THE INN BETWEEN

The goal of the program is to provide a homelike setting, housing, and death with dignity to terminally ill homeless men and women. The INN Between can comfortably house 50 individuals per night. We also provide respite housing to men and women who are too well to stay in the hospital, but too ill to recover on the street. We serve low-and no-income adults who are (1) experiencing homelessness, (2) have severe and/or terminal illness, and (3) have nowhere else to go; the majority of our clients have been chronically homeless (more than one year); a small percentage are facing homelessness when their illness led to loss of work, depletion of savings, and subsequent loss of insurance and housing.

In Fiscal Year 2022-2023, we expect to provide over 15,000 days of medical housing to 150 people, comprising 35 Hospice clients and 115 Medical Respite clients. A major outcome of our program is the reduction or elimination of inappropriate 911 calls and hospital emergency room visits by homeless individuals who are forced to use these services for primary care. At an average cost of $2,000 per 911 call with medical transport, The INN Between saves our communities an estimated $1,000,000 or more annually.

Program outcomes include:
1. 150 homeless adults (100% of total clients) will be admitted to The INN Between, removing them from a medical crisis situation. They will receive safe, medically appropriate housing with basic needs, proper medical care, and comprehensive social, emotional, and spiritual support. (20% Hospice, 80% Medical Respite).
2. 150 clients (100%) will drastically reduce or stop making unnecessary 911 calls, saving the community approx. $1 million annually (two calls per person at $2,000 per call and hospital cost of $3,000).
3. 150 clients (100%) will be actively case managed to connect with mainstream resources such as Medicaid, Disability Income, employment, housing, and primary medical care.
4. 35 Hospice Clients (100% of Hospice clients) will gain access to professional hospice care, receive end-of-life doula services including help reconnecting with estranged family members and making end of life preparations (paying for cremation), and receive a free obituary posting, memorial service, and name plaque in our memorial garden.
5. 104 Medical Respite clients (90% of Medical Respite clients) will exit The INN Between with their acute medical condition resolved.
6. 30 Medical Respite Clients (26% of Medical Respite clients) will exit The INN Between into stable housing, preventing a return to shelter/streets (the lack of affordable housing is a significant inhibitor of this outcome).

Collaboration is critical to the continuum of care for our homeless population, not only to improve outcomes for our homeless friends, but also to deliver services more efficiently. The INN Between collaborates with homeless service providers and medical providers to maintain a watch list of individuals who should be considered for placement at The INN Between and to case manage respite clients as they progress along the path to self-sufficiency. Collaborative partners include Volunteers of America, the Fourth Street Clinic, The Road Home, Valley Behavioral Health, Crossroads Urban Center, Catholic Community Services, St. Marks Hospital, LDS Hospital, Intermountain Medical Center, Huntsman Cancer Hospital and University Hospital.

We also collaborate with homeless service providers like Volunteers of America and The Road Home to swap donated items, ensuring that items are utilized where the need is greatest.

It truly takes a village to serve homeless individuals at the end of life. For an individual we will call “John," who came to us on hospice, transitioned off hospice and moved to our independent program and with the assistance of another resident, learned how to read and manage his medications. This individual was case managed in tandem by our case managers as well was Volunteer of America's case manager and moved in to permanent housing. Our partnership and working together to gave "John" a second chance at life.

The INN Between is a member of the Salt Lake Valley Coalition to End Homelessness and many of its taskforces, the Utah Housing Coalition, Utah Assisted Living Association, and the Medicaid Workgroup.

The INN Between has a staff of 30 FTE and a large team of volunteers (165 annually providing 6,000 hours of service) who work together to give our residents all the comforts of home in a sober-living environment. We provide a week's supply of clothing (through our partnership with Deseret Industries), pillows and bedding, meals and snacks (through our partnership with Utah Food Bank and LDS Bishop's Pantry), laundry service, personal care items, household supplies, social activities, special holiday activities, emotional support, spiritual support and 24/7 end of life companionship. Three House Managers live on-site to provide 24/7 oversight, meals, housekeeping and transportation.

End of Life clients live at The INN Between through the end of life. The length of stay has varied from hours to months. Respite clients typically stay for 2–6 weeks, or more, depending on the doctors' plan of care or new diagnosis being discovered during their stay.

All on-site medical care is delivered by licensed home health and hospice agencies or our RN and team of CNA's. Hospice care includes in-home visits by doctors, nurses and home health aides; medications to ease pain and anxiety; home medical equipment such as walkers, bedside commodes and hospital beds; social worker visits to apply for available resources and manage end of life affairs; and chaplain visits to provide spiritual support. Many of our clients lack health insurance; however, Intermountain Healthcare Home Health and Hospice recognizes the value of our program and has committed to providing charitable care to all uninsured residents at The INN Between.

We strive to reconnect our clients with their estranged family members, to reestablish family ties and begin the healing process for old emotional wounds. The INN Between serves as a neutral space where families can meet and begin the healing process, sometimes resulting in the family's willingness to accept the individual back into their home.

As the end-of-life draws near, we initiate 24/7 companionship so that no one has to die alone. After a client dies, we post an obituary on our website, hold a community memorial service and place their name on our Memorial Garden wall-etched in stone.

We encourage all respite clients to apply for housing assistance with the goal of exiting The INN Between directly to housing, without having to return to camping or shelters. Our volunteers accompany respite clients on the many required appointments to ensure that they feel supported, to help them document the information learned, and to help navigate the health system. We provide intensive case management to help link them to needed community resources such as housing, Medicaid, mainstream benefits, and jobs in order to prevent a return to the streets whenever possible.

The INN Between opened on August 17, 2015, and has been in full operation since that time. New staff positions were added, as well as a core of close to 150+ volunteers, all of whom work diligently to provide quality end-of-life (via our No One Dies Alone program) and supportive services for the hospice and recuperative clients served at The INN Between. Since opening, we have helped over 110 individuals experience death with dignity, in a homelike setting, surrounded by people who cared about them.

We are working hard to establish a stable and broad funding base that will enable us to continue to fill this critical gap in homeless services in Salt Lake County and the surrounding areas of Utah.

We moved into this newer, larger, ADA accessible location in June, 2018. This facility replaced our 16-bed Independent Living Facility which operated at 99% capacity, with 50 available beds. By July, 2018, we had expanded to 32 beds daily, and maintained this level of funding throughout the 2018-19 fiscal year. Our 2021-2022 fiscal year we increased to nearly 40 beds daily. This fiscal year we've increased our budget to appropriately staff for 50 beds and have been near capacity the majority of the year. Our new facility, with our Assisted Living license, allows us to serve homeless individuals with illnesses that require high medical intervention (a current gap in homeless services).