Resolution No. 93671
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RESOLUTION NO. 9367
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF
VERNON SUPPORTING THE SALVATION ARMY RECUPERATIVE
CARE PROGRAM WITHIN THE EXISTING BELL SHELTER
WHEREAS, mobile clinic organizations have instituted a
Recuperative Care Program for homeless individuals with medical
conditions that are not serious enough to require impatient care but
are not well enough to live on their own, on the streets, or in a
transitional housing facility without some medical oversight to
convalesce; and
WHEREAS, despite the Programs, there is still more demand for
services than capacity; and
WHEREAS, the Salvation Army has proposed a plan to develop 30
recuperative care beds within an existing facility known as the Bell
Shelter located at 5600 Rickenbacker Road, Building 1E, in the City of
Bell in partnership with mobile clinics and public and private
hospitals in an effort to assist in eliminating patient dumping; and
WHEREAS, the Salvation Army has asked for the City's support
of its Recuperative Care Program.
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE
CITY OF VERNON AS FOLLOWS:
SECTION 1: The City Council of the City of Vernon hereby
finds and determines that the recitals contained hereinabove are true
and correct.
SECTION 2: The City Council of the City of Vernon hereby
states its support of the Salvation Army's Recuperative Care Program
and directs the Mayor to send a letter of support to La Rae Neal,
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Executive Director of the Salvation Army Bell Shelter.
SECTION 3: The City Clerk of the City of Vernon shall
certify to the passage of this resolution, and thereupon and thereafter
the same shall be in full force and effect.
APPROVED AND ADOPTED this 16th day of July, 2007.
AT EST:
� /-X, M �-
VELA GIRO , C' y Clerk
Name: Leonis C. Malburg
Title: Mayor / 44ay@r-
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1 STATE OF CALIFORNIA )
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2 COUNTY OF LOS ANGELES )
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I, MANUELA GIRON, City Clerk of the City of Vernon, do hereby
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certify that the foregoing Resolution, being Resolution No. 9367, was
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6 duly adopted by the City Council of the City of Vernon at a regular
7 meeting of the City Council duly held on Monday, July 16, 2007, and
8 thereafter was duly signed by the Mayor or Mayor Pro-Tem of the City of
9 Vernon
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11 MANUELA GIRON, City Clerk
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(SEAL)
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THE SALVATION ARMY BELL SHELTER
FACSIMILE TRANSMITTAL SHEET
TO: 0�kw
�;��FROM: Qi rW
PHONE N ER: PHONE NUMBER:
(323) 263-1206
FAX/NUMBER: FAX NUMBER:
-A- 7 1, iLLaa".% 023) 263-8543
DATE: _ 1 oll o-1 TOTAL N06f F PAGES
RE: ptwmVANe- ?'yat 1 i wyam
DURGENT OFOR REVIEW OPLEASE COMMENT OPLEASE REPLY
I + q�0
ZP11014
5600 RICKENBACKER RD. BLDG. 2A-B, BELL, CA. 90201
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11iR',` THE SALVATION ARMY BELL SHELTER
BE� .
5600 12ickenbacker Rd July 5, 2007
Building 2A-B
Bell, California 90201
The City of Vernon
Re: The Salvation Army Recuperative Care Program in Conjunction with JWCH
Phone 323-263-1206
Fax 323-263-8543 Support Letter
Dear Mayor Malburg:
After several meetings with Mr. Andrew Barns, Senior Project Analyst, National Health
William Booth Foundation, Mr. Cody Ruedaflores, Project Manager for Kaiser Permanente, and Dr. Paul
Founder Gregerson, Chief Medical Officer for JWCH the team has decided to address the necessity for
a recuperative bed program that will assist in controlling the recent dumping issues that have
become a serious issue within the Los Angeles County Health services.
