The California-based hospice provider YoloCares has recently received nearly $1.14 million in funding to launch a new residential hospice shelter for homeless populations.

Branded as Joshua’s House, the funds were approved by local board officials in Sacramento County, California, and will support the site’s construction. The location is set to open in April 2025 and will feature six three-bedroom homes for terminally ill homeless individuals in need of food, clothing, shelter and end-of-life care.

The project has been several years in the making, with the homes already built and ready to be placed across a 1.2-acre area, according to YoloCares CEO Craig Dresang. Support has mounted with greater recognition around the unmet needs of underserved homeless communities, Dresang said.

“The site is really going to operate more as a shelter,” he told Hospice News. “It’s housing for people who are unhoused, have a terminal diagnosis and are appropriate for hospice. We were really surprised and pleased that the board of supervisors from Sacramento County were unanimous and really full-throttled in their support of Joshua’s House. There are a lot of people who die on the streets every month.”

Roughly 72% of the estimated 9,278 homeless individuals in Sacramento County, California do not have shelter, according to a report from the region’s Department of Homeless Services and Housing.

Adults 50 and older represent nearly half (48%) of homeless populations statewide, a number projected to triple by 2030, according to recent research from the University of California San Francisco (UCSF). These individuals often have similar comorbid health conditions to those in older age groups, while also reporting complex behavioral health needs, the research found.

The impetus for the project began when community leader and advocate Marlene von Friederichs-Fitzwater’s homeless grandson Josh died from an overdose on the streets of Omaha, Nebraska. Fitzwater was instrumental in garnering funding and working out a “favorable renewable lease” with local city officials, Dresang stated.

Development of Joshua’s House has in part been fueled by roughly $2 million in philanthropic donations, including a $400,000 investment from the insurance company Anthem Blue Cross Blue Shield, part of California’s Medicaid program.

“Anthem is proud to support and partner with the city and county of Sacramento on expanding the Joshua’s House hospice program to be able to serve more terminally ill homeless people who do not have the ability to cope with their tragic circumstance in their own home,” Les Ybarra, president of Anthem Blue Cross Medi-Cal, told local news. “Anyone who is facing an end-of-life circumstance deserves the right to be comfortable and safe, regardless of housing status.”

Future goals for Joshua House include adding an additional three homes for terminally ill homeless populations, according to Dresang.

The project is the latest iteration of YoloCares’ service growth, coming on the heels of its recently unveiled Enhanced Care Management (ECM) model. That program is designed to address social determinants of health and other related patient needs.

YoloCares provides hospice, palliative and supportive care, adult day and advance care planning services in five California counties. The hospice provider also offers educational resources through YoloCares University and operates grief and caregiver support centers.

YoloCares will collaborate with other hospices to provide support to unhoused and underhoused populations, said Dresang.

“Theoretically, any hospice provider could refer a patient there. The hospice can follow their patient, or not, just like they would do in all other facilities,” Dresang told Hospice News. “We’re hoping it’ll serve as a model for all Western states. Everybody deserves to spend their final days with dignity, respect and compassion — and that’s what this is really about.”