Medical home without walls: Community integrated mobile care for people experiencing homelessness with HIV

In 2012, through the Special Projects of National Significance Program, the HIV/AIDS Bureau of HRSA funded 9 sites throughout the country and an Evaluation and Technical Assistance Center in a multisite evaluation of medical homes for persons with HIV who were experiencing homeless and suffering from behavioral health and substance use disorders. Two of those sites, San Francisco Department of Public Health and Yale University, have developed mobile teams to address the needs of the most vulnerable of this population and to address some of the systems issues that create barriers to improving health outcomes. The panel will describe the programs from a consumer and staff perspective. One of the panel members, a consumer from San Francisco, will tell her story and we will share other consumer stories, illustrating the importance of being “patient centered”. The integration of behavioral health services and substance use services in these teams will be described. The panel will provide a brief overview of the stakeholder development process as well as the program model and design. Preliminary findings of a local evaluation will be shared. Outcome measures include housing, HIV viral load, cost/utilization in addition to qualitative measures such as consumer satisfaction, stigma, and self-efficacy are part of the longitudinal multisite study.