measure H, a sales tax that pays for homeless services.

If someone no longer needs the level of care that the program provides, DHS tries to find them another place, either in temporary or permanent housing. But “even people with housing vouchers have trouble finding apartments,” Boyce said. This means people are staying longer in temporary accommodation – more than six months and sometimes up to a year, she said.

Dobbins, of the National Health Care Council for the Homeless, said the same issue is facing programs across the country. When someone is ready to leave, “the ideal is not to put someone back in a situation of homelessness that led them to respite in the first place. We don’t want people going in and out of bike respite programs.

“And it’s really difficult right now because of our lack of housing options,” Dobbins said.

Among the residents of Oasis is Maria Todd, 86, who had previously stayed in a row shelter. Oasis staff members said the elderly woman had been victimized there; Todd said her purse was stolen but blamed herself for being distracted while watching TV. She had withdrawn thousands of dollars from the bank to send to her epileptic son in Mexico, she said.

“We have sworn to keep her until we can actually provide her with a suitable place to go,” said Abbye Walker, director of the Wesley Health Centers Recovery Care and Enhanced Services Program. “Because she doesn’t need to be victimized anymore.”

Todd, who converts from English to Spanish, has been in recovery care for about two years, initially at another site run by Wesley Health. She claimed that “they don’t let me go out on my own”, but said that “they take me to the doctor, whatever I need”. What she really wants, Todd says, is a house – a new one in Mexico.

“A good house, made of stone, not wood,” Todd said in Spanish. “So I can die there.”

“It’s my dream,” Todd said. “Dreaming costs nothing.”




Los Angeles Times

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