Overview

Homeless Patient Aligned Care Teams (HPACTs), an innovative treatment model being implemented at VA medical centers across the country, play a key role in the fight to end Veteran homelessness.

Located on the campuses of VA medical centers, community-based outpatient clinics, and Community Resource and Referral Centers, HPACT clinics co-locate medical staff, social workers, mental health and substance use counselors, nurses, and homeless program staff. These professionals form a team that provides Veterans with comprehensive, individualized care, including services that lead to permanent housing. HPACT teams are attuned to how housing insecurity and other social factors like poverty harm Veterans’ health overall, worsen sickness, delay care, and exacerbate both temporary and long-term homelessness. VA’s HPACT approach ensures that a fully integrated team is aware of and can treat the issues involved in and contributing to homelessness among Veterans.

Why HPACTs make sense

Veterans can walk into HPACT clinics without an appointment and receive medical care, case management, housing placement supports, substance use and mental health treatment, community referrals, triage services, benefits counseling, and even hot showers and clean clothes. This unified treatment approach makes sense for a number of reasons:

• It advances VA’s Housing First policy, which is the most effective and economical way to reduce homelessness among Veterans.
• It’s designed to reach Veterans living on the streets—or in cars, shelters, or other unstable situations—and assist them with finding the housing of their choice, even if they use alcohol or drugs or have chronic health issues.
• It furthers the concept that housing is a form of treatment for Veterans who are homeless and have medical problems because having safe, stable housing can prevent illness and promote recovery.

Results so far

VA has piloted HPACT only since January 2012, and so data are incomplete. However, HPACTs are showing promise in improving health and other outcomes among participating Veterans compared with non-HPACT patients. Here are the data so far:

• Patients enrolled in HPACT experience on average 31 percent fewer emergency room visits.
• HPACT patients require an average of 24 percent fewer hospitalizations. If duplicated across the entire health care system, this reduction could save VA about $5 million per year.