Abstract Background and Objectives LGBTQ+ veterans are more likely to require home care services than non-LGBTQ+ veterans. Yet evaluations of how these services accommodate older LGBTQ+ veterans are scarce. This study assesses the state of LGBTQ+ inclusion in the U.S. Department of Veterans Affairs’ (VA) Home Based Primary Care (HBPC) program. Research Design and Methods Using a mixed-method approach, we conducted a national survey of VA HBPC staff, focus groups at three sites, and interviews with LGBTQ+ veterans served by HBPC. Results Of approximately 10,000 HBPC staff invited to participate, 321 completed the survey. Respondents included nurses and physicians (31%), social workers (20%), psychologists (13%), and other staff (36%). Most reported minimal training on LGBTQ+ care, with over half (54%) receiving fewer than three hours in the past five years. Despite this, 89% agreed they were aware of the unique challenges faced by LGBTQ+ veterans. Regarding community resources, 71% endorsed confidence in finding affirming community providers. In both surveys and focus groups, VA HBPC staff noted a strong desire for training in LGBTQ+ care and disagreed over how much control they have in determining affirming care for older LGBTQ+ veterans in the community. In interviews, four LGBTQ+ veterans expressed satisfaction with HBPC services and a need for more social connections. Discussion and Implications Opportunities to increase training for HBPC staff could improve access to affirming VA and community services, and are desired by most HBPC staff. Tailoring services for older LGBTQ+ veterans is needed to enable exemplary care for all veterans.
Lee et al. (Tue,) studied this question.