A respite nursing unit at the new Higher Ground homeless shelter in St. Paul has health care leaders hopeful that they will no longer have to choose between letting homeless patients languish in hospital beds and releasing them to the streets, where they often struggle to care for themselves.
The 16-bed unit, which is being funded through a unique partnership of Regions, St. Joseph's and United hospitals in St. Paul, opened to homeless patients in mid-January but is being formally announced today.
Homeless patients with prescription medications often struggle to keep them refrigerated and take them as scheduled, or change hygienic wound dressings, or make follow-up appointments, said Dr. Ravi Balasubrahmanyan, a United physician who helped plan and raise funds for the unit.
"These folks can deteriorate and end up back in the hospital … and that can become a recurring cycle," he said. "They never get well enough … to actually leave homelessness."
The first of 21 patients sent to the unit by one of the three St. Paul hospitals had suffered frostbite when he fell asleep under a bridge on a cold night. The 38-year-old needed to keep his feet dry and change his dressings after leaving the hospital, which would have been difficult if he had been homeless in the winter and had to line up outside shelters for meals and beds, said Diana Vance-Bryan, a chief administrator for Catholic Charities of St. Paul and Minneapolis, which operates the new unit.
"It's not a healing environment on the street," she said. "To … carry a tray when you are carrying crutches and everything you've got on your back — for some of these people what we're asking them to accomplish is impossible."
The unit was created partly due to the growth in homeless mentally ill patients and the lack of places to transfer them after they have stabilized in inpatient psychiatric units.
Those patients either clog up hospital beds long after they need them — leaving other patients in crisis to wait in emergency departments for days — or get discharged without adequate support, said Mary Brainerd, chief executive of HealthPartners, which operates Regions.