Encampment Medicine: Innovating Care Delivery in a Community of Tiny Shelters on Veterans Affairs Grounds.

Veterans experiencing homelessness face barriers to traditional U.S. Department of Veterans Affairs (VA) care, even when temporarily housed on VA grounds. An encampment medicine team was launched at the West Los Angeles VA to deliver primary care, psychiatry, and harm reduction within a community of tiny shelters. Using principles of street outreach and continuous quality improvement, the team embedded services around the shelters, coordinated closely with peer support specialists and social workers, and adapted care with real-time feedback from a veteran-led engagement committee. Over 15 months, the team conducted 923 official visits with 181 veterans, initiated long-acting antipsychotics, expanded naloxone distribution, administered vaccines, supported housing transitions, and cured seven cases of hepatitis C. By integrating continuous quality improvement into a low-barrier, person-centered care model, the team built trust and improved health engagement. This approach offers a model for reaching high-need veterans in emergency housing environments.