Non-VA Health Care: A Case Study

I work at the veterans’ affair hospitals in Houston and in November 2011, Veteran Health Administration (VHA) committed to developing an outpatient mental health staffing model which comprised an interdisciplinary care team to ensure adequate general outpatient mental health care .

a whole. We will then determine surveyors’ perception of veterans’