Increasing medical respite capacity for Washington’s homeless population

In 2025 a point-in-time count found that more than 22,000 people in Washington were experiencing homelessness – a 4% increase from 2024.¹ When people experiencing homelessness face injury or illness, a lack of access to post-acute care and stable housing leads to longer hospital stays, higher rates of readmission, and worsened health conditions.^2,3

Medical respite care offers those in need with safe, supportive spaces where they can recover from illness, receive care coordination and access social services. As a longstanding national leader in medical respite policy and program design, Washington has demonstrated how innovation – such as the inclusion of medical respite services in its 1115 Medicaid Transformation Project waiver – can expand access and improve outcomes for individuals experiencing homelessness. Recognizing the impact of this work, UnitedHealthcare Community & State has invested $400K in the National Health Care for the Homeless Council (NHCHC) to provide technical assistance for providers and community organizations. The investment will support capacity-building across five states, launching first in Washington.

Strengthening local infrastructure and sustainability

NHCHC was launched in 2020 by the National Health Care for the Homeless Council (NIMRC). NIMRC is the first national institute, made up of staff and consulting teams, that advances best practices and provides expert technical assistance and services specific to medical respite, also called recuperative care. NHCHC’s support will focus on aligning programs with the Standards for Medical Respite Care, increasing readiness for certification and developing customized, state-specific tools and strategies to ensure long-term viability.

This initiative will unite medical respite providers, housing organizations and health care systems. By creating a shared space for learning and collaboration, stakeholders can address local needs and policies more effectively. Additionally, NHCHC will develop resources to help Washington communities serve individuals with complex needs, such as those requiring behavioral health support, medication-assisted treatment or palliative care. By building capacity at the local level, the collaboration helps reduce avoidable hospitalizations, lower costs and supports better outcomes for those experiencing homelessness.

Advancing a unified, comprehensive approach

UnitedHealthcare is advancing multiple efforts to strengthen access to medical respite care and improve system coordination.

• Collaborating with Accountable Communities of Health (ACHs) to assist medical respite providers in meeting contracting requirements
• Reaching out to housing providers in areas of Washington that do not yet have medical respite to evaluate adding respite to their services, and assisting with start-up
• Piloting a unified referral process between Managed Care Organizations (MCOs) and housing service providers as part of a workgroup including Washington Managed Care Organizations, the Department of Health, the Department of Commerce and Balanced of State housing providers.

UnitedHealthcare Community Plan of Washington’s collaboration with NHCHC is a key piece of a comprehensive approach to strengthen elements of the health system that support people experiencing homelessness. By helping more communities develop and sustain medical respite care programs, this initiative supports individuals during periods of recovery, improving health, reducing barriers and advancing a more effective care system for people experiencing homelessness.

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