Respite center offers a safe and supportive space for unhoused people to recover after hospital discharge.
[Updated Aug. 26, 2025]
This summer, Whatcom County’s new respite center has accepted its first round of clients, an attempt to alleviate some of the weight of one of the region’s most urgent concerns.
A nonprofit collaboration between the Opportunity Council, Unity Care Northwest — UCNW — and PeaceHealth along with support from Whatcom County, opened the medical respite center in May, which is designed to be a space for unhoused people who have been deemed fit to be discharged from the hospital but not to completely re-enter society unsupported. In June, the center accepted its first round of clients.
This is part of the Way Station Health and Hygiene Center, a facility run by UCNW, that opened last November and offers a variety of free services. These include access to restrooms, showers and laundry services as well as case management and basic health care, such as drop-in medical support, labs and behavioral health support.
Although the medical respite center has 16 beds, officials chose to do a soft launch. They began with four beds open for use, then increased to eight in July, 12 in August and will open the rest in September. This makes a total of 16 beds for regular use, plus one “flex” bed to be used as needed. So far, the center has had 10 clients stay at the medical respite center. Clients must be 18 or older and are admitted only by referral from PeaceHealth St. Joseph’s Medical Center in Bellingham.
According to Rachel Lucy, the director of community health for the Northwest branch of PeaceHealth, home care and care management nurses at the hospital refer the patients and meet with them before they leave to prepare them for the transition. [Ed.: Director’s title corrected.] She said that those referred are people who hospital physicians have determined to be 100% prepared to be medically discharged from the hospital and that the medical respite center is meant to be a space for people to rest and recuperate. The staff at the center itself aren’t medical staff but can assist with things like medication prompting, following care plans and arranging transportation to appointments or visits from home care providers.
Teri Bryant, the Whatcom homeless service center director for the Opportunity Council, said that most of the staff at the center are former home care aides or have worked in similar positions who can’t physically handle those types of jobs anymore or who have been in the clients’ positions before. She said that the team decided not to use volunteers because they “want to keep consistent faces. It is such a small space we want to keep consistent faces and not have volunteers running in and out.”
According to Lucy, the center was designed so the guests can have privacy but the staff can have oversight. Each guest has their own space — similar to a cubicle — with a bed. During their stay, clients are provided with clean linens, snacks and three meals a day — made in-house — from PeaceHealth St. Joseph Medical Center. Clients also have access to other Way Station services and there are private spaces for them to meet with home health care providers.
However, the center does not just focus on getting clients through this phase of the transition; staff also try to prepare them for the next. Bryant said that one of the reasons it was important for the Opportunity Council to be a part of this project was because it gives them a chance to enter people into Coordinated Entry, a program designed to connect unhoused people with housing and other related services. She said this helps “keep them from falling in the gap and losing connection.”
Lucy said she’s found that people typically need about 2–4 weeks after being medically cleared to rest and recuperate before they can find what next housing placement is best for them. This might be a tiny home, a stay at the Lighthouse Mission — which offers temporary shelter to those who are unhoused, including 26 medical respite beds — or some other living situation that’s tailored to their needs — including, ideally, being put into housing.
She said that before the respite center opened, people were at the hospital for short durations and there wasn’t enough time to walk them through next steps. Now, the coordination between visiting care providers and Opportunity Council staff gives them the ability to help them move on and arrange housing and next steps. They lean on the service providers to stay coordinated “so they aren’t having to tell their story five million times.”
Lucy said this collaboration is especially important because “it’s all about trust.”
Marisa Schoeppach, Way Station medical respite manager and a member of the homeless outreach team for the Opportunity Council, said that some clients have left early because either it wasn’t what they expected, or they were unable to follow the rules they have for safety. She explained that some people who are unhoused are “so used to being in survival mode … so used to being denied care and support” that “they’re not ready to accept care.”
Emily Martens, the communication coordinator for the Opportunity Council, said, “It’s really important to us that we’re coming alongside people when they’re ready … making sure they can retain the sense of personal agency and autonomy, and … really providing people a safe place to heal.”
Navigating a complex system
Kristen Ekstran, the senior community health analyst for Skagit County Public Health and a board member for the Population Health Trust Advisory Board, said that her and her department’s work on the upcoming Community Health Assessment for Skagit County is focusing a lot on access to care. Her work includes gathering data on about 176 data indicators of public health, with a core set of 40 that she follows over time.
She said that people have primarily reported that their biggest barrier to accessing healthcare is difficulty navigating a complex system. She said that people are “in need off… folks that can help them navigate the healthcare system step by step.”
Of the specific factors affecting people’s ability to access healthcare, Ekstran said that the first is lack of insurance and the second is cost.
According to Lucy, PeaceHealth has been acting as the “financial backbone so this program can have a really strong start until things like Medicaid can cover the costs.” They provided the first grant, which was for $400,000, and have since spent approximately another quarter of a million dollars.
According to Martens, until recently, medical respite wasn’t recognized as a billable service, which makes it’s difficult to find employees who know how to bill them properly. She said that they’re working to contract with Medicaid managed care organizations — such as Community Health Plan of Washington — in order to bill for these newly allowable services. The Opportunity Council is also speaking with other nonprofits for potential partnerships.
