By Jennifer Vanore, Ph.D.

If you were to ask any Angeleno what is the most salient political issue right now for the city, I imagine most would say the crisis of homelessness. Skyrocketing rents, limited affordable housing, climbing interest rates, high property values, and the time it takes to build new housing have contributed to the rising number of people experiencing homelessness in LA County.

As the number of people experiencing homelessness has risen in LA County, so has the number of the unhoused seeking treatment in emergency rooms and hospitals. Recuperative care beds have been one option for discharging unhoused patients who were well enough to leave the hospitals but too ill to return to the street (if there is such a thing). In the past in California, hospitals typically paid for recuperative care beds since medical insurance plans did not cover the cost of “housing,” (recuperative care’s technical category).

This changed dramatically in 2023 when Medi-Cal insurance introduced reforms called CalAIM, including the addition of recuperative care as a reimbursable service. While this was a massive win for the health of our neglected and underhoused neighbors, it was also an enormous bureaucratic undertaking for the State, the providers, and the entire health and housing systems writ large.
UniHealth Foundation has been deeply committed to the success of these systems changes. We have invested heavily in organizational capacity building and community collaboration to imbed CalAIM practices and ensure their successes within both the housing and healthcare systems, particularly with recuperative care. We have called this effort our Pathway to Health and Home initiative.

One of our many grantees, the National Health Care for the Homeless Council, has been working locally with the Los Angeles Recuperative Learning Network. This group of representatives from recuperative care providers, managed care contractors, and hospital administrators meets monthly and has grown in scope and influence to such a degree that it now hosts an annual convening. They held their second conference in March.

Having attended both the first and second annual convening, I was struck by the differences between Year 1 and Year 2. The collaboration, communication, and camaraderie achieved between Year 1 and 2 was remarkable. There were victories celebrated, such as a shared and uniform referral form across managed care plans for hospital staff to use for discharging patients to recuperative care sites. These seemingly small wins resulted from months and months of conversations and trust-building across multiple partners.

Panel after panel highlighted stories of patients who had transitioned from hospital to recuperative care to health and then into a home of their own. These stories captured the shared purpose and calling from everyone in the room. Not every patient or client achieved the success they sought, of course, but it was clear that every provider and person in the room had tried their hardest to connect the patient to care and community.

As UniHealth enters our fourth year of the Pathway to Health and Home initiative, we plan to assess what we have accomplished and learned from our partners. We will share more in the next year, but just based on the LA Recuperative Care Learning Network, I am seeing a change that is improving the health of those who are the most vulnerable, and often ignored.

I hope you will continue to check in with UniHealth as we continue to share what we have learned from all our grantees and the community.