In October, Manuel Correa underwent double hip replacement surgery.

His doctor sent him to a facility out of town to recuperate for three weeks, and then he was back in Yakima, living at the Union Gospel Mission, where he stayed for about nine months last year.

The 62-year-old from Puerto Rico went to see his primary care doctor in November at Yakima Neighborhood Health Services for a checkup. She asked him about his living situation, and was concerned about where he’d be able to rest in order to recover from his procedure.

“I told her, ‘I rest in my car,’” Correa said.

Correa is representative of an ongoing issue in health care: how to ensure good health outcomes for people who have nowhere to go after they leave the hospital or doctor’s office. At Neighborhood Health, federal and state money helps a dedicated team of employees find housing for homeless clients.

“In the beginning, that was tough for us — that’s not a service we would normally provide as a community health center,” said Annette Rodriguez, director of homeless and housing services for Neighborhood Health. “But you can’t really do good health care unless people are housed. That’s a big thing; we know they go hand-in-hand.”

The organization runs a respite care center on South Naches, where patients can go to recover from surgery or other medical treatments for up to 30 days. From there, Rodriguez and case managers work with various landlords in the area to find affordable, safe housing for the recently homeless.

Finding a place that works is tricky. Most landlords want background checks, credit history, first and last month’s rent and a security deposit, which can pose an insurmountable hurdle to people who have been sleeping on the streets or are teetering on the edge of losing their homes.

Neighborhood Health, which has an overall budget of about $14 million, uses several different sources of funding to help, almost all of which comes through Yakima County’s Department of Human Services, which subcontracts with a number of agencies. Grant money comes from the U.S. Department of Housing and Urban Development and the state Department of Commerce.

Neighborhood Health subsidizes some programs through donations from United Way and local churches, and also uses that money for clients who don’t exactly fit strict government requirements.

The money can help with deposits, rent, utility payments, even credit repair. In total last year, the program operated on a little over $1 million.

Rodri-guez has built relationships with about a dozen local landlords willing to house her clients. She’s established lines of communication and makes sure they know she and Neighborhood Health are committed to helping their clients be good tenants.

A lot of that is education. Life on the streets comes with its own set of rules, and often, those who have recently been homeless feel an obligation to help former camp-mates by taking them in.

“Some of these folks haven’t been housed in a long time; don’t realize that it’s important that only the people on the lease can be in the apartment,” Rodriguez said. She says she acts as a liaison, so landlords call her if any problems arise.

Scott Lamb has worked with Neighborhood Health for the past five years. He owns two small apartment buildings on South Second Street, where currently six of 23 units are occupied by Neighborhood Health clients.

He says he sees himself as a “landlord case worker,” and helps his tenants learn to pay bills on time, establish credit, change their address and follow general courtesies of living in an apartment complex.

“It’s like teaching a young person all over again how to live in the community with other people,” he said. “That’s pretty tough for the newbies. They don’t understand that — if they’ve been homeless, they pretty much do what they want, when they want.”

Lamb pitches in by driving his tenants to medical appointments or job interviews, and babysits if they need someone to care for kids while they’re out. He buys birthday cakes when a child has a birthday, holds giant barbecues every month or so, and last Thanksgiving bought enough food to make sure that everyone got a full turkey dinner. He also hires tenants for any odd jobs he needs done at the apartments.

“My thought’s always been that everybody deserves a second chance,” he said. He sets the expectations at the beginning: He’s willing to help if people communicate with him when there’s a problem, but won’t tolerate lying. He rarely has to evict anyone, because once they learn the rules, his tenants help to enforce them and make the apartments a safe community.

“Once you show a little bit of interest with people, you’re friends for life,” he said. “It’s really amazing.”

Most Neighborhood Health clients who can be housed are receiving disability payments, so they’re able to pay their rent. Some are able to get jobs after they’ve stabilized their housing situation.

Correa’s adult son helped front him the money to get into a small apartment on West D Street, which he keeps tidy. Before his hip problems worsened, he worked at the SunDome, helping set up for events. But now he’s on SSI, which covers his basic bills. He has a case worker through Neighborhood Health who helps make sure he gets to his doctor appointments.

Follow-through is critical to achieve good health outcomes, providers say.

At Yakima Valley Memorial Hospital, Ignacio Orozco is a case manager and discharge coordinator who works closely with Neighborhood Health to make a plan for homeless patients about to leave the hospital. He frequently refers people to the respite center.

“When you have a place like respite care, with a room and a shower and someone to check over and watch you and make sure you’re doing OK, that’s a big huge plus,” Orozco said. “Patients who don’t qualify for respite care … they have repeated (ER) visits, with the same condition over and over again, which racks up a big huge bill.”

Plus, he says, fixing their problems in the ER is less effective if they have nowhere to recover.

Without respite or other transitional housing, “They’d be out by the river somewhere, or out by dangerous areas where they’re trying to protect themselves. ... They’re not really thinking about their own care because there’s so many other factors involved.”

Once housed, Rodriguez said, people can focus not only on their health care, but on bringing order back to other aspects of their life. Case workers teach budget management, help find them clothes for job interviews, and get clients into training programs so they can find jobs with decent wages.

“The goal for our service is to be needed less and less,” she said. “We’re not telling the client what to do or how to do it; we’re just encouraging them along the way to make the right decisions for themselves.”

• Molly Rosbach can be reached at 509-577-7728 or mrosbach@yakimaherald.com.