Roberto Arce, 47, at the men’s dorm at the Illumination Foundation Recuperative Care iin Santa Fe Springs, Calif., on Friday, February 12, 2016. Arce, a Mexican native, will be at the dorm for 2 weeks after suffering from heart failure. (Heidi de Marco/KHN)
After someone has a health crisis and gets emergency medical care, the patient is sent home to recover. But what if that person has no home? The homeless can't get well when they go back to the street, and they end up cycling back into expensive hospitals and emergency rooms.
Now one program in Southern California has tackled that dilemma by giving people just out of the hospital a place to heal – by turning cheap motels into triage and recovery wards.
Just up the freeway from Disneyland, in the city of Buena Park in Orange County, Paul Leon stands outside the beat-up remnant of a seedy motel. Above him, a faded pink sign advertises the Coral Motel – whose rooms back in its prime cost 35 bucks a night.
"This particular motel was going to be taken back by the city of Buena Park," Leon says, "because of the drugs, alcohol, prostitution at the motel."
Leon had another idea. As a public health nurse in Orange County, he proposed turning the motel lobby into a triage center and converting the rooms into clean recovery facilities for homeless people recently released from local hospitals.
Usually recuperative care centers are pricey to set up -- but this, Leon says, was just the opposite.
"The beauty of this, it's the poor man’s recuperative," Leon says. "They’re not the Hyatt or the Hilton, but they do serve a purpose for us. The costs to run it are much less."
The motel recovery room costs about half as much as a hospital would, that's about $2,000 less per person for each day. In some ways, it's better than being at home, because it has a nurse on staff to help supervise care and handle complications.
Elvin Quiñones is one of the patients staying at the Coral Motel. He walks me across the motel parking lot so he can show off his previous home -– a small white Datsun B210 sedan.
"I'll show you my house," he says, "it's not very big."
Quiñones is a solid guy, and it's hard to picture him crammed in the car along with his two dogs. In the days right after his gall bladder operation, he had a bunch of medical gear, too.
"I'll be honest, I was sleeping in front of Walmart, the 24-hour Walmart, because they had a bathroom," Quiñones says. "I still had a tube stuck inside me that was draining, so I needed someplace where I could empty out the drain."
Being homeless and helpless, he says, is "surreal."
"You think you're going to wake up, and it'll all be a nightmare. And you wake up and it's not," he says. "It's just the next day."
A week after his medical release, the hospital called and helped place him in the motel. Ginny Ripslinger is a nurse administrator at St. Joseph's Hospital in the city of Orange.
"This is a new model of care for Orange County," she says.
Over and above any state payments from Medi-Cal, California's health care program for the poor, hospitals and health insurers are happy to pony up some cash, she says. They save money by stabilizing these patients.
More than that, Ripslinger says, it's just the right thing to do.
"We don’t want to discharge them to the street," she says. "And there's an obligation on the hospitals to provide continuity of care and safe discharges."
While those homeless patients are recovering in the motel room over two or three weeks, there's a hidden benefit, Ripslinger says.
"You might say they're a captured audience. We can then provide the social services and the linkages to the community for stable housing and get them in a protected environment," she says.
Leon launched the homeless services nonprofit called the Illumination Foundation to help provide those community links and health services.
The foundation now has expanded the motel model of care to six sites in four counties –- Orange, Los Angeles, Riverside, San Bernardino -- and Leon says he has been working with dozens of cities across the country to establish similar models elsewhere.
"If you're just starting and you don't have a recuperative care program," Leon says, "one easy quick method is to use motels. They could basically start within days to house some of the patients that are the most vulnerable."
Every city has a homeless problem, he adds, and every city has its own version of the beat-up Coral Motel. It's a rare opportunity, Leon says, to turn two big problems into one solution.