Santa Rosa’s safe haven for the homeless

One morning in early February, James O’Rourke collapsed in the bathroom at a Santa Rosa Motel 6. He was bleeding profusely when a housekeeper discovered him and called 911.

“It was really scary,” O’Rourke said recently, recalling the 25 long days and nights he spent in the intensive care unit at Santa Rosa Memorial Hospital for problems associated with alcoholism and cirrhosis of the liver.

During O’Rourke’s hospitalization, he underwent five blood transfusions and required around-the-clock care because of severe bleeding in his abdomen. Doctors had to band lesions in his esophagus so they wouldn’t rupture and cause more health problems. After nearly a month in the hospital, O’Rourke was ready to be discharged by the end of February. But because the former deck hand has been homeless for the past five years, it wasn’t safe to send him back to the streets.

Rather than lengthening O’Rourke’s hospital stay, doctors were able to transport him to a modest recovery center located at Santa Rosa’s Brookwood Health Center, courtesy of a Sonoma County program that provides homeless people a safe, warm place to recover after intensive hospitalizations.

“I don’t know where I would have gone,” O’Rourke said. “It’s a place of security so I can get better … Otherwise I’d be stuck out there in the cold.”

Launched in 2011 by Catholic Charities, a local homeless services provider, Project Nightingale has transformed the way Sonoma County’s three largest hospitals treat homeless people and has freed up much-needed bed space. Often, homeless patients are too sick or frail to return to the streets, so they remain hospitalized, costing hospitals - and the health care system - millions of dollars every year.

Recognizing the need, Catholic Charities spearheaded the new local recovery program, gaining financial support and buy-in from the hospitals and finding the space for 26 beds at two Santa Rosa locations. While the daily price of a hospital emergency room is about $2,000, the total annual cost of Project Nightingale is $675,000, according to Jennie Lynn Holmes, director of shelter and housing for Catholic Charities. Hospitals pick up roughly two-thirds of that, with the rest provided by the state and Sonoma County Board of Supervisors.

“We want to make sure people are getting the care they need and, eventually, we want them to get into permanent housing,” Supervisor Shirlee Zane said.

Added Terri Dente, vice president of mission integration for St. Joseph Health Sonoma County, “This is helping us get people into the most appropriate level of care. Sometimes, all they need is a little TLC. And we don’t like discharging people to an uncertain future. If we have people who are ready to be discharged but there’s no place for them to go, that’s holding up other patients who need to be seen.”

St. Joseph Health Sonoma County is the parent organization for Santa Rosa Memorial Hospital, Queen of the Valley Medical Center in Napa and Petaluma Valley Hospital.

With 13 beds at Brookwood clinic and another 13 at the Samuel L. Jones Hall homeless shelter in Santa Rosa, Holmes said the program has saved Kaiser Permanente, St. Joseph Health Sonoma County and Sutter Santa Rosa Regional Medical Center $17.3 million since 2011.

“That’s just from calculating the days people would have been in the hospital had it not been for Nightingale,” she said. “Hospitals are the backbone of this project. They’re very committed because of the cost-savings, and because people are actually getting better treatment.”

A few blocks away from Santa Rosa Memorial, Sonoma County’s largest acute care hospital, homeless patients trickled out in and out of Brookwood earlier this month. Some were just arriving from the hospital, others were headed out to pick up medications or for doctor’s appointments.

Carolyn Rose Moore, 60, was recovering from a hip problem that left her unable to walk. Stan Laughlin, 59, had a diabetic ulcer on his foot that led to gangrene. Richard Denholm, 55, had recently undergone brain surgery on his prefrontal cortex for problems associated with chronic seizures.

“Where would I go if I couldn’t stay here?” Denholm said. “Good question.”

Until his surgery last month, he had been camping at a park outside Calistoga.

O’Rourke was gathering his few possessions. Brookwood is reserved for the most frail; he was being transfered to Samuel L. Jones, which also reserves space for Nightingale’s overnight patients. Unlike many shelters, its residents are allowed to stay inside during the daytime.

In addition to saving money, Project Nightingale is being credited with helping hospitals reduce readmission rates, a metric under President Barack Obama’s health care law that indicates an institution’s quality of health care delivery. When homeless patients are discharged with nowhere to go, health problems often return and people are readmitted to hospitals.

“We’re penalized if patients are readmitted within 30 days, so part of the rationale for hospitals making this investment is keeping those readmission rates down while at the same time keeping patients well,” said Penny Cleary, director of development for Sutter Health in the North Bay.

The program’s local success in reducing readmissions and hospital emergency room costs also has attracted the attention of hospitals and homeless service providers in other parts of the country.

“People are really looking at us as a model,” Holmes said.

Last month, officials from San Francisco, Virginia, Washington and Alaska came to Sonoma County for a firsthand look, among them Lisa Aquino, executive director for Catholic Social Services in Anchorage, Alaska.

“We learned so much from Sonoma County,” said Aquino. “We’re working with the mayor’s office to implement this. It provides people who don’t have a home with that time they really need to heal.”

Meanwhile, O’Rourke continues his recovery at Samuel L. Jones and is working to get into a sober living home.

“I’m getting better,” he said. “I want to see my grandkids grow up, and I want to help young people so they don’t do this to themselves.”

You can reach Staff Writer Angela Hart at 526-8503 or angela.hart@pressdemocrat.com. On Twitter @ahartreports.