Onsite Primary Care to Address Medical Needs Among Permanent Supportive Housing Tenants: A Feasibility Demonstration Project

BackgroundThere is limited evidence on interventions to address the health needs of vulnerable patients in permanent supportive housing (PSH).Aim, Setting, ParticipantsEvaluate the feasibility of Project HOPE, a weekly onsite primary care pilot intervention for tenants of a single-site PSH program.Program DescriptionPhysicians, nursing, and pharmacy providers work with existing case managers to provide onsite routine and acute care, outreach, and care coordination. Operations began in November 2020.Program EvaluationChart review (n = 26) of electronic health records assessed primary care engagement during the 180 days pre- and post-implementation using paired t tests and McNemar's exact tests, alongside formative observations from site visits and monthly meetings. Compared to the pre period, there was a 50% increase in the proportion of tenants with any primary care engagement (95% CI, 0.24, 0.76), and 84.6% of tenants had at least one visit with Project HOPE. Tenants averaged 2.65 more PCP visits during the post period compared to the pre period (95% CI, 1.60, 3.71). Housing staff perceived improvements in care continuity, chronic disease management, and access to care for tenants.DiscussionAn onsite primary care delivery model led to increases in primary care engagement for high-acuity PSH tenants.