John Larson The Project:
General Attached please find a copy of the Recuperative Care Project Draft Evaluation describing the
project along with the mission of the Program.. A Recuperative bed program has been a
discussion in the past, but now we have a chance to be part of the solution to help in the
Philip Swyers prevention of patient dumping. We are truly looking forward to becoming the model agency
that will provide a place for those who are too well to stay in the hospital yet too sick to go
Territorial Commander home. I am sure you can all agree that this is an area where we TSA Bell Shelter can Do the
Most Good. We are asking for support from our Mayors in surrounding cities. Attached is a
short letter of support draft, that I am graciously asking our Mayors to sign. Please if you have
any concerns feel free to add them into the letter of support. I am also willing to present the
Major Paul Seiler program in person at your next City Council Meeting if necessary.
Divisional Commander Thanking you in advance for your time and support on such a critical need.
Respectfu
Dr. Douglas Loisel
Executive Director
LaoltT
Executive Director
Enclosure:
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Recuperative Bed Program
Description
JWCH currently operates a 45 bed Recuperative Care Program in downtown Los Angeles at the
Weingart Center. The Program is operated for homeless individuals with medical conditions that
are not serious enough to require inpatient care but are not well enough to live on their own on
the streets or in a transitional housing facility without some medical oversight to convalesce.
Despite these 45 Recuperative Care beds, there is still more demand for services than capacity.
It is estimated that last year in Los Angeles County over 3000 homeless patients ready for
discharge from private hospitals were kept up to four extra days in a hospital inpatient setting
because there were insufficient beds upon which to discharge them. The Los Angeles County
Department of Health Services (LAC-DHS) has had the same difficulty placing its homeless
patients into a Recuperative Care setting.
The Hospital Association of Southern California (HASC), in association with LAC-DHS, JWCH
Institute Inc., Kaiser Permanente, LA Health Action, Neighborhood Legal Services and the
National Health Foundation (NIHF), have been proposing a two year demonstration project to
double the number of Recuperative beds from 45 to 90. In September 2006, The Los Angeles
County Board of Supervisors approved funding for 15 additional beds over a two year period.
The business plan for private hospital participation has also been approved by the HASC
Hospital Leadership Group and there has been funding solicited from private hospitals and
several philanthropic organizations to support this two year demonstration project.
The Coalition is in the process of selecting the location(s) for the additional'' beds. These beds are
intended to be located outside of skid row, and Bell Shelter is a proposed site for 30 of the 45
additional beds, which are anticipated to be online by June 2007. JWCH will be contracted to
provide the health care staff and other oversight of the beds at Bell Shelter. In turn, JWCH
would like to subcontract the shelter care activities of providing space, meal service,
housekeeping, linen, laundry and security to the Bell Shelter at a specified bed rate to be
determined. JWCH would also like to transition its patients to the Bell Shelter transitional
housing facility when the Recup Care patients are medically stable for discharge.
The Coalition recognizes that there will need to be a build out of the Bell Shelter facility to
accommodate the Program and make it operative. Discussions between the Recup Care
Coalition and the Bell Shelter Executive staff regarding the funding and oversight of the build
out should be scheduled. Questions regarding permits for expansion also need to be addressed, if
applicable. Pending successful negotiation and agreement regarding the utilization of the Bell
facility, the Coalition is requesting to use the space vacated by the LAHSA Winter Program until
the construction is completed.
Regarding the Scope of Work, briefly, JWCH shall provide Recuperative Care services and
would be directly responsible for the implementation, management and coordination of the
Program. As such:
1) JWCH will provide 24 hour LVN or Nursing services, along with medical oversight of the
Program. JWCH will provide medical services to include the following:
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-primary care intake/admission M-F 8:30-5
-provider coverage 20 hours/week (M-F, 4 hours/day)
-daily vital signs and nursing care
-provider on call 24/7 (via beeper or cell phone)
2) JWCH will subcontract for the office and medical care delivery space to Bell Shelter
3) J WCH will subcontract the shelter care activities of bed space for 30 clients to Bell Shelter,
to include:
-3 meals per day
-linen services
-laundry
-housekeeping
-security
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Recuperative Care Project
DRAFT EVALUATION PLAN
(5-10-07)
Overview: The evaluation will focus on changes in three main domains 1) use of medical
services, 2) impact of case management, and 3) .individual health status as well as assessing the
cost effectiveness of the program and participant satisfaction. Administrative data will provide
baseline and follow-up data, while surveys will establish self -reported baseline access and
receipt of services and health status, and the Social Security death index will be used to assess
the mortality rate. To provide comparative information individuals who are eligible for
recuperative care but for whom a bed is not available can comprise a control group which would
assist in establishing the changes in major outcomes that are due do the intervention of
recuperative care.
