Abstract
Background: Veterans experiencing homelessness often have unmet medical needs and experience barriers to accessing and/or engaging in traditional clinic-based care.1,2 The Veterans Affairs (VA) Homeless Patient Aligned Care Team (HPACT) model provides primary care, mental health, housing services, case management, and key wrap-around services in a multi-disciplinary, population-tailored approach that is designed to address these unique needs and distinct challenges homeless veterans face. Combing these elements with a mobile medical unit (MMU) provides the HPACT team with the necessary infrastructure to provide care in community-based settings in a safe and confidential space with medical supplies and equipment readily available.3 MMUs bring services directly to where veterans are and help reduce barriers to care.
Objective: To evaluate adoption, implementation, and maintenance of the HPACT MMU program and the impact on homeless veterans and the VA healthcare system.
Design: A mixed methods approach was used guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework.4 Data collected included HPACT MMU national meeting minutes, VA electronic medical record data, and monthly MMU travel logs.
Results: 25 MMUs were deployed across 18 states and fully operational serving homeless veterans. Healthcare encounters with veterans in the community setting increased especially among those who struggled accessing traditional clinic-based care at VA medical centers like unsheltered homeless veterans. Resulting qualitative themes included MMU experiences, patient outcomes, and operational challenges.
Conclusion: The VA HPACT MMU program is the largest integrated mobile health program serving homeless veterans in the United States. Findings from this program evaluation provide insights into an innovative approach that expand the boundaries of VA healthcare to better serve one of the most vulnerable populations and improve health equity. Finally, this program plays a pivotal role in making connections to the broader VA healthcare system and contributes to the goal of ending veteran homelessness.5
Notes
References:
1. Kinney RL, Szymkowiak D, Tsai J. Growing Concern About Unsheltered Homelessness Among Veterans: Clinical Characteristics and Engagement in Health Care Services. Public Health Rep. 2024 Feb 7:333549241227155. doi: 10.1177/00333549241227155. Epub ahead of print. PMID: 38323557.
2. Funk MF, Greene RN, Dill K et al. The impact of homelessness on mortality of individuals living in the United States: a systematic review of the literature. Journal of Health Care for the Poor and Underserved. 2022;33(1):457-477. doi: 10.1353/hpu.2022.0035
3. Christian NJ, Havlik J, Tsai J. The use of mobile medical units for populations experiencing homelessness in the United States: a scoping review. J Gen Intern Med. 2024;39(8): 1474-1487.
4. Shelton RC, Chambers DA, Glasgow RE. An Extension of RE-AIM to Enhance Sustainability: Addressing Dynamic Context and Promoting Health Equity Over Time. Front Public Health. 2020 May 12;8:134. doi: 10.3389/fpubh.2020.00134.
5. O’Toole TP, Pape LM, Kane V et al. Changes in homelessness among US veterans after implementation of ending veteran homelessness initiative. JAMA Open Network. 2024;7(1): 1-10.
Sigma Membership
Beta Iota
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Mixed/Multi Method Research
Keywords:
Primary Care, Health Equity or Social Determinants of Health, Policy and Advocacy, Promoting Clinical Outcomes, Veterans, Homelessness
Recommended Citation
Weber, Jillian and Kinney, Rebecca, "A Mobile Medical Unit Program to Improve Access to Care for Veterans Experiencing Homelessness" (2025). Biennial Convention (CONV). 209.
https://www.sigmarepository.org/convention/2025/presentations_2025/209
Conference Name
48th Biennial Convention
Conference Host
Sigma Theta Tau International
Conference Location
Indianapolis, Indiana, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2025-12-08
A Mobile Medical Unit Program to Improve Access to Care for Veterans Experiencing Homelessness
Indianapolis, Indiana, USA
Background: Veterans experiencing homelessness often have unmet medical needs and experience barriers to accessing and/or engaging in traditional clinic-based care.1,2 The Veterans Affairs (VA) Homeless Patient Aligned Care Team (HPACT) model provides primary care, mental health, housing services, case management, and key wrap-around services in a multi-disciplinary, population-tailored approach that is designed to address these unique needs and distinct challenges homeless veterans face. Combing these elements with a mobile medical unit (MMU) provides the HPACT team with the necessary infrastructure to provide care in community-based settings in a safe and confidential space with medical supplies and equipment readily available.3 MMUs bring services directly to where veterans are and help reduce barriers to care.
Objective: To evaluate adoption, implementation, and maintenance of the HPACT MMU program and the impact on homeless veterans and the VA healthcare system.
Design: A mixed methods approach was used guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework.4 Data collected included HPACT MMU national meeting minutes, VA electronic medical record data, and monthly MMU travel logs.
Results: 25 MMUs were deployed across 18 states and fully operational serving homeless veterans. Healthcare encounters with veterans in the community setting increased especially among those who struggled accessing traditional clinic-based care at VA medical centers like unsheltered homeless veterans. Resulting qualitative themes included MMU experiences, patient outcomes, and operational challenges.
Conclusion: The VA HPACT MMU program is the largest integrated mobile health program serving homeless veterans in the United States. Findings from this program evaluation provide insights into an innovative approach that expand the boundaries of VA healthcare to better serve one of the most vulnerable populations and improve health equity. Finally, this program plays a pivotal role in making connections to the broader VA healthcare system and contributes to the goal of ending veteran homelessness.5
Description
The Homeless Patient Aligned Care Team (HPACT) program is one of multiple homeless programs operated by VA that together provide a continuum of housing, employment services, legal assistance, outreach and clinical care all working towards the goal of ending veteran homelessness. This presentation will highlight results of the evaluation of an innovative HPACT mobile medical unit program that brings primary care directly to homeless veterans in the community and is guided by the RE-AIM framework.