Social Worker and Nurse Practitioner Consultation: An Innovative Approach to Bridging Healthcare Service and Communication Gaps for Veterans Experiencing Homelessness

Veterans experiencing homelessness have complex physical, mental health, and substance use disorders that impact their ability to obtain and maintain housing. The Veterans Health Administration (VHA) maintains robust homeless programs with MSW social workers as case managers. In the absence of on-site specialized healthcare services, there is a gap in communication between the homeless program social worker and the broader healthcare system. This article reports on the development and implementation of a six-month interdisciplinary project designed to provide the homeless program social workers at one Veterans Administration Medical Center access to consultation with a dually prepared primary care and psychiatric nurse practitioner embedded in the VHA homeless program team. Three different consultation modalities were implemented: face-to-face, curbside, and electronic consultation (e-consult). The six-month project included 21 consultations. In locations where on-site healthcare providers are not readily available, e-consults can be an effective and sustainable means for communication between homeless program social workers and the healthcare system to improve advocacy for veterans experiencing homelessness and empowerment of the social workers.