Q&A with Respite Leadership

From left: Evan Russell, Omar Marrero, Carol Benner, Carmen Rios, Hannah Matheson, Georgia Thomas-Diaz, Christy Sheehan and Jordy Laks

In this insightful Q&A interview, you’ll be hearing from Omar Marrero, LICSW, Director of Respite Operations, Jordy Laks, MD, Medical Director, Georgia Thomas-Diaz, LMHC, Behavioral Health Director, and Christy Sheehan, RN, Director of Nursing. We applaud the efforts of the entire respite leadership team for their devotion to creating the best medical respite environment for our patients to heal from their varying ailments. We hope you enjoy the read!

Question: For those who are not familiar with medical respite, can you briefly describe what it is and why it’s important?

Omar: Respite provides high quality health care for people experiencing homelessness that are too sick to be in the shelter or the street but not sick enough for a hospital admission. Our average length of stay is 18 days.

Jordy: It provides essential, integrated medical, behavioral health, and SUD focused care and respite from the daily survival of being homeless.

Q: What are the most common health issues addressed during our patients’ respite stay?

Jordy: Infections, chronic wounds, withdrawal syndromes, and complications of chronic conditions like diabetes, heart failure, and COPD are very common. We often start medications for opioid use disorder and other SUD, address co-occurring psychiatric disorders and trauma. Patients also come for postoperative recovery and cancer workup and treatments.

Georgia: We work with patients who have major mental illnesses (ex:schizophrenia, bipolar and major depressive disorders), complex trauma (PTSD, anxiety), substance use disorders (SUDs), and chronic medical illnesses (ex: diabetes, hypertension, COPD, among others). Our comprehensive and person-centered approach ensures physical and behavioral health needs are addressed during the respite stay.

Q: Can you describe the nursing care we provide in respite? How is it similar to or different from other nursing jobs at BHCHP?

Christy: Our nurses at BMH provide patients with extraordinary care for a variety of health conditions. We provide extended hospital care for infections and patients on IV antibiotics. We provide wound care for injuries such as frostbite or abscesses.  We provide education for patients on new medications or with new medical diagnosis. The nursing staff at BMH provides stigma free care for those experiencing difficulty with substance use. It is different from other settings in that we care for the whole patient. We try to meet patients where they are at and prioritize what is important to them. We work with patients to keep them engaged in care until they are ready to return to shelter, street or housing.  

Q: How did you come into your current role in respite leadership?

Omar: I started as the Respite Director of Operations eight years ago. I have been working in this field for over 21 years, primarily in housing first and outreach services. I’m a social worker by training. Before joining BHCHP, I was the Administrator of Housing Services for BPHC Homeless Bureau.

Jordy: I took on the Medical Director of Respite position in December 2024, taking over for the wonderful Joanna D’Afflitti! I was drawn by the wide variety of medical problems seen in respite, the dynamic multidisciplinary team, and the vital value of respite to improve people’s lives.

Georgia: I came into my current role in respite leadership after over 23 years of working with underserved populations. Throughout my career, I’ve held various positions, including roles as a manager and director. My journey began as an HIV counselor/tester and case manager, followed by serving as an HIV/STI Prevention Director, an OBAT clinician, and the Family Team Director. Now, I serve as the Director of Integrated Behavioral Health Services in Respite. Providing care in respite has always been my core focus, and I remain committed to ensuring patients receive comprehensive, compassionate care throughout their stay.

Christy: I have been with BMH for 13 years. I started as a floor nurse, then became a charge nurse, then Associate Director of nursing and now Director of Nursing. I love McInnis and learned a lot in my experience as a nurse and charge nurse on the floor. We are a very unique organization and I thought it was important to have someone with lived experience in leadership. I applied for the job so that I could be an advocate for our patients and staff in leadership.  

Q: What do you enjoy most about your work?

Omar: Having the opportunity to serve those that have been historically neglected by the health care system and doing this work closely with so many people who are committed to this cause.

Jordy: Working with lots of different people who are dedicated to patient care, seeing people get better and change perspective during their respite stays, working on improving systems to provide excellent care. Having time to sit with a few patients and hear their stories in depth.

Georgia: What I enjoy most about my work is serving this population and being surrounded by my colleagues. It’s fulfilling to make a meaningful impact in the lives of those who need it most, and I value the collaboration and support that comes from working alongside a dedicated team. Together, we create a compassionate and inclusive environment where patients can feel seen, heard, and cared for.

Christy: I still love interacting with patients the most. Our patients are so grateful for the exceptional care that they receive here. Often times they don’t feel welcome in the traditional hospital setting. BMH provides stigma free care to our patients who often face head on the stigma associated with homelessness. 

Q: In your opinion, what’s the number one challenge to providing patient care in this kind of setting?

Omar: Meeting people where they are regardless of their complex background is challenging. Also, the lack of additional community resources available for our patients adds another layer of difficulty.

Jordy: Conflict over control. Respite is a more controlled environment than outpatient clinics with respect to rules, medication administration, schedule of the day, and physical space. This is necessary to maintain a safer and therapeutic environment, and it also leads to struggles between patients and between patients and staff.

Georgia: In my opinion, the number one challenge to providing patient care in this setting is addressing the complex layers of trauma that many patients carry. Many individuals in respite have experienced significant adversity, and post-traumatic stress reactions, traumatic brain injuries (TBIs), substance use, and untreated mental illnesses can often interfere with their care. These layers of trauma can limit how much medical or behavioral health clinicians can accomplish during their stay. It requires a trauma-informed, patient-centered approach, understanding that healing is a process and that building trust and safety is essential to effective care.

Christy: The number one challenge from a nursing perspective is lack of time. We have 13 patients per nurse and it is really challenging that we do not have more time per patient. The acuity of our patients has increased and we haven’t been able to adjust for that with staffing. We are always operating in a staffing deficit so our nurses are working overtime and can quite easily burn out. This is hard work and our nurses are so dedicated and helpful. It may be hard for them to say no.

Q: How would you characterize our staff? Does it take a certain type of person to work in respite?

Omar: We are blessed to work with many caring and compassionate staff who are committed to the cause and resilient in their work endeavors.

Christy: If you ask our nursing staff what they like most about their job, the answer is almost always “the patients and the staff”.  I believe that it is a certain type of person that is committed to work with this population. Our nurses are kind and empathetic. This is evident in interactions with patients and their fellow co-workers.  

Q: Can you share any recent updates from respite that might be interesting?

Omar: The integration of EMT certified staff that provides additional support to the nursing and behavioral health teams, has allowed us to better meet the needs of our patients struggling with SUD and/or active mental health crisis. Our new partnership with the CTC methadone clinic has also enabled us to begin offering methadone dosing in respite.

Jordy: Evan Russell, NP joined as our Associate Medical Director this year, which has been a major positive in this work! Also we have many patients who are incredibly talented musicians and artists, including one who draws professional level Smurf cartoons.

Georgia: One of the respite’s most impactful recent updates has been hiring Milieu Managers to provide additional support. This approach has significantly strengthened our ability to offer consistent, compassionate care and maintain a supportive environment for patients and staff. I genuinely enjoy coming to work each day and collaborating with my team. Their dedication and passion for serving this population make a meaningful difference, and it’s inspiring to be part of such a committed group.