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In-Shelter Care is a shelter-based medical program to prevent relinquishment due to urgent medical needs when the shelter can legally provide medical care to owned animals and the owner/caretaker is unable to access that care. The shelter can intervene by providing cost-effective, resource-efficient interventional medical care directly to the pet therefore, removing the need to surrender the animal for services. In-Shelter Care is meant to be for “one and done” scenarios, not chronic management.
In-Shelter Care serves as a safety net within the community to save lives, reduce animal relinquishment, keep overall shelter care costs down, and support the human-animal bond in communities.
Ideally this person will also act as the medical to provide triage and liaise between the medical team and the client.
Although the goal is that programs be budget neutral by shifting costs from standard shelter care to shorter term interventional care. It is likely that for the first 12-18 months, this program will need added funds for staff support and additional materials, but these may be offset by client contributions, payment plans, reallocation of staff, and efficient use of specialized volunteers.
For example, allow for management/intake of these cases on specific days of the week when supporting staff has been delegated to work on this program.
Example: Flow Chart for Case Management
Don’t reinvent the wheel – adapt others’ protocols for your operations. These are most likely to be useful and relevant to you if developed by similar organizations in your area or a comparable location.
Ideally, scope of care cases should not require this level of care, but there must be at least a process by which cases can be triaged and access emergency care in the event it is needed.
Consider developing a shared document among staff to collect and compile stories and photos that your marketing team can use for social media, reports and grant reporting.
Focus on whether the new program can be implemented with current staffing levels or if additional staffing is needed. In theory, many of the initial cases your shelter supports would be potential surrenders to the shelter (i.e. cases your shelter were already likely to have to handle), so workload or caseload should not increase and re-allocation of staffing should suffice. Initial re-allocation of staffing should include the designation of a point person (medical case manager). As the program grows and the community learns of the program, you may need additional staffing. For example, you may need to eventually designate staff to shelter pet services or public pet services.
Use incremental care techniques when treating animals. For example, use a tiered diagnostic and treatment approach over time. Non-critical procedures are avoided and diagnostics are limited to those that could provide results that will change how the case is handled. Strong communication with clients and the ability to adjust a patient’s treatment plan are needed.
Start small and simple with what you have, and grow the program over time. Document effective protocols and practices as you go, so they can be replicated for the next case. Develop a record keeping system for the program to track touch points and to slowly better understand what services your community is most in need of. Utilize staff where they are most essential, prioritizing veterinary staff to veterinary care and communications and management staff to client and community relations. Over time, consider additional ways to make the program financially sustainable. For instance, grow your financial model by updating sliding scales for emergency surgeries or, if legally allowed, by providing service to non-qualifying clients who are willing to pay higher fees.
In general, this is why we recommend that in-shelter care programs start on a referral basis only; e.g. the client is referred by a veterinary practice or social service agency, or at the point of surrender to the shelter. While the ultimate goal of the program may be to allow access for any pets and people that have need, care should be taken in the early stages to avoid exceeding the program’s capacity. This can be achieved through limited acceptance of referrals and/or triage by the case manager based on an assessment of need and on current veterinary team bandwidth.
Although adoption fees are a source of revenue, they are rarely substantial once the cost of shelter care is factored in, especially if placement is delayed by medical care or other issues. In-shelter medical programs can also be a source of revenue by collecting some degree of client contribution, reducing the costs of sheltering the animal to the point of rehoming. They may also serve as an attractive grant or donor program.
This depends on the ease of providing spay/neuter in your facility. In some communities, low-cost spay neuter is available through organizations other than the shelter. Spay/neuter status should not be a barrier to accessing in-shelter interventional care; however, the shelter may want to provide these services once the condition has resolved.
There may be initial additional costs in establishing the program. Ultimately, the intention is to be budget neutral, and in the end the program should reduce the shelter’s expenses associated with animal care by reducing treated pets’ length of stay in the shelter and daily shelter census, as those pets are cared for by their owners or members of the community.
Regulations regarding veterinary practice differ widely from state to state, and so investigating your state requirements is essential. A guide to VCPR regulations by state is available here. It is important to be clear on who owns the animals and makes decisions regarding its care throughout all stages of the intervention. In some places, regulations determine the scope of care that can be provided by nonprofits to owned animals. In some jurisdictions, relinquishment may still be required if the shelter is not legally allowed to provide care for publicly-owned pets. In all cases, the intended outcome for the pet will be adoption back to their owner (or a designated return-to-owner subtype outcome).
This can be a serious rate-limiting step. In some states or jurisdictions, the only way to provide medical care to an animal is to have it surrendered to the shelter or to pay for services through a veterinary clinic. However, the HASS legal working group is a great resource for exploring how your organization might begin to make headway in providing medical services to owned animals at risk of relinquishment. Contact HASS to learn more about creating change in your state.
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