1) Use of medical services: The individuals enrolled in'the program will be homeless and have
had a need for recuperative care at the time of discharge from a hospital facility. The goal of the
evaluation for this domain to assess whether a change in medical services occurs over time,
either a decrease in overall services or a shift in the use of ER/hospital services to ambulatory
care services. Using administrative data baseline use of services will be established at the time of
enrollment into the program including number of ER visits in the preceding 12 months, number
of hospitalizations in the preceding 12 months and average length of stay, and number of visits to
other DHS providers (including PPPs), if possible the costs of these services should be
established.'Establishment of a usual source of care (USOQ if not present at baseline will also
be assessed. Repeat examination of these measures from administrative data one year after
discharge from the recuperative care facility will allow for the assessment of a change in the use
of medical services and/or shift in where medical care is received, and associated cost-
effectiveness. Specifically we will assess number of hospitalizations and total number of days,
and calculate average length of stay; number of ER visits and number of outpatient clinic visits.
The ability to comment on utilization of services will be,enhanced if data is available from the
hospitals that participate in the coalition. Relying only on DHS administrative data will have a
significant probability of underestimating utilization of services both before and after
recuperative care. Participant reported barriers to needed health care, including unmet need and
receipt of preventive services at baseline will also be assessed.
2) impact of case management: At baseline, the needs of the participant will be determined and
recorded, as well as prospectively. The case manager is responsible for facilitating access
to/enrollment in a medical home, SSI benefits, substance abuse treatment, mental health
treatment and other resources as necessary. Documentation of successU facilitation can be used
to measure the effectiveness of the case management component of this project. Participant
satisfaction with the case management process and expected outcomes will also be assessed at
the time of discharge from the recuperative care facility.
3) Health status: Health status will be assessed at baseline and at time of discharge from the
recuperative care facility using the SF-36 this will allow for an assessment of physical and
mental health functioning. Measures of health risk behaviors (e.g., tobacco, alcohol and drug
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use) will also be measured at baseline. In addition, mortality at 12 months post discharge from
recuperative care will be assess using the Social Security death index, with plans to match by
social security number, name and date of birth.
4) Cost-effectiveness: The costs and cost-effectiveness of the program will be assessed and
calculated. If average costs for DHS facilities are available these will be used, if not an estimate
for inpatient care costs from the Agency for Healthcare Quality and Research for the appropriate
period of time. The average cost of recuperative care services will be calculated by dividing the
total annual budget by the total number of patient -days provided per year.
5) Satisfaction: Levels of participant satisfaction with recuperative care services will be assessed
just prior to discharge from RC care. An assessment of needs at baseline and resolution of these
needs will be assessed, as well as evaluation of satisfaction with the various aspects of the
program including but not limited to nursing care, social work, case management, primary care
access, mental health services access, substance abuse treatment facilitation, cultural
competence, physical plant, suggestions for improvements, etc.
DHS Measures for the Contractor
The collection of data on utilization after discharge from recuperative care will be key to
assessing two of the measures that LAC-DHS has determined for the contractor including:
a) 50% of discharged recuperative care patients will NOT have an ER visit within three
months of their hospital discharge.
b) 90% participants will have a referral and/or appointment scheduled (i.e., date and
time) and a plan for accessing services at a primary care site prior to discharge from
recuperative care.
