Medical respite care

Why is MRC important?

MRC is an essential component within the continuum of care needed to serve individuals experiencing homelessness or at risk of homelessness. MRC programs offer clients discharging from inpatient care with a housing option when they do not already have one, and helps ensure that the medical care received in a hospital or clinic setting is not compromised due to unstable living situations. Combined with housing placement services and effective case management, MRC allows individuals with complex medical and psycho-social needs to recover from an acute medical condition in a stable environment while reducing future hospital utilization.

What services are included in MRC?

The following services are included under MRC:

• Shelter
• Clinical assessments
• Behavior health screenings (for psychosocial needs)
• Case management support in accessing benefits and housing
• Access to a bed for 24 hours per day and daily wellness checks
• Medical oversight that includes medication monitoring and ongoing assessments to determine whether or not treatments/care plans are effective
• Minor clinical interventions (e.g. wound care, infection control, non-pharmacological pain management)
• Medical case management for care coordination, transportation to medical appointments, 3 meals per day
• Safe storage for belongings, laundry
• Cell phone or tablet for use with telehealth appointments

MRC services are limited to up to 90 days per stay per global cap of a combined 6 months per 5-year demonstration period for all HRSN housing interventions that include room and board services (all services listed under rent and temporary housing on HRSN services webpage).

Who is eligible for MRC services?  

Individuals must meet the following conditions to be eligible to receive MRC services:

• Eligible for federally funded Apple Health (Medicaid) 
• Homeless, at risk of homelessness, or transitioning out of an emergency shelter, as defined by 24 CFR 91.5 
• Youth transitioning out of the child welfare system, including foster care
• Individuals who have medical or physical health condition and meet one of the following criteria:
  • Recently discharged from a hospital setting
  • Referred from a medical clinic and have an acute medical condition that can be safely managed in a sheltered outpatient setting and medical respite care is necessary to provide the conditions to support recovery from the acute medical condition

Individuals screened and accepted into MRC must be able to perform activities of daily living (ADLs) and instrumental activities of daily living (IADLs).

For more detailed answers to questions about the referral process, billing guidelines, and the role of Accountable Communities of Health (ACHs) in providing MRC services, please see the Medical Respite Care FAQs document. 

Who are MRC providers?

MRC providers may include:

• Transitional housing (such as community residences or group homes).
• Medical centers or hospitals.
• Communities of action agencies.
• Federally Qualified Health Centers (FQHCs).
• Neutral and faith-based nonprofit organizations.

A list of providers in Washington State can be found using the Medical Respite Care Directory on the National Health Care for the Homeless Council website.

How to become an MRC provider

Providers interested in becoming an MRC provider should visit HCA's Enroll as a billing provider for instructions on how to enroll as a billing provider for Washington Apple Health (Medicaid). Key steps to enroll as an MRC provider include:

1. Completing the Core Provider Agreement and other related enrollment forms.
2. Completing the HCA Medical Respite Attestation form.
3. Submitting a copy of the IRS W-9 form.