Primary Care for Homeless Veterans

Abstract

In many ways homelessness is both a health issue and a reflection of the viability of our social safety net and health care system. Despite advances made in our understanding of how to best provide care and assist homeless persons, significant health disparities and gaps in care persist, as does the conundrum of chronic and persistent homelessness. Primary care tailored to homeless persons provides a unique opportunity to address some of these health disparities and vulnerabilities as well as the platform on which to engage them in an array of additional services over a continuum of time and need. Core tenets of the most successful models capture several key elements: (1) availability of care based on an open-access, on-demand, and non-contingent model; (2) one-stop, wrap-around services that are integrated and coordinated; (3) capacity for intensive, longitudinal and community/social service–linked case management; (4) high-quality, evidence-based, and culturally sensitive care that both destigmatizes seeking care and supports professionalism among the providers delivering that care; and (5) accountability to specific measurable goals and outcomes. However, it will not happen without deliberate planning and organization and a commitment to the capacity needed to bring services to scale.