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2011 HSR&D National Meeting Abstract

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2011 National Meeting

1065 — Improving Access for Homeless Veterans: A New Health Care Model of Collaboration

Ramchandani N (Palo Alto VA), Kohl J (Santa Clara Valley Homeless Healthcare Program), Reed P (Menlo Park VA Clinic), Ho C (Santa Clara Valley Homeless Healthcare Program), Kuang A (Santa Clara Valley Homeless Healthcare Program), Tong I (Palo Alto VA)

Objectives:
Homeless veterans have unique barriers to getting health care. The lack of adequate housing, finances, transportation, and knowledge of the VA health care system leads to inadequate or absent medical care. The Santa Clara Valley Homeless Healthcare Program and Palo Alto VA Health Care System have constructed a new health care model, called Medical Respite, which uses collaboration between a county health care system and the VA to decrease these barriers.

Methods:
The Medical Respite Program is housed within the James F. Boccardo Center, a community housing shelter. Veterans are referred to the Respite Program from VA or community hospitals and outpatient clinics. A Veteran is eligible for referral if: the Veteran has a medical condition that can be addressed within six weeks, lacks adequate housing for recovery, is able to perform activities of daily living independently, has been clean and sober for at least 72 hours, is behaviorally appropriate for a group setting, and has no skilled nursing needs. The application is reviewed by a VA Social Worker and accepted based on bed availability. Once accepted, the Veteran meets with the county Respite Nurse Manager. She then discusses the Veteran’s case with a VA physician. The Veteran and the physician have an intake appointment at the shelter to discuss what further evaluation and/or treatments are needed. During this appointment, the Veteran gains access to VA resources and medications. The physician then communicates the plan of care to the Nurse Manager. The Veteran has access to the VA physician and social worker during the respite stay to facilitate medical care and placement in a more stable housing situation.

Results:
In the first two months of operation, nine Veterans have been admitted to the Medical Respite Program and five veterans have been discharged. Four of the five discharged Veterans are now in stable housing arrangements. All five discharged Veterans were able to establish a relationship with a primary care provider at a VA clinic.

Implications:
Examination of long term outcomes is necessary.

Impacts:
Our initial success demonstrates that an innovative and collaborative health care model may be the first step in helping homeless Veterans obtain health care.


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