Listen to article \u2022\u00a00:00 min<\/p>\n
After months of living on the streets, Alexis DiBella felt she had finally turned a corner at the end of last year.<\/p>\n
The 31-year-old had just gotten a bed in a women\u2019s shelter. Excited to \u201cto dig into life again\u201d after a frigid winter, she brushed off some lingering pain in her feet. <\/p>\n
Over a few days, they grew red and swollen. One night, still in her first week at the shelter, DiBella took off her socks and shoes and discovered that both feet had turned black. <\/p>\n
She had developed frostbite while living outside.<\/p>\n
Doctors eventually amputated one of her feet. After a month in the hospital, DiBella was ready to be discharged \u2014 but the shelter where she\u2019d hoped to start a new life could not accommodate her disability. <\/p>\n
\u201cI didn\u2019t know where I was going,\u201d DiBella said.<\/p>\n
That\u2019s when a social worker recommended she move to a medical respite in West Philadelphia<\/a> run by the Public Health Management Corporation, a healthcare organization that runs several federally qualified health centers and health programs for homeless Philadelphians. <\/p>\n Medical respites are shelters specially equipped to house people with medical needs that are not severe enough for hospital care, but exceed the care available at traditional shelters. <\/p>\n The Medical Respite on Cedar, where DiBella has lived since January, has 20 beds and opened in 2023. An additional 20 beds are available at the Medical Respite at Serenity Court, a facility in North Philadelphia<\/a> that opened in 2014. They are the only shelters of their kind in the city. <\/p>\n Nationwide, there are 237 medical respites in 45 states; Pennsylvania has five total medical respite programs, and New Jersey and Delaware operate one apiece, according to the National Health Care for the Homeless Council<\/a>.<\/p>\n The respites help patients with a wide range of medical conditions, from diabetes complications to ongoing cancer treatment. A few years ago, there was an influx of patients with wounds from xylazine<\/a>, the animal tranquilizer then ubiquitous in Philadelphia\u2019s illicit drug supply. Lately, after a particularly severe winter<\/a>, the respites have dealt with another type of wounds: complications from frostbite, like DiBella\u2019s. <\/p>\n \u201cSo many young folks are coming in here with either finger or toe amputations,\u201d said Sabrina Thigpen, the Cedar respite\u2019s program administrator. <\/p>\n PHMC began floating the idea of a medical respite after hearing from its nurses working with shelters across the city about residents with medical needs that required more attention than a traditional shelter could provide, Thigpen said.<\/p>\n Both facilities are consistently full and operate waiting lists. \u201cWe know that 40 beds for an entire city doesn\u2019t meet the need,\u201d said Jake Becker, PHMC\u2019s managing director.<\/p>\n Medical respites exist in other cities around the country and share common funding challenges. \u201cWho takes responsibility for the healing of people that are too well to be in a hospital and too sick to be on their own?\u201d Becker said. <\/p>\n The respites are hoping to find funding to expand into more complex care, like delivering intravenous antibiotics, he said. <\/p>\n Insurance coverage for patients can be complicated, and many respites operate by cobbling together funding from partnerships with hospitals and other healthcare organizations. Together, PHMC\u2019s respites have a $5 million operating budget and receive $50,000 from the city; the rest comes from healthcare institutions who pay set rates to send patients to the respites.<\/p>\n \u201cWe would love to be able to step up our capacity for services to bridge even more of the gap,\u201d Becker said.<\/p>\n