Documentation by the case manager will be used to assess if
c) 90% of participants -will have been evaluated for public benefit eligibility
Data provided by the contractor to DHS will include the,following reporting elements: Number
of:
-participants referred but not enrolled, and why
-participants served
-participants who entered RC services
-days of RC services for each RC participant
-participants who returned to the hospital or ER during RC stay
-participants discharged from RC services
-participants referred to and received appointment date/time with primary care
-participants linked to mental health, substance use treatment and other support services
-participants evaluated for public benefits
-participants for whom an application for public benefits was initiated
-participants discharged to shelter, temporary housing, permanent housing
The contractor will also provide a narrative of RC activities highlighting the achievements and
challenges.
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Issues to Consider:
-How specifically will participants be recruited?
-Who will recruit them?
-Will there be a waiting list? And if yes, who will maintain it?
-When will patients complete the baseline survey? -Perhaps analogous to AHi patients
would be required to complete the survey as one Components of eligibility for the
program.
-Is there any way to coordinate accessing pre and post RC care hospitalization and ER
visits from the non-DHS coalition members?
..tb
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City of Vernon Letterhead
(Date)
Dear Ms. Neal
I have reviewed your proposed plan on July 02, 2007, to develop 30 recuperative care beds
within the existing facility located at 5600 Rickenbacker Road Bldg IE, Bell California 90201.
We support this effort and understand that 30 recuperative care beds will be implemented in
partnership with public and private hospitals in an effort to assist in eliminating patient
dumping.
Sincerely,
Mayor Malburg
Mayor of Maywood
JUL-9-2007
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July 24, 2007
Ms. La Rae Neal
Executive Director
The Salvation Army Bell Shelter
5600 Rickenbacker Road, Bldg. 2A-B
Bell, CA 90201
Dear Ms. Neal:
I have reviewed your proposed plan presented at the City Council Meeting on 07/16/07,
to develop 30 recuperative care beds within the existing facility located at 5600
Rickenbacker Road, Bldg. 1E, Bell, California 90201.
We support this effort and understand that 30 recuperative care beds will be implemented
in partnership with public and private hospitals in an effort to assist in eliminating patient
dumping.
Sincerely,
Leonis C. Malburg
Mayor of Vernon
LCM:dr
Resolution No. 9367
E-)(Asively Industriaf
2tN
40
BELL SHELTER
THE SALVATION ARMY BELL SHELTER
5600 RICKENBACKER ROAD, BLDG. 2A-B, BELL, CA 902001
TEL: (323) 263-1206 FAX: (323) 263-8543
July 17, 2007
City of Vernon
City Council Chambers
4305 Santa Fe Avenue
Vernon, CA 90058
WEB: www.salvationarmvsoeal.ora
Re: The July 16'h 2007 City Council Meeting Item # 9367
Dear Nelly Giron,
I just wanted to take the time out to thank you and the City Council for allowing me
the opportunity to present the improvements here at Bell Shelter along the
development of a recuperative care program for Homeless Individuals. Your support
in our mission is greatly appreciated. Attached is a short example of the support letter
we are requesting from all of our neighboring cities. If the Mayor or any other council
member has concerns please do not hesitate to give me a call.
Once the letter of support has been signed we will send a driver over to pick it up for
your convenience. I would also like to invite the Council members and any interested
staff to come visit us for a tour of our facility to see first hand what we do.
Looking forward to hearing from you soon. And once again thank you for your
support.
Sincerely,
()a ae eal
Executive Director
cc: Leonis C. Malburg — Mayor
City Council Members
William Booth, Founder • Shaw Clifton, General • Philip W. Swyers, Territorial Commander 9 Paul E. Bollwahn, Divisional Commander
(Your Letterhead)
City of Vernon
(Date)
Dear Ms. Neal
I have reviewed your proposed plan presented at the City Council Meeting on 07/16/07, to
develop 30 recuperative care beds within the existing facility located at 5600 Rickenbacker
Road Bldg IE, Bell California 90201.
We support this effort and understand that 30 recuperative care beds will be implemented in
partnership with public and private hospitals in an effort to assist in eliminating patient
dumping.
Sincerely,
Leonis C. Malburg
Mayor of Vernon