Certification for Medical Respite Programs: On the Horizon 2024-2025

ON THE HORIZON 2024-2025

Certification for Medical Respite Programs

Why is certification needed? And why now? Medical respite care (MRC) fills an important gap in the health services continuum, offering short-term residential programming where people experiencing homelessness can rest, recover, and heal in a safe environment while accessing medical care and other supportive services. The field of medical respite care (MRC) is growing rapidly, and health systems, managed care plans (MCPs), and policymakers at all levels of government are increasingly recognizing the value of MRC programs. At least 14 states are in various stages of exploring and/or implementing Medicaid reimbursement mechanisms for MRC services. As the field continues to evolve, there is an increasing need to clearly define characteristics, quality standards, and oversight of MRC programs. A carefully designed certification process from a trusted national voice can meet these needs and safeguard the dynamic and innovative work done by MRC operators. It can also prevent unintended consequences that may arise if government agencies institute prescriptive licensure processes.

Why NIMRC?

As the preeminent entity dedicated to expanding access to high-quality MRC nationwide, the National Institute for Medical Respite Care (NIMRC) — a special program of the National Health Care for the Homeless Council (NHCHC) — is uniquely equipped and positioned to meet this need through the design and implementation of a voluntary certification process for MRC programs. Building on knowledge and expertise accumulated by NHCHC and the Respite Care Providers’ Network (RCPN) over the past 30-plus years, NIMRC was launched in 2020 to strategically advance and elevate the field of MRC.

In 2022, our team at NIMRC began to carefully consider the implications and explore the feasibility of creating such a certification process by interviewing dozens of key informants representing MRC programs, hospital systems, MCPs, state officials, and more.

These interviews provided resounding affirmation that there is appetite for a certification specific to MRC — particularly one that is reliable, inclusive, pragmatic, and does not compromise access to this life-saving intervention.

“NIMRC’s certification process is an important next step in furthering support and structure for medical respite programs across the nation. I appreciate the thoughtful way that NIMRC has built the certification process, gathering feedback and data along the way from national partners and providers, which in turn creates a peer-led and supportive learning environment.”

SUSANNAH KING, MSW, LICSW

Chair of the Respite Care Providers’ Network, Social Services Manager at Hennepin County Health Care for the Homeless

ON THE HORIZON CERTIFICATION FOR MEDICAL RESPITE PROGRAMS

How will the certification process work?

Our certification process is built on robust stakeholder input and a nationally recognized Framework for Medical Respite Care Programs developed in collaboration with the long-established network of MRC providers (the RCPN). We have carefully developed and tested mechanisms for assessing MRC programs’ fidelity to the Guiding Principles of MRC and to the Standards for MRC.

Further, our typology for grouping programs by their Model of MRC augments the certification by providing sufficiently detailed information about a given program’s bundle of services to be useful for funders, referring partners, potential clients, and other stakeholders.

Additional certification components include: (1) collecting evidence that MRC programs systematically gather feedback from clients and incorporate clients’ voices into their programming, and (2) an in-person site visit from a qualified peer MRC provider.

Importantly, we have intentionally designed this to be a supportive and collaborative certification process, with NIMRC offering guidance, resources, technical assistance, and peer connections to help MRC programs succeed in providing high-quality care that aligns with nationally recognized standards and practices. We are confident that our certification meets a demonstrable need in the evolving MRC landscape, while presenting MRC programs with an opportunity to enhance the care they provide, strengthen partnerships, promote their work, maximize impact, and elevate the field.

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“Kaiser Permanente is proud to support NIMRC and the work to advance medical respite, which is vital in caring for people experiencing homelessness. Certification will strengthen the ties between healthcare systems and respite programs, ensuring their financial stability. NIMRC is well positioned to guide organizations through certification due to its focus on local needs and strengthening the network of respite programs.”

PAM SCHWARTZ, MPH Executive Director of Community Health, Kaiser Permanente

“This certification process helps to validate the great work that NHCHC and NIMRC have been doing for years and will help to achieve long-term sustainability for medical respite/recuperative care services under Medicaid.”

ASHLEY BRAND, MA, MPH, CPH System Director, Community Health, Integration and Housing – CommonSpirit Health

The National Institute for Medical Respite Care (NIMRC) is a special program of the National Health Care for the Homeless Council, a national nonprofit working at the nexus of homelessness and health care. NIMRC is a singular national institute that advances best practices, delivers expert technical assistance services, and disseminates state-of-field knowledge in medical respite care. Visit nimrc.org to learn more.

What’s already been accomplished?

From June to December 2023, our team field tested the first iteration of the certification process with five MRC programs. Encouragingly, all five participating programs successfully completed each element of the certification process. This highly effective field test represents a pivotal step toward launching the first national certification process for MRC. It yielded valuable insights, and we’re currently refining the process based on lessons learned.

At the conclusion of the field test, participating programs saw an increase in the quality and

consistency of their services. They appreciated the structured process for formally recognizing existing strengths, and even more so, they valued the key opportunities for growth that were identified. Additionally, participants noted that certification demonstrates credibility and legitimacy that can be leveraged to enhance funding proposals and garner community support.

With guidance and resources from NIMRC, participating MRC programs realized substantial improvements in their fidelity to the Standards over the course of the field test. The objective results of the 2023 field test, the feedback from those who participated, and the recommendations of many other key contributors offer confidence that this certification will effectively meet the needs of the MRC field, while minimizing unintended consequences.

“By helping us to codify many of our practices — which we carried out intuitively — our staff has grown in their understanding of the value of adhering to well-vetted standards of care.”

JAMES GINSBURG, MNM, CAC III Executive Director of RecoveryWorks, a field test participant

What’s next?

Questions?

Feedback?

Please reach out to Julia Dobbins at jdobbins@nhchc.org. We look foward to hearing from you.

In Summer of 2024, we will launch the next phase of implementation: piloting the certification process with 10 MRC programs. This pilot will lay the groundwork for our anticipated rollout of a fully operational certification for the field of MRC in early 2025. Consistent with NIMRC’s underlying values, we will continue to prioritize the input and expertise of our MRC community in each stage of development. We are excited to enter the next phase of this initiative, and we will continue to share updated information as this vital work progresses.

Summer 2024 Pilot (10 programs)

Early 2025 Rollout of certification Late 2023

Fall/Winter 2024 Refine and finalize the certification process