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Research, Community, & Services Partnerships
Published Online: 26 July 2023

Improving a Sanctioned Homeless Encampment for Veterans During COVID-19 Through Multilevel Partnerships

Matthew McCoy, Ph.D. [email protected], Ippolytos Kalofonos, M.D., Ph.D., Lisa Altman, M.D., Lillian Gelberg, M.D., M.S.P.H., Peter Capone-Newton, M.D., Ph.D., Kimberly Lynch, M.D., M.S., Kimberly Clair, Ph.D., … Show All … , Mariam Nazinyan, M.P.A., Matthew McGahran, L.C.S.W., Chanin Santini, L.C.S.W., M.Ed., Monte Daugharty, P.S.S., Emily DeFraites, M.D., M.P.H., and Sonya Gabrielian, M.D., M.P.H.Authors Info & Affiliations
Publication: Psychiatric Services
Volume 75, Number 1
https://doi.org/10.1176/appi.ps.20220385
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Abstract

A veteran-clinician-researcher partnership—the Care, Treatment, and Rehabilitation Service (CTRS)—enabled quality improvement within a U.S. Department of Veterans Affairs–sanctioned homeless encampment created in response to the COVID-19 pandemic. Although the differing concerns of clinicians and operational leaders led to challenges in defining CTRS’s goals and quality metrics, partnering with frontline social work and peer staff (N=11) and veterans (N=21 of 381 CTRS participants) and considering their feedback resolved those differences. Multilevel partnerships improved care within the encampment, leading to the development of an encampment medicine team (providing onsite integrated health care) and a veteran engagement committee (providing feedback).

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Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services
Psychiatric Services
Volume 75 • Number 1 • January 01, 2024
Pages: 94 - 97
PubMed: 37494116

History

Received: 25 July 2022
Revision received: 7 March 2023
Accepted: 9 June 2023
Published online: 26 July 2023
Published in print: January 01, 2024

Keywords

  1. Homelessness
  2. Housing needs
  3. Quality improvement
  4. COVID-19
  5. Veterans’ issues
  6. Participatory research

