H4’s medical respite service, which opened in February 2021 provides 24-hour residence with meal service for homeless individuals who are too ill or frail to recover from an acute illness or injury on the streets but are not sick enough to meet inpatient level of care criteria for a hospital or nursing facility.  Medical respite provides a clean and safe environment for a few days to a few weeks, with medical and social service support, for patients in recovery or receiving near-death hospice care.  The maximum stay is 60 days.

The majority of patients are referred from a hospital after being discharged from an inpatient stay, outpatient surgery, or treatment in the emergency room.  But some patients are referred by other homeless service agencies or by the staff of the Punawai Rest Stop.

The respite floor has 20 fully furnished patient rooms plus communal space that includes a fully-equipped kitchen, dining area, and laundry.  With select double occupancy, up to 29 patients can be accommodated.  However, two of the patient rooms will be used to house H4’s interim medical clinic for several months, until the permanent space for the Punawai Clinic becomes available in the summer of 2021.

Staffing on the medical respite unit includes an RN plus at least two care coordinators or medical assistants on duty at all times. In addition, an H4 provider (physician or APRN) will make rounds on the floor each day to monitor patients’ condition and adherence to care their care plans, and a provider will remain available onsite or on-call 24/7 to deal with patients requiring an urgent medical response.