Short-Term Post Hospitalization Housing

A CalAIM Community Support Service for Safe Recovery in Solano and Sonoma Counties

When a patient is ready for discharge but lacks a safe or stable place to recover, short-term post-hospitalization housing (STPHH) provides a bridge between hospital care and permanent housing. At Hammock Homes, we deliver this vital CalAIM Community Support to help unhoused Medi-Cal members heal in dignity while planning their next steps.

How Short-Term Post-Hospitalization Housing Differs from Recuperative Care

Understanding which service fits your needs is important—they're designed for different situations:

Choose Short-Term Post-Hospitalization Housing if:

You're medically cleared and ready for discharge

You can manage medications and health needs independently

Your primary need is stable housing while you search for permanent placement

You want to focus on housing navigation, employment, or skill-building

Choose Recuperative Care (Medical Respite) if:

You still need medical monitoring (vital signs, wound care)

You require medication management support and nursing oversight

You're recovering from surgery, illness, or injury

Your doctor says you need more than just housing—you need medical support

What Both Services Share:

Safe housing in a home-like environment

Wraparound support services and case management

Care coordination with your healthcare providers

Covered through CalAIM Community Support for eligible Medi-Cal members

Still not sure which fits?

Contact us. We'll talk through your situation and help you access the right level of support. If you start in one service and your needs change, we can help you transition.

Who Qualifies for STPHH

Short-term post-hospitalization housing is designed for individuals who meet these criteria:

Recently discharged from a hospital, psychiatric facility, correctional institution or substance use disorder treatment program

Be medically and behavlorally stable for independent living with limited support.

Currently unhoused or at immediate risk of losing housing

Have Medi-Cal coverage through Partnership HealthPlan or another managed care plan

What's Included in STPHH

Hammock Homes Short‑Term Post‑Hospitalization Housing services include:

Safe Housing and Daily Support

Private or shared rooms in a stable, home‑like environment.

Three nutritious meals per day.

On‑site wellness checks and access to nursing staff for  medical coordination.

Integrated Care Coordination

Collaboration with treating physicians and case managers.

Assistance with activities of daily living and transportation  to appointments.

Continuity of care monitoring to prevent readmissions.

Integrated Care Coordination

Dedicated case management for benefits access and  housing referrals.

Connection to housing transition navigation services to secure  permanent placement.

Behavioral health and peer support linkages as needed.

Length of Stay:

Flexible Timeline

STPHH provides housing for up to six months within a 12-month period, giving you time to secure permanent housing.

Combined with Recuperative Care

If you've received recuperative care services, your combined room and board cannot exceed six months total within the 12-month period.

Based on Progress

Length of stay is flexible based on your progress finding permanent housing and achieving your goals.

Who Benefits from STPHH

Following Psychiatric Hospitalization

When you need time to stabilize after inpatient mental health treatment before living independently.

After Substance Use Treatment

Providing a supportive environment following residential treatment or detox while you search for permanent housing.

Medically Cleared with Nowhere to Go

When your medical treatment is complete but you cannot return to your previous living situation.

Building Financial Stability

Time to save money for a housing deposit or first month's rent while in stable housing.

Awaiting Permanent Supportive Housing

A safe place to stay while waiting for permanent supportive housing placement to become available.

Developing Independent Living Skills

Space to practice and build the skills needed for successful independent living.

The Difference STPHH Makes

Prevents Returns to Housing Instability

Stable housing after discharge prevents individuals from returning to unsafe living situations.

Supports Treatment Gains

A safe environment helps you maintain the progress made during hospitalization or treatment.

Reduces Rehospitalization

Housing stability decreases the likelihood of crisis situations that lead to emergency room visits or readmission.

Increases Housing Success

Case management and navigation services improve the chances of securing and maintaining permanent housing.

Promotes Long-Term Wellness

Connection to ongoing healthcare and support services sets the foundation for sustained recovery and stability.

Get Started with STPHH

Whether you're a healthcare provider planning a patient's discharge or an individual who has been hospitalized and needs stable housing, we're here to help.

For Healthcare Professionals:

Contact us to discuss patient needs and initiate referrals for individuals who qualify for STPHH services.

For Individuals:

Reach out to learn about eligibility and how short-term post-hospitalization housing can support your transition.

Leaving the hospital without a safe place to go shouldn’t be your reality. Our short-term
post-hospitalization housing program provides the stability and support you need to successfully
transition to permanent housing.

FAQ

Hammock Homes adheres to the highest standards for medical respite as outlined by leading national organizations and California's managed care regulations, promoting recovery through a safe, supportive environment with medical oversight and strong care coordination.​

Research from health foundations and state programs shows that high-quality medical respite and post-hospitalization housing reduces readmissions, supports faster healing, and provides essential connections to outpatient care and social services.​

Under California’s CalAIM initiative and similar national trends, medical respite and short-term post-hospitalization housing are increasingly covered by health plans for eligible clients, aligning Hammock Homes with statewide priorities for health and housing integration.​

Hospitals and partners benefit from clear referral pathways and coordinated care planning. Families, when appropriate, may be included in care meetings and discharge planning for smooth transitions back to independence or permanent housing.​

Discharge planning includes assistance with securing permanent housing, linkage to ongoing medical care, and connections to supportive community services, in line with best practices for transitional care from hospital to housing stability.​