The Los Angeles Recuperative Care (LARC) Learning Network held its first-ever in-person event on March 23, 2023, at the Los Angeles Marriott Burbank Airport. Presented with the National Institute for Medical Respite Care (NIMRC) and HASC, the forum was sponsored by California Health Care Foundation, Kaiser Permanente and UniHealth Foundation.
One hundred attendees representing hospitals within the Los Angeles region, recuperative care providers and managed care plans (MCPs) came together to better understand and improve recuperative care services related to the California Advancing and Innovating Medi-Cal (CalAIM) initiative.
Pamela Mokler, MSG, LARC Learning Network consultant; Julia Dobbins, director of medical respite, NIMRC; and Ana Reza, vice president of patient access services, HASC, facilitated the discussion. Panelists shared how Los Angeles MCPs, which have opted to provide and pay for recuperative care using Medi-Cal funds as part of the CalAIM initiative, are integrating these services into their medical management workflows. Panelists also discussed what is and is not working and described their operations, practices and workflows related to engaging with people experiencing homelessness. This population can benefit from recuperative care provider services and support upon discharge from acute care settings.
The forum also featured keynote speaker Jacey Cooper, California state Medicaid director and chief deputy director, Department of Health Care Services, who described her goals for recuperative care and services for unhoused patients under CalAIM. Special guest speaker Bobby Watts, chief executive officer of National Health Care for the Homeless Council, discussed the state of recuperative care across the country.
During the forum, network members identified challenges, promising practices and opportunities related to recuperative care. Discussion themes included:
- Recognizing that 80% of recuperative care referrals come from general acute care hospitals.
- Standardizing processes such as referrals, authorizations, care coordination and shared databases among hospitals, recuperative care providers and payors.
- Improving emergency room department referral opportunities.
- Incorporating the use of evidence-based practices, including embedding homeless navigators in emergency departments to engage with unhoused patients and refer them for services.
- The 90-day authorization for recuperative care has enabled improved engagement and connection to services. However, transitioning from recuperative care into housing takes more than 90 days.
- Increasing recuperative care for older adults and providing palliative and end-of-life care.
- Benefits of a dedicated recuperative care workforce among hospitals and payors.
- Integrating more opportunities for collaboration among vested partners.
- Building a network of trust among people experiencing homelessness, hospital staff, recuperative care providers, community partners and payors.
With support from the LARC Learning Network leads, network participants considered the following priorities:
- Launch the LARC Learning Network Advisory group in May 2023. The advisory group will:
- Identify common and shared challenges that recuperative care providers must address for CalAIM implementation to succeed.
- Recommend feasible solutions to address these challenges and enhance or impact successful partnerships and, ultimately, the experience of MCP members experiencing homelessness.
- Establish regular meetings among hospitals and recuperative care providers.
- Evaluate the recuperative care referral and authorization process for emergency department referrals, develop best practices and provide input to MCPs.
For more information about the LARC Learning Network, please contact Ana Reza at [email protected].