The Veterans Mobile Outreach Program is designed to target and reach homeless veterans and their families who have become disconnected from VA and community services. Services that are offered include distribution of clothing and items that can make an immediate difference in the veteran’s day-to-day life. Also, an assessment is conducted of the veteran’s needs along with appropriate referrals to VA and community services. Other services include enrollment into the Portland VA Medical Center, photo identification, opportunities to speak face to face with homeless community providers, and screening for entry into the Portland VA Medical Center’s addictions program. As well as referral’s to White City, Roseburg and American Lake Domiciliary.

The program’s collaborative efforts help ensure that homeless veterans, particularly those who have a diagnosis of mental illness or dual diagnosis, will have easier access to those programs which may help stabilize their lives. The connections that are currently being built between the Portland VA Medical Center and homeless community providers of Multnomah, Marion, Polk, Clackamas, Clark and Cowlits County will support this continuity of care and increased access in a population that has historically had only patch work health care. Ultimately, the project seeks to break down barriers to services such as transportation, untimely appointment dates and wait periods, and inability to access traditional services. Providing this conduit to health care services will ensure assistance for those with the greatest need.

The Outreach Program is also designed to provide education and referrals for homeless veterans and their families. Upon contact veterans and their families will become informed of the variety of services that they may be eligible for. Services may include vocational training and assistance, shelter and long-term housing assistance, mental health treatment, alcohol and/or drug treatment, pensions, and medical treatment. Veterans will also be informed of community-based programs, and have the opportunity to speak with a variety of community providers. Veterans are often assisted with appointments to speak with a service officer regarding pensions and benefits related to their specific disability.

Several studies indicate that case management that includes frequent contacts helps this population to interact with the system in a way that will avoid the use of high cost emergency room services and improve the health status of homeless individuals.
Homelessness is a life threatening condition that worsens a veteran’s existing medical conditions, and increases the likelihood of illness due to exposure and inability to meet basic needs. The VA Outreach Program aids these individuals through providing a vehicle of trust that will serve as a bridge to health services. Initially, the outreach workers interact with veterans by providing some basic needs. As trust builds, they will begin to encourage the vets to seek services addressing their health care concerns. Referrals are made to appropriate services such as chemical dependency treatment programs and primary care providers. Workers also seek to aid individuals with housing and vocational rehabilitation referrals. As vets begin to develop a natural support network, many often stay to talk to social workers present and to connect with other veterans. The advice and referrals that the van outreach workers provide the vets aids them by increasing options that they might not have seen for themselves. Workers gain a sense of each person’s needs, and through these visits, though brief, can keep the individual moving towards more effective interactions with other health care providers in a way that encourages more appropriate use of the system.

There is no other program that does on-the-street outreach to homeless veterans. The Veterans Mobile Outreach Program is unique not only due to the material goods that this health care system distributes, but also because of the collaboration between several programs outside of the Medical Center. Staff from Multnomah County, VA Claims Division, Vet Centers, and Central City Concern are active in attending the outreach and connecting with the veterans who participate. We are also encouraging any other relevant agencies to attend the curbside service. This interaction allows clients to begin initial interviews and connect with other agencies that could serve them.

A recent report done by Care for the Homeless, New York City states that, “homeless people will utilize primary health care services, but only when providers, services, and delivery models are responsive to their needs.” (Care for the Homeless, New York City, 1998). This program begins with basic needs and literally provides a vehicle to respond to the needs of this population.

We are currently seeing approximately 100-150 veterans during the bi-monthly van outreach in Portland, Salem, Longview and Vancouver. Vets coming to the van have improved levels of hygiene, less visible alcohol usage, and self reports to workers that they have reconnected with health care providers. This becomes acutely obvious with clients who go back on psychotropic medications for conditions of mental illness.

In summary, The Outreach Programs goal is to empower the homeless veterans with increased access to services that will stabilize their lives, promote the greatest amount of independence, so that they may lead more fulfilling and productive lives.