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Objectives. To investigate the impact of an integrated care model on the health-related quality of life (HRQOL) of formerly chronically homeless individuals in permanent supportive housing. Methods. From 2014 to 2017, eligible individuals in Houston, Texas (n = 323), were placed in 1 of 2 permanent supportive housing service delivery models. Both models included coordinated care teams. In the intervention group, teams had a single plan of care with the partnering clinic. The 9-item Patient Health Questionnaire and 36-item Short Form Survey were administered at baseline and every 6 months for 30 months. We assessed intervention group emergency department use at 2 years. We evaluated change by using hierarchical linear growth models. Results. There was a significant and clinically meaningful increase in HRQOL in the intervention group, with the intervention group reporting improvement over the comparison group. Intervention group emergency department use decreased by 70% (no comparison group). Conclusions. Those in the intervention group with a single, coordinated plan of care reported significant and clinically meaningful increases in their HRQOL. Public Health Implications. Coordinated care models have potential to reduce societal costs and increase HRQOL, providing a financial and humanitarian justification for the continued investment in collaborative care in permanent supportive housing.

In part 1 of this 2-part series, we discussed principles of palliative care to help understand the goals of treatment in developing a plan of care. This article, Part 2, aims to provide knowledge of practical topical wound management by common wound etiologies and symptoms among persons who would benefit from palliative wound care.

PRACTICAL TOOLSamong those predisposed for chronic disease. 3 The transient nature and daily living conditions of individuals experiencing homelessness may interfere with their ability to effectively manage their chronic illness as they are often forced to respond to periodic crises and prioritize immediate daily living and survival needs, making the long-term planning required for continuity or preventive care unfeasible. Those individuals who are able to access health care may find that the delivery of these services is often fragmented and may be interrupted when structural factors prohibit access to care. [4][5][6] Thus, burdened with often insurmountable barriers, those experiencing homelessness

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