Authors

Details

Matthew McCoy, Ph.D. [email protected]
Center for the Study of Healthcare Innovation, Implementation and Policy, Health Services Research & Development (McCoy, Kalofonos, Altman, Gelberg, Lynch, Clair, Nazinyan, Gabrielian), Office of Healthcare Transformation and Innovation (Altman, Gelberg, Capone-Newton), Community Engagement and Reintegration Service (Santini, Daugharty), and Mental Health Intensive Case Management (DeFraites), U.S. Department of Veterans Affairs (VA) Greater Los Angeles Healthcare System, Los Angeles; University of California, Los Angeles (UCLA)–VA Center of Excellence for Training and Research in Veteran Resilience and Recovery, Los Angeles (McCoy, Kalofonos, Clair, Nazinyan, Gabrielian); AltaMed Health Services, Los Angeles (Lynch); VA New Mexico Healthcare System, Albuquerque, New Mexico (McGahran); Departments of Preventive Medicine (Capone-Newton) and Psychiatry and Biobehavioral Sciences (DeFraites), David Geffen School of Medicine, UCLA, Los Angeles.
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Ippolytos Kalofonos, M.D., Ph.D.
Center for the Study of Healthcare Innovation, Implementation and Policy, Health Services Research & Development (McCoy, Kalofonos, Altman, Gelberg, Lynch, Clair, Nazinyan, Gabrielian), Office of Healthcare Transformation and Innovation (Altman, Gelberg, Capone-Newton), Community Engagement and Reintegration Service (Santini, Daugharty), and Mental Health Intensive Case Management (DeFraites), U.S. Department of Veterans Affairs (VA) Greater Los Angeles Healthcare System, Los Angeles; University of California, Los Angeles (UCLA)–VA Center of Excellence for Training and Research in Veteran Resilience and Recovery, Los Angeles (McCoy, Kalofonos, Clair, Nazinyan, Gabrielian); AltaMed Health Services, Los Angeles (Lynch); VA New Mexico Healthcare System, Albuquerque, New Mexico (McGahran); Departments of Preventive Medicine (Capone-Newton) and Psychiatry and Biobehavioral Sciences (DeFraites), David Geffen School of Medicine, UCLA, Los Angeles.
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Lisa Altman, M.D.
Center for the Study of Healthcare Innovation, Implementation and Policy, Health Services Research & Development (McCoy, Kalofonos, Altman, Gelberg, Lynch, Clair, Nazinyan, Gabrielian), Office of Healthcare Transformation and Innovation (Altman, Gelberg, Capone-Newton), Community Engagement and Reintegration Service (Santini, Daugharty), and Mental Health Intensive Case Management (DeFraites), U.S. Department of Veterans Affairs (VA) Greater Los Angeles Healthcare System, Los Angeles; University of California, Los Angeles (UCLA)–VA Center of Excellence for Training and Research in Veteran Resilience and Recovery, Los Angeles (McCoy, Kalofonos, Clair, Nazinyan, Gabrielian); AltaMed Health Services, Los Angeles (Lynch); VA New Mexico Healthcare System, Albuquerque, New Mexico (McGahran); Departments of Preventive Medicine (Capone-Newton) and Psychiatry and Biobehavioral Sciences (DeFraites), David Geffen School of Medicine, UCLA, Los Angeles.
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Lillian Gelberg, M.D., M.S.P.H.
Center for the Study of Healthcare Innovation, Implementation and Policy, Health Services Research & Development (McCoy, Kalofonos, Altman, Gelberg, Lynch, Clair, Nazinyan, Gabrielian), Office of Healthcare Transformation and Innovation (Altman, Gelberg, Capone-Newton), Community Engagement and Reintegration Service (Santini, Daugharty), and Mental Health Intensive Case Management (DeFraites), U.S. Department of Veterans Affairs (VA) Greater Los Angeles Healthcare System, Los Angeles; University of California, Los Angeles (UCLA)–VA Center of Excellence for Training and Research in Veteran Resilience and Recovery, Los Angeles (McCoy, Kalofonos, Clair, Nazinyan, Gabrielian); AltaMed Health Services, Los Angeles (Lynch); VA New Mexico Healthcare System, Albuquerque, New Mexico (McGahran); Departments of Preventive Medicine (Capone-Newton) and Psychiatry and Biobehavioral Sciences (DeFraites), David Geffen School of Medicine, UCLA, Los Angeles.
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Peter Capone-Newton, M.D., Ph.D.
Center for the Study of Healthcare Innovation, Implementation and Policy, Health Services Research & Development (McCoy, Kalofonos, Altman, Gelberg, Lynch, Clair, Nazinyan, Gabrielian), Office of Healthcare Transformation and Innovation (Altman, Gelberg, Capone-Newton), Community Engagement and Reintegration Service (Santini, Daugharty), and Mental Health Intensive Case Management (DeFraites), U.S. Department of Veterans Affairs (VA) Greater Los Angeles Healthcare System, Los Angeles; University of California, Los Angeles (UCLA)–VA Center of Excellence for Training and Research in Veteran Resilience and Recovery, Los Angeles (McCoy, Kalofonos, Clair, Nazinyan, Gabrielian); AltaMed Health Services, Los Angeles (Lynch); VA New Mexico Healthcare System, Albuquerque, New Mexico (McGahran); Departments of Preventive Medicine (Capone-Newton) and Psychiatry and Biobehavioral Sciences (DeFraites), David Geffen School of Medicine, UCLA, Los Angeles.
