Setting

The VA Greater Los Angeles Healthcare System (VAGLAHS) is among the largest VA medical centers and is located in Los Angeles, California. During the project period from September 2018 to August 2019, the VAGLAHS served approximately 3600 homeless veterans at 3 Homeless Patient Aligned Care Team (HPACT) clinics designated to address the complex medical, mental health, and social needs of veterans experiencing homelessness. Established in 2012, the West Los Angeles (WLA) HPACT cares for approximately 2200 veterans and is the largest HPACT nationwide. WLA HPACT employs more than 60 permanent staff and serves as an interprofessional training site for nurse practitioner residents, clinical pharmacy residents, social workers, psychology fellows, and resident physicians in internal medicine and psychiatry. In Fall 2018, WLA HPACT interdisciplinary trainees and faculty formed a quality improvement (QI) team to improve uptake of PrEP in the primary care setting. This evaluation was categorized as an operation improvement activity based on Veterans Health Administration Handbook 1058.05 where information generated is used for business operations and quality improvement. The overall project was subject to administrative oversight rather than oversight from a human subjects institutional review board.