VA’s Homeless Patient Aligned Care Team (H-PACT) program was recently recognized as a promising model of care for adults with complex needs.
The H-PACT model, developed and implemented by VA’s Office of Homeless Programs and National Center on Homelessness Among Veterans, was created to meet the unique challenges homeless and at-risk Veterans face accessing health services under traditional models of care. These models, which often require patients to visit multiple locations to receive treatment for various conditions, present a barrier to treatment options for many homeless Veterans who suffer from chronic and acute illnesses.
In 2011, VA launched the H-PACT program to address this issue. The program’s model employs an integrated care team to deliver coordinated and comprehensive health treatment, along with wrap-around services in areas such as housing and employment, to address the root causes of a Veteran’s homelessness – all in a single location. Mental health, homeless programs and primary care staff are co-located to reduce barriers to receiving care. By providing Veterans with health care and services they may otherwise have trouble accessing – either because of a lack of transportation or due to the fragmented nature of traditional models of care – the H-PACT program aims to stabilize Veterans to a point where they are ready to move into transitional or permanent housing and can better manage their physical and mental well-being.
First piloted at 32 sites, 19,000 homeless Veterans are currently enrolled in the program and receive care at 62 active sites across the country. On average, H-PACT participants experienced 31 percent fewer emergency department visits and 24 percent fewer hospitalizations. Other program achievements include effectively engaging homeless Veterans in ambulatory care, identifying un-diagnosed conditions and housing more homeless Veterans at a faster rate. Located in community-based outpatient centers, VA Medical Centers, and Community Resource and Referral Centers, the H-PACT program demonstrates the effectiveness of integrating the social elements of health into the clinical care of homeless Veterans.
“Even though I am no longer homeless or at risk for being homeless, I do not want to leave the H-PACT clinic because I get the best care the VA has to offer in the little building with people who have big hearts,” said William Childers, a Marine Corps Veteran who recently received care at the H-PACT clinic in Detroit, Michigan. “Words cannot explain the care the H-PACT has provided and I thank them all from the bottom of my heart.”
You can read more about Childers’ experience here.
H-PACT will be recognized alongside 21 other programs in the Commonwealth Fund’s upcoming reference guide, which will be live on the Institute for Health care Improvement’s new website: The Playbook: Better Care for People with Complex Needs.
To learn more about VHA’s H-PACT program, please visit the program website by clicking here.
Dr. Tom O’Toole is the director of the National Center on Homelessness among Veterans as well as national director of the Homeless Veterans Patient Aligned Care Team (H-PACT) Program for the Veterans Health Administration. He is a general internist based at the Providence VA Medical Center in Rhode Island where he is also a professor of medicine at Brown University.