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Kimberly Lynch, M.D., M.S.
Center for the Study of Healthcare Innovation, Implementation and Policy, Health Services Research & Development (McCoy, Kalofonos, Altman, Gelberg, Lynch, Clair, Nazinyan, Gabrielian), Office of Healthcare Transformation and Innovation (Altman, Gelberg, Capone-Newton), Community Engagement and Reintegration Service (Santini, Daugharty), and Mental Health Intensive Case Management (DeFraites), U.S. Department of Veterans Affairs (VA) Greater Los Angeles Healthcare System, Los Angeles; University of California, Los Angeles (UCLA)–VA Center of Excellence for Training and Research in Veteran Resilience and Recovery, Los Angeles (McCoy, Kalofonos, Clair, Nazinyan, Gabrielian); AltaMed Health Services, Los Angeles (Lynch); VA New Mexico Healthcare System, Albuquerque, New Mexico (McGahran); Departments of Preventive Medicine (Capone-Newton) and Psychiatry and Biobehavioral Sciences (DeFraites), David Geffen School of Medicine, UCLA, Los Angeles.
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Kimberly Clair, Ph.D.
Center for the Study of Healthcare Innovation, Implementation and Policy, Health Services Research & Development (McCoy, Kalofonos, Altman, Gelberg, Lynch, Clair, Nazinyan, Gabrielian), Office of Healthcare Transformation and Innovation (Altman, Gelberg, Capone-Newton), Community Engagement and Reintegration Service (Santini, Daugharty), and Mental Health Intensive Case Management (DeFraites), U.S. Department of Veterans Affairs (VA) Greater Los Angeles Healthcare System, Los Angeles; University of California, Los Angeles (UCLA)–VA Center of Excellence for Training and Research in Veteran Resilience and Recovery, Los Angeles (McCoy, Kalofonos, Clair, Nazinyan, Gabrielian); AltaMed Health Services, Los Angeles (Lynch); VA New Mexico Healthcare System, Albuquerque, New Mexico (McGahran); Departments of Preventive Medicine (Capone-Newton) and Psychiatry and Biobehavioral Sciences (DeFraites), David Geffen School of Medicine, UCLA, Los Angeles.
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Mariam Nazinyan, M.P.A.
Center for the Study of Healthcare Innovation, Implementation and Policy, Health Services Research & Development (McCoy, Kalofonos, Altman, Gelberg, Lynch, Clair, Nazinyan, Gabrielian), Office of Healthcare Transformation and Innovation (Altman, Gelberg, Capone-Newton), Community Engagement and Reintegration Service (Santini, Daugharty), and Mental Health Intensive Case Management (DeFraites), U.S. Department of Veterans Affairs (VA) Greater Los Angeles Healthcare System, Los Angeles; University of California, Los Angeles (UCLA)–VA Center of Excellence for Training and Research in Veteran Resilience and Recovery, Los Angeles (McCoy, Kalofonos, Clair, Nazinyan, Gabrielian); AltaMed Health Services, Los Angeles (Lynch); VA New Mexico Healthcare System, Albuquerque, New Mexico (McGahran); Departments of Preventive Medicine (Capone-Newton) and Psychiatry and Biobehavioral Sciences (DeFraites), David Geffen School of Medicine, UCLA, Los Angeles.
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Matthew McGahran, L.C.S.W.
Center for the Study of Healthcare Innovation, Implementation and Policy, Health Services Research & Development (McCoy, Kalofonos, Altman, Gelberg, Lynch, Clair, Nazinyan, Gabrielian), Office of Healthcare Transformation and Innovation (Altman, Gelberg, Capone-Newton), Community Engagement and Reintegration Service (Santini, Daugharty), and Mental Health Intensive Case Management (DeFraites), U.S. Department of Veterans Affairs (VA) Greater Los Angeles Healthcare System, Los Angeles; University of California, Los Angeles (UCLA)–VA Center of Excellence for Training and Research in Veteran Resilience and Recovery, Los Angeles (McCoy, Kalofonos, Clair, Nazinyan, Gabrielian); AltaMed Health Services, Los Angeles (Lynch); VA New Mexico Healthcare System, Albuquerque, New Mexico (McGahran); Departments of Preventive Medicine (Capone-Newton) and Psychiatry and Biobehavioral Sciences (DeFraites), David Geffen School of Medicine, UCLA, Los Angeles.
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Chanin Santini, L.C.S.W., M.Ed.
