The "Safety Net" of Community Care: Leveraging GIS to Identify Geographic Access Barriers to Texas Family Planning Clinics for Homeless Women Veterans.

The Veterans Healthcare Administration (VHA) is developing a civilian referral system to address specialty access issues to VHA healthcare. Homeless women Veterans may not have the resources to navigate referral systems when travel to VHA Medical Centers (VAMCs) is limited, especially for family planning needs. Recent Texas legislation restricted funding to civilian, publically-funded family planning clinics, limiting comprehensive services. This study's goal was to assess geographic availability of VAMCs and family planning clinics for homeless Texan women Veterans. We identified 3,246 Texan women Veterans, age 18-44y with administrative homelessness evidence anytime between 2002-2015. Significant clusters of homeless women Veterans were near VHA facilities, yet mean travel distance was 24.1 miles (range 0-239) to nearest family planning clinic compared to 82.6 miles (range 0.8316.4) to nearest VAMC. Community clinics need ongoing civilian funding support if the VHA is to rely on their geographic availability as a safety net for vulnerable Veterans.