Field Placement: Veteran's Administration (VA) Homeless Program -- West Los Angeles VA
Location: Los Angeles, CA
Preceptor: Jim McGuire, LCSW, PhD
Student Name: Heather Long
Year: 2002

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To address the situation that homeless veterans constitute approximately 30% of the overall homeless population, the Veteran's Administration (VA) has designed programs that specifically target the medical, psychiatric, and substance use needs of homeless veterans. According to the VA, as many as 250,000 veterans (male and female) are living on the streets or in shelters on any given day. I completed my Community Health Sciences summer internship at the VA Homeless Program at the West Los Angeles VA. My preceptor for the internship was Jim McGuire, LCSW, PhD who directs the research and evaluation department of the homeless program. The main evaluation project that I was involved with aims to examine health outcomes of homeless patients who received primary care in the standard way (i,e, not coordinated) vs. homeless patients who will soon receive care in a co-located facility. The co-located facility houses the homeless programs, the mental health clinic, and the primary care clinic.

My primary objectives were related to improving services for homeless veterans. These objectives included: designing a qualitative questionnaire as an addendum to the standard VA patient satisfaction survey for homeless program clients, writing the protocol for administering the patient satisfaction survey to homeless program patients, creating a questionnaire about ways to increase adherence to follow-up medical appointments for homeless program clients, analyzing a dataset of over 1000 incarcerated veterans who had received VA outreach in the LA County Jails and generating subsequent tables, developing the primary care study follow-up protocol to guide the procedure of finding difficult-to-locate study participants, and administering the primary care study structured interviews for research evaluation purposes.

The inclusion of homeless clients in the patient satisfaction survey will allow Dr. McGuire and the homeless program team to see how patients feel about the services they are receiving. Answers collected on adherence to medical appointments will inform the staff on how to best schedule patients for their primary care appointments. Investigating the characteristics of incarcerated veterans will help to identify the sub-groups (i.e., those with substance use problems and serious psychological problems vs. those with substance use problems only) who may need more services than other groups of incarcerated veterans. A tracking protocol will help future personnel search for difficult-to-locate homeless veterans and thus will maintain or increase the retention rate for the primary care study.

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