title: Co-location of health care services for homeless veterans: a case study of innovation in program implementation.
abstract: This case study examines how the Veterans Affairs Greater Los Angeles Healthcare System (GLA) improved homeless veteran service utilization through program innovation that addressed service fragmentation. The new program offered same-day co-located mental health, medical, and homeless services with a coordinated intake system. The program is analyzed using a framework proposed by Rosenheck (2001) that has four phases: the decision to implement, initial implementation, sustained maintenance, and termination or transformation. GLA was able to successfully implement a new program that remains in the sustained maintenance phase five years after the initial decision to implement. Key factors from the Rosenheck innovation model in the program's success included coalition building, linking the project to legitimate goals, program monitoring, and developing communities of practicing clinicians. The key lesson from the case study is the need for a coalition to persistently problem solve and act as advocates for the program, even after successful initial implementation. Social work leadership was critical in all phases of program implementation.
authors.affiliation: VA Greater Los Angeles Healthcare System, West Los Angeles Healthcare Center, 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA. Jessica.Blue-Howells@va.gov
authors.forename: Jessica
authors.initials: J
authors.lastname: Blue-Howells
authors.forename: Jim
authors.initials: J
authors.lastname: McGuire
authors.forename: John
authors.initials: J
authors.lastname: Nakashima
mesh_terms: D000553:Ambulatory Care / Q000458:organization & administration*; D003156:Community Mental Health Services / Q000458:organization & administration; D003695:Delivery of Health Care / Q000458:organization & administration*; D003729:Dental Care; D006297:Health Services Accessibility; D006703:Ill-Housed Persons; D006801:Humans; D015141:Los Angeles; D019982:Organizational Case Studies; D011320:Primary Health Care; D014481:United States; D014493:United States Department of Veterans Affairs / Q000458:organization & administration*