Center for the Study of Healthcare Innovation, Implementation and Policy, Health Services Research & Development (McCoy, Kalofonos, Altman, Gelberg, Lynch, Clair, Nazinyan, Gabrielian), Office of Healthcare Transformation and Innovation (Altman, Gelberg, Capone-Newton), Community Engagement and Reintegration Service (Santini, Daugharty), and Mental Health Intensive Case Management (DeFraites), U.S. Department of Veterans Affairs (VA) Greater Los Angeles Healthcare System, Los Angeles; University of California, Los Angeles (UCLA)–VA Center of Excellence for Training and Research in Veteran Resilience and Recovery, Los Angeles (McCoy, Kalofonos, Clair, Nazinyan, Gabrielian); AltaMed Health Services, Los Angeles (Lynch); VA New Mexico Healthcare System, Albuquerque, New Mexico (McGahran); Departments of Preventive Medicine (Capone-Newton) and Psychiatry and Biobehavioral Sciences (DeFraites), David Geffen School of Medicine, UCLA, Los Angeles.
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Monte Daugharty, P.S.S.
Center for the Study of Healthcare Innovation, Implementation and Policy, Health Services Research & Development (McCoy, Kalofonos, Altman, Gelberg, Lynch, Clair, Nazinyan, Gabrielian), Office of Healthcare Transformation and Innovation (Altman, Gelberg, Capone-Newton), Community Engagement and Reintegration Service (Santini, Daugharty), and Mental Health Intensive Case Management (DeFraites), U.S. Department of Veterans Affairs (VA) Greater Los Angeles Healthcare System, Los Angeles; University of California, Los Angeles (UCLA)–VA Center of Excellence for Training and Research in Veteran Resilience and Recovery, Los Angeles (McCoy, Kalofonos, Clair, Nazinyan, Gabrielian); AltaMed Health Services, Los Angeles (Lynch); VA New Mexico Healthcare System, Albuquerque, New Mexico (McGahran); Departments of Preventive Medicine (Capone-Newton) and Psychiatry and Biobehavioral Sciences (DeFraites), David Geffen School of Medicine, UCLA, Los Angeles.
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Emily DeFraites, M.D., M.P.H.
Center for the Study of Healthcare Innovation, Implementation and Policy, Health Services Research & Development (McCoy, Kalofonos, Altman, Gelberg, Lynch, Clair, Nazinyan, Gabrielian), Office of Healthcare Transformation and Innovation (Altman, Gelberg, Capone-Newton), Community Engagement and Reintegration Service (Santini, Daugharty), and Mental Health Intensive Case Management (DeFraites), U.S. Department of Veterans Affairs (VA) Greater Los Angeles Healthcare System, Los Angeles; University of California, Los Angeles (UCLA)–VA Center of Excellence for Training and Research in Veteran Resilience and Recovery, Los Angeles (McCoy, Kalofonos, Clair, Nazinyan, Gabrielian); AltaMed Health Services, Los Angeles (Lynch); VA New Mexico Healthcare System, Albuquerque, New Mexico (McGahran); Departments of Preventive Medicine (Capone-Newton) and Psychiatry and Biobehavioral Sciences (DeFraites), David Geffen School of Medicine, UCLA, Los Angeles.
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Sonya Gabrielian, M.D., M.P.H.
Center for the Study of Healthcare Innovation, Implementation and Policy, Health Services Research & Development (McCoy, Kalofonos, Altman, Gelberg, Lynch, Clair, Nazinyan, Gabrielian), Office of Healthcare Transformation and Innovation (Altman, Gelberg, Capone-Newton), Community Engagement and Reintegration Service (Santini, Daugharty), and Mental Health Intensive Case Management (DeFraites), U.S. Department of Veterans Affairs (VA) Greater Los Angeles Healthcare System, Los Angeles; University of California, Los Angeles (UCLA)–VA Center of Excellence for Training and Research in Veteran Resilience and Recovery, Los Angeles (McCoy, Kalofonos, Clair, Nazinyan, Gabrielian); AltaMed Health Services, Los Angeles (Lynch); VA New Mexico Healthcare System, Albuquerque, New Mexico (McGahran); Departments of Preventive Medicine (Capone-Newton) and Psychiatry and Biobehavioral Sciences (DeFraites), David Geffen School of Medicine, UCLA, Los Angeles.
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Notes

Send correspondence to Dr. McCoy ([email protected]). Debra A. Pinals, M.D., Enrico G. Castillo, M.D., M.S.H.P.M., and Ayorkor Gaba, Psy.D., are editors of this column.

Competing Interests

The authors report no financial relationships with commercial interests.

Funding Information

Funding was provided by a pilot grant from the UCLA-VA Center of Excellence for Training and Research in Veteran Resilience and Recovery (to Drs. Altman and Gabrielian) and by a fiscal year 2022 intramural award from the National Center on Homelessness Among Veterans (to Dr. McCoy).These views represent the opinions of the authors and not necessarily those of the VA Greater Los Angeles Healthcare System, the UCLA-VA Center of Excellence for Training and Research in Veteran Resilience and Recovery, or UCLA.

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