Fact Sheet
Homeless Patient Aligned Care Team (HPACT) Fact Sheet
HPACT is a multi-disciplinary, population-tailored medical home designed around the unique needs and distinct challenges homeless Veterans face both accessing and engaging in health care. HPACT addresses the unique needs of homeless Veterans in one setting. The HPACT care model centers on five core elements that distinguish it from traditional primary care models:
- Reducing barriers to care by providing open-access, walk-in care in addition to community outreach to engage those Veterans disconnected from VA services.
- One-stop, wrap-around services that are integrated and coordinated and include mental health, homeless programs, and primary care staff that are co-located to create a continuum of care and integrated care team. Most HPACTs also provide food and clothing assistance, hygiene items, showers, laundry facilities, and other services on-site to meet the full spectrum of Veteran needs.
- Engaging Veterans in intensive case management that is coordinated with community agencies and partners and other VA services for continuous care with more seamless transitions.
- Providing high-quality, evidence-based, and culturally sensitive care that is validated through research evaluation and achieved through the provision of ongoing education for HPACT staff.
- Being performance-based and accountable with real-time data and predictive analytics to assist teams in targeting Veterans most in-need, provide ongoing technical assistance and personalized feedback to teams, and inform field-based performance.
Program Statistics and Evaluations
Launched in 2011 by the VHA Homeless Program Office, HPACT began with 32 pilot sites and now has 65 sites across the US in VA Medical Centers (VAMCs), Community Based Outpatient Clinics (CBOCs), and Community Resource and Referral Centers (CRRCs). HPACTs are located in every VISN, in cities with high rates of homelessness as well as in rural communities, with over 200 full-time equivalent staff serving over 23,000 Veterans annually. Compared to standard primary care, HPACT is associated with lower rates of emergency department use and hospitalizations1, more effective at engaging Veterans in ambulatory care with decreased care cost2, assists Veterans in obtaining housing faster3, provides better care experiences for homeless Veterans4, and increases timely access to mental health care5.
HPACT Initiatives
HPACT serves as a platform for new initiatives aimed at improving homeless Veteran care and access to key programs and services. Examples include:
- Mobile Medical Units: VA deployed 25 new Mobile Medical Units, or MMUs, to HPACT sites across the country in fiscal years 2023 and 2024. The purpose of the MMUs is to increase access to medical care, mental health care, and social services for Veterans experiencing homelessness, or those who are at risk of experiencing homelessness, by meeting them where they are. The units provide HPACT staff with the necessary infrastructure to provide care in community-based settings in a safe and confidential space with equipment and medical supplies readily available. In fiscal year 2025, HPACT MMUs provided over 8,000 clinical encounters, served over 3,500 unique Veterans, and visited nearly 500 locations. Early program evaluation shows MMUs are a viable way to reach a complex population while reducing barriers to care and increasing positive veteran outcomes.6, 7
- Opioid Overdose Education and Naloxone Distribution (OEND): In FY23 14 HPACT sites participated in an Opioid Overdose Education and Naloxone Distribution Quality Improvement Initiative to increase access to overdose education and life-saving overdose reversal medication for Veterans at increased risk of death by opioid overdose. Among participating HPACT sites, naloxone prescribing increased by 121% during the 6-month initiative and over 1,000 Veterans received overdose education and a naloxone prescription. Following this FY23 initiative, all HPACT sites have been provided with resources to enhance OEND access for Veterans.
- Predictive Analytics/Super-Utilizer Identification Tool: This tool works by developing a real time predictive algorithm for identifying homeless Veterans at high risk for being “super utilizers” of acute care services in the next three months. Included in this algorithm are pre-identified evidence-based interventions the HPACT team can use to mitigate this risk.
- Hospital to Housing Program: This partnered initiative tested the feasibility of providing direct transfers from inpatient care to transitional housing for homeless Veterans with the bridging of health care and care management support by the HPACT team. The goal being to use acute hospitalization as a facilitator to start the housing process while supporting the respite needs of these Veterans, both saving money and ending that Veteran’s homelessness.
Next Steps
HPACT presents a unique model that can enhance access and integrate VA resources in an efficient way while caring for the whole Veteran. As HPACT reaches across the continuum of care, needs are met for homeless and at-risk Veterans who may be challenged in their capacity to access and engage in traditional care models. In FY26-28, the focus of HPACT is on increasing Veteran connections to care through expanding utilization of MMUs and closely evaluating their effectiveness on health outcomes for homeless Veterans. Additionally, six new HPACT sites began operating in fiscal year 2025 and HPACT is focused on supporting the launch of these new sites, along with existing sites, to continue to address the physical, mental health, and social needs of this vulnerable population across the VHA system.
Additional Information
For additional information or questions, email homelessvets@va.gov.
References
- O’Toole et al. (2016). Tailoring care to vulnerable populations by incorporating social determinants of health: The Veterans Health Administration’s “Homeless Patient Aligned Care Team” program. Preventing Chronic Disease, 13. DOI: 10.5888/pcd13.150567 ↩︎
- O’Toole et al. (2018). Populations-tailored care for homeless Veterans and acute care use, cost, and satisfaction: A prospective quasi-experimental trial. Preventing Chronic Disease, 15. DOI: http://dx.doi.org/10.5888/pcd15.170311 ↩︎
- Johnson et al. (2017). No wrong door: can clinical care facilitate veteran engagement in housing services? Psychology Service, 14(2). DOI: 10.1037/ser0000124 ↩︎
- Jones et al. (2019). Providing positive primary care experiences for homeless Veterans through tailored medical homes: The Veterans Health Administration’s Homeless Patient Aligned Care Teams. Medical Care, 57(4). DOI: DOI: 10.1097/MLR.0000000000001070 ↩︎
- Jones, A. L., Chu, K., Rose, D. E., Gelberg, L., Kertesz, S. G., Gordon, A. J., … & Leung, L. (2023). Quality of Depression Care for Veterans Affairs Primary Care Patients with Experiences of Homelessness. Journal of General Internal Medicine, 1-9. ↩︎
- Weber, J.J., Kinney, R.L., Roncarati, J.S., Bruemmer, K. Diaz, M., & Albanese, J. (2025). A national mobile medical unit (MMU) program to address the healthcare needs of veterans experiencing homelessness: An evaluation protocol. Health Service Insights, 24(18). DOI: 10.1177/11786329251320200 ↩︎
- Yoon, J., Chow, A., Weber, J.J., Wong, E.P., Blonigan, D.M., & Tsai, J. (2026). Utilization and costs of mobile medical units for veterans experiencing homelessness. JAMA Network Open, 2(9). DOI: 10.1001/jamanetworkopen.2025.55068 ↩︎
Contact VA for help
If you are a Veteran who is homeless or at imminent risk of homelessness, we strongly encourage you to contact the National Call Center for Homeless Veterans at 877-424-3838 for assistance.
The call is free, confidential, and available 24 hours a day, 7 days a week. Trained professionals are standing by to connect you to your nearest VA for help.