Housing, income and health outcomes
Schoeppach said that the medical respite center has been at capacity consistently since it began accepting clients. Bryant said that the homeless outreach team has been dealing on a regular basis with people being released from the hospital with nowhere to go.
She said, “I just want to make sure everyone understands this is a huge need and it’s been a long time coming.”
The most recent Community Health Assessments in Whatcom, Skagit, and San Juan counties all list housing as a key social determinant of health.
According to a 2024 update on houselessness in Whatcom County by Whatcom County and the Opportunity Council, the number of applicants for housing assistance reached an all-time high of 1,028 households. According to reports on the number of Asset Limited, Income Restrained, Employed, or ALICE, households, 45% of households — or 42,370 households — in Whatcom County fell beneath the ALICE threshold by the end of 2023; the highest number on record. ALICE refers to households who make more than the federal poverty level, but less than the basic cost of living in their county.
Reports show that 27% of households in Skagit fell beneath the ALICE threshold as of the end of 2023 — the same as San Juan County.
An aging population at risk
The ALICE report for Whatcom County showed that, as of 2023, 52% of people aged 65 or above fell below the ALICE threshold as well 82% of those under 25. In Skagit County, 47% of those 65 or older and 76% of those below 25 were below the threshold. In San Juan County, those percentages are 40% and 83%, respectively.
Michelle Nienhaus, the lead case manager for Base Camp as well as a case manager for the respite dorms at the Lighthouse Mission, said that there’s been a large influx in the number of elderly people seeking the Mission’s services. Social Security payments are often not enough to pay for housing, especially if they need some form of assisted living. “If you only get $900–1,200 a month, that’s not going to pay for anything,” she said.
Schoeppach said that across all their programs, they’re seeing a population that’s aging while unhoused. She said that they’re also seeing more people who are younger but are presenting with issues more common in people in their 60s and 70s. She said that unhoused people often experience co- or tri-morbidities, such as mental health conditions, chronic health issues and substance abuse disorders.
Schoeppach said that many people who seek medical respite are looking for other treatment programs, including for mental or physical health as well as alcohol and drug recovery, but they need a chance to recover fully after their hospitalization before they can start.
She said, “We try to set it up so they feel supported and know you want them to succeed.”
“I think what we’re finding is, especially on the health and hygiene side, everything is connected,” said Lucy. She said that people’s access to care affects their need for care and then for respite. The hospitals can only do so much, and when people don’t have a safe space to focus on recovery and get connected to ongoing care — such as wound treatment, physical therapy, etc. — they could wind up back at the hospital.
“I think (the Way Station) is going to make a big difference,” she said.
Progress and solutions
Bryant said, “No matter how much planning you do, you can never cover every need for every person.” She said she knows they’ll likely have to expand services one day, but that “the biggest thing to keep in mind is that this little respite center is a really big start.”
A press release from PeaceHealth read, “The Way Station’s unique partnership — between Unity Care NW, Opportunity Council, PeaceHealth and Whatcom County — aids in the disruption of cycles that keep people from accessing available housing.”
Lucy described being a part of this collaboration as an “honor.” She said that her team members from the collection of nonprofits have worked closely together since the project’s inception, meeting weekly — if not more — until a couple of months ago when they switched to meeting about once a month. “You don’t see partnerships like this everyday,” she said. “It’s going so well … It’s been amazing to see.”
In place of a community health improvement plan following the last Community Health Needs Assessment — which was released in 2021, in the middle of the COVID-19 pandemic — Skagit County created a COVID Recovery Plan. In a 2024 progress report for that recovery plan, the first strategy listed — “Advocate for cross-organizational and cross-jurisdictional efforts on housing affordability and availability” — was marked as “complete or significant change,” and they noted progress in the other two, which include “increase diversity of options to address local housing needs” and “increase awareness of housing resources and supports to people of color and other minority groups.”
PeaceHealth’s CHNA for Skagit County addressed the housing issue in Skagit and its plans to help, saying, “We’re working with our partners to support building housing and shelter capacity in our community and to reach our most medically fragile community members, families and youth experiencing homelessness.” One of the projects they’ve supported is known as Cascade Landing — affordable apartment homes that were created by renovating an unused office building. Rent is scaled to be affordable for the qualifying tenant, and these are permanent housing — not shelters or transitional housing — so once someone is accepted, they won’t have to reapply to stay in their home.
San Juan County’s assessment lists steps being taken to improve access to affordable housing, including voter-approved, government-funded projects, partnerships with the county, local land, home and community trusts, resource centers, community foundations and other community agencies. It also includes steps being taken to improve access to care, including partnerships with local health care providers, health and hospital districts, pharmacies, resource centers, community foundations, schools and other community organizations to identify and fill gaps in access to health care services.
— By Rebecca Sutch
Also read in Salish Current:
• “Seeking stability: services for the unhoused,” Feb. 5, 2025
• “Dementia Support Northwest awarded $240,000 grant,” Sept. 19, 2024
• “Commentary: CAST is a hidden gem needing help, to help,” Dec. 11, 2023
• “Commentary: From surviving to thriving — with help,” Aug. 17, 2022