{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T14:20:55Z","timestamp":1793370055845,"version":"4.5.0"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"7-8","funder":[{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>The U.S. DVA Grant and Per Diem (GPD) program funds community agencies to provide housing and case management services to Veterans experiencing homelessness. GPD is one of the few VA programs that can enroll Veterans with Other-than-Honorable (OTH) military discharges. The characteristics of OTH Veterans and their outcomes in GPD are unknown.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>We linked the Homeless Operations and Management Evaluation System database and VA Corporate Data Warehouse to identify Veterans with complete GPD enrollment and discharge data between 2018 and 2020. We categorized Veterans into three military discharge groups: Honorable, OTH, or Punitive. We evaluated key GPD process and outcomes measures: days enrolled in GPD, use of VA-funded emergency department care while in GPD, and whether a Veteran was successfully discharged from GPD, their housing status at program exit, employment status at program exit, and connection to mental health and substance abuse treatment at discharge. We conducted multivariable regressions to determine the adjusted association (controlling for demographics and comorbidities) between military discharge status and process and outcome measures.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 21,646 Veterans in the GPD program, 20,517 (95%) were honorably discharged; 811 (4%) had an OTH discharge; and 318 (1%) had a Punitive discharge. There was no difference in GPD length of enrollment by discharge status. Compared to honorably discharged veterans, OTH and Punitive discharged Veterans were less likely to successfully exit GPD, more likely to be homeless and employed at program exit, and were less likely to have a VA-funded emergency department visit while in GPD and less likely to be connected to mental health care or substance use treatment at program exit.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The GPD program serves hundreds of homeless Veterans with OTH and Punitive discharges every year, but they seem to be at greater risk for negative health and psychosocial outcomes and do not have the same access to VA services as other Veterans. These findings may inform policy considerations about expanding VA care and opportunities for community providers to serve Veterans with OTH and Punitive discharges.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/milmed\/usad485","type":"journal-article","created":{"date-parts":[[2024,1,22]],"date-time":"2024-01-22T17:52:47Z","timestamp":1705945967000},"page":"e1443-e1449","source":"Crossref","is-referenced-by-count":1,"title":["What We Know About Homeless Veterans With Other-than-honorable and Punitive Discharges: Data From the Grant and Per Diem (GPD) Program"],"prefix":"10.1093","volume":"189","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1735-8434","authenticated-orcid":false,"given":"Eric","family":"Jutkowitz","sequence":"first","affiliation":[{"name":"Center of Innovation in Long Term Services and Supports, Providence VA Medical Center , Providence, RI 02908, USA"},{"name":"Department of Health Services, Policy & Practice, Brown University School of Public Health , Providence, RI 02903, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"McCreedy","sequence":"additional","affiliation":[{"name":"Department of Health Services, Policy & Practice, Brown University School of Public Health , Providence, RI 02903, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Halladay","sequence":"additional","affiliation":[{"name":"Center of Innovation in Long Term Services and Supports, Providence VA Medical Center , Providence, RI 02908, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack","family":"Tsai","sequence":"additional","affiliation":[{"name":"U.S. Department of Veterans Affairs, National Center on Homelessness Among Veterans , Tampa, FL 33637, USA"},{"name":"School of Public Health, San Antonio Campus, University of Texas Health Science Center at Houston , San Antonio, TX 78229, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,1,19]]},"reference":[{"issue":"4","key":"2024070405060354200_R1","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1176\/appi.ps.201800393","article-title":"National utilization patterns of Veterans Affairs Homelessness Programs in the era of housing first","volume":"70","author":"Tsai","year":"2019","journal-title":"Psychiatric Services"},{"issue":"Suppl 2","key":"2024070405060354200_R2","doi-asserted-by":"publisher","first-page":"S239","DOI":"10.2105\/AJPH.2013.301322","article-title":"Latent homeless risk profiles of a national sample of homeless veterans and their relation to program referral and admission patterns","volume":"103","author":"Tsai","year":"2013","journal-title":"Am J Public Health"},{"issue":"11","key":"2024070405060354200_R3","doi-asserted-by":"publisher","first-page":"1325","DOI":"10.1176\/ps.62.11.pss6211_1325","article-title":"Requiring sobriety at program entry: impact on outcomes in supported transitional housing for homeless veterans","volume":"62","author":"Schinka","year":"2011","journal-title":"Psychiatr Serv"},{"issue":"1","key":"2024070405060354200_R4","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1176\/appi.ps.201400022","article-title":"Health risk factors and differences in outcomes between younger and older veterans using VA transitional housing","volume":"66","author":"Brown","year":"2014","journal-title":"Psychiatr Serv"},{"issue":"6","key":"2024070405060354200_R5","doi-asserted-by":"publisher","first-page":"705","DOI":"10.1007\/s10597-012-9482-5","article-title":"Comparison of outcomes of homeless female and male veterans in transitional housing","volume":"48","author":"Tsai","year":"2012","journal-title":"Community Ment Health J"},{"key":"2024070405060354200_R6","article-title":"Applying for benefits and your character of discharge","author":"Veterans Benefits Administration","year":".."},{"key":"2024070405060354200_R7","article-title":"United States District Court For The District Of Connecticut","author":"Monk","year":".."},{"issue":"5-6","key":"2024070405060354200_R8","doi-asserted-by":"publisher","first-page":"e153","DOI":"10.1093\/milmed\/usx110","article-title":"Characteristics and health needs of Veterans with other-than-honorable discharges: expanding eligibility in the Veterans Health Administration","volume":"183","author":"Tsai","year":"2018","journal-title":"Mil Med"},{"issue":"8","key":"2024070405060354200_R9","doi-asserted-by":"publisher","first-page":"832","DOI":"10.1001\/jama.2015.8207","article-title":"Military misconduct and homelessness among US Veterans separated from active duty, 2001-2012","volume":"314","author":"Gundlapalli","year":"2015","journal-title":"Jama"},{"key":"2024070405060354200_R10","doi-asserted-by":"publisher","first-page":"428","DOI":"10.1016\/j.psychres.2017.07.011","article-title":"The association between discharge status, mental health, and substance misuse among young adult Veterans","volume":"256","author":"Holliday","year":"2017","journal-title":"Psychiatry Res"},{"key":"2024070405060354200_R11","article-title":"Dramatic increase in mental health services to other-than-honorable discharge Veterans","author":"U.S. Department of Veterans Affairs; Office of Mental Health and Suicide Prevention"},{"key":"2024070405060354200_R12","article-title":"Military Law Information","author":"JAG Defense","year":"2023"},{"issue":"5","key":"2024070405060354200_R13","doi-asserted-by":"publisher","first-page":"855","DOI":"10.1016\/j.ajem.2013.02.046","article-title":"Risk factors for ED use among homeless veterans","volume":"31","author":"Tsai","year":"2013","journal-title":"Am J Emerg Med"},{"issue":"1","key":"2024070405060354200_R14","doi-asserted-by":"publisher","DOI":"10.21037\/atm.2018.12.10","article-title":"Balance diagnostics after propensity score matching","volume":"7","author":"Zhang","year":"2019","journal-title":"Ann Transl Med"},{"issue":"5","key":"2024070405060354200_R15","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.20f13681","article-title":"Mean difference, standardized mean difference (SMD), and their use in meta-analysis: as simple as it gets","volume":"81","author":"Andrade","year":"2020","journal-title":"J Clin Psychiatry"},{"issue":"2","key":"2024070405060354200_R16","doi-asserted-by":"publisher","first-page":"455","DOI":"10.1016\/j.addbeh.2013.02.002","article-title":"Alcohol and drug use disorders among homeless veterans: prevalence and association with supported housing outcomes","volume":"39","author":"Tsai","year":"2014","journal-title":"Addict Behav"}],"container-title":["Military 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