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HPACT West Haven Initiates Mobile Health Services for Veterans Experiencing Homelessness

April 18, 2024
by Chigoziri Konkwo

Homeless Patient-Aligned Care Teams (HPACT) of the VA Connecticut Healthcare System in West Haven were developed as a system for providing adequate care for veterans experiencing homelessness. Previously led by David Rosenthal, MD, the program has successfully expanded the scope of VA care within the New Haven catchment area. However, HPACT leaders both locally and from sites across the country recognized the limitations in their ability to provide services to a large portion of patients who are unable to access their brick-and-mortar services. Caroline Falker, MD, the new medical director of HPACT, and the rest of her team were determined to introduce new services to address these limitations.

“There are barriers to accessing the clinic that are more than distance, which we know are impactful even for veterans who are only within a mile of where your clinic is. So we thought, how are we going to do this with limited additional funds or staffing? How do we actually staff two places at once?” asked Falker.

The HPACT National Program, with funding obtained through the American Rescue Plan (a.k.a. the COVID-19 Stimulus Package), proposed the creation of mobile medical units for use by HPACT centers across the country. However the proposal necessitated further thought towards how exactly the units would be put into practice. Members of VA Connecticut HPACT initiated outreach to veterans and stakeholders, identifying what services they would like to see in the units, and what they felt were gaps in their care.

“A couple of themes came out of our stakeholder interviews, one of which is that we need consistency. We know that it can take months to generate a presence in these locations, but what's really important to us is the ability to provide this care consistently. So once we pick locations, we must stick with them,” said Falker.

The team received a 27-foot Ford F-550, outfitted with an exam space and services for providing point-of-care influenza A, influenza B, and COVID-19 testing, vaccinations, and blood draws. Falker described the efforts made towards ensuring consistency between the services provided by the mobile medical unit and those provided by their brick-and-mortar services.

“We want to make sure that the care we're providing on the mobile medical unit is the exact same care that we're providing in our clinic. Because we have a lot of veterans who are at risk for homelessness or are unstably housed outside of the New Haven catchment area, the mobile medical unit will give some very cool opportunities to engage with veterans in other far-reaching parts of the state,” she said.

Just like their role within their brick-and-mortar clinic, HPACT provides primary care and addiction medicine services through their mobile medical unit, along with referrals to other medical subspecialties. Falker noted some of the aspirational goals they have for providing care through these units, such as providing mental health services.

“It would be really great for us to be able to have a mental health provider at least part-time with us on the mobile medical unit. We’ve also spoken with many other VA departments about partnerships and coming out with us [on the mobile units], somebody from our medical legal partnerships, eligibility, all of these other offices that help serve our patients, that can have a rotating presence with us.”

The Department of Internal Medicine at Yale School of Medicine is among the nation's premier departments, bringing together an elite cadre of clinicians, investigators, educators, and staff in one of the world's top medical schools. To learn more, visit Internal Medicine.

Submitted by Julie Parry on April 18, 2024