Interfaith House offers after-hospital care, refuge for homeless

A Chicago program gives recuperative care to homeless patients after hospital discharge but doesn't release them until they have somewhere to go.

By Sher Watts, amednews staff. Aug. 4, 2003.

Community Spirit
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When most patients leave the hospital, they go home. When homeless patients are discharged, there's usually nowhere for them to go but back on the street.

But in Chicago, homeless patients can go to Interfaith House, a 64-bed recuperative care center for homeless patients recovering from an acute illness or injury.

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"If they don't get in here, they try to recover on the street, which is impossible," said Executive Director Michael Cook.

Interfaith House started in 1994 as an offshoot of the Chicago Interfaith Council for the Homeless. The center took over an empty nursing home on Chicago's West Side.

"The No. 1 cause of referral to Interfaith House is trauma," said internist Bruce Doblin, MD, medical director of Interfaith House since its inception. "They'll be sleeping somewhere and get run over by a car, or they'll get jumped and robbed."

While an emergency department can stitch patients up, it takes a visit to Interfaith House to deal with other problems, such as substance abuse, hypertension and diabetes, Dr. Doblin said. "We take a holistic view here."

Full-time medical staff

When a patient comes to the center, the referring hospital is asked to provide a 30-day supply of needed medication. Then the patients see Interfaith staff.

Each patient at Interfaith House gets care from an on-site physician or nurse practitioner. Its health clinic, with three exam rooms, is staffed from 9 a.m. to 5 p.m. five days a week.

Interfaith House turns away 3 people for every 2 it accepts.

Besides medical care, patients have a full day of individual meetings, health education sessions on such topics as hypertension and HIV, and optional prayer groups. In the summer and spring they work in the Interfaith gardens, growing vegetables for meals at the center.

The center serves about 350 people a year. The average length of stay for residents is 45 days. Once released, about 70% of the patients end up in either stable housing or a treatment facility. Cook estimates that 90% complete their medical care plans.

But the center can't meet all of the need. For every two people it accepts, Interfaith House has to turn away three. The only center of its kind in northern Illinois, Interfaith House accepts patients from within a roughly 50-mile radius from 60 area hospitals.

Dr. Doblin now is setting up a research project with David Buchanan, MD, from the John H. Stroger Jr. Hospital of Cook County, which serves Chicago's indigent community. The study will compare the conditions, one year after their respective injuries or illnesses, of Interfaith patients with those of homeless patients who couldn't get into the facility. Preliminary data indicate that the center prevents further hospitalizations.

Interfaith House has an annual budget of $2 million. Funds come from churches, private and corporate donations, and government money through the U.S. Dept. of Housing and Urban Development and local and state agencies. The center has a staff of 34 paid workers and 100 volunteers.

With so much volunteer help and donated supplies, Interfaith House is able to keep costs down. While the average cost of a day in the hospital is $1,200, a day at Interfaith House costs only $87.

Volunteer inspiration

family physician Mark Loafman, MD, MPH, first heard about Interfaith House from his church, First United Church of Oak Park, Ill., which has supported the center since its inception. After volunteering himself, he got his medical group, PCC Community Wellness Center, involved.

At any time, three staff physicians or community medicine fellows at Dr. Loafman's group as well as nurse practitioners, see patients at Interfaith House. Part of the money for their salaries comes from government grants through HUD. The group is working on being designated as a community health center, as well.

The group's assistant medical director, Paul Luning, MD, MPH, sees Interfaith patients regularly. When patients leave the center, they sometimes continue seeing him as their personal physician, ensuring continuity and follow-up care. The practice also hooks patients up with social service support to help find jobs and deal with other issues.

The medical care at Interfaith House comes from a coalition called the Health Services Collaborative, through partnerships with Rush University College of Nursing and Chicago Health Outreach, as well as Dr. Loafman's group.

Dr. Loafman, who sees medicine as "more of a priesthood than a business," said the work touches a spiritual core. "There's just something therapeutic about providing a little service," he said. "It's so important for physicians to volunteer. But the complexity and comprehensiveness of Interfaith House provides more than a Band-Aid."

Watts is a staff copy editor. She can be reached at e-mail (sher_watts@ama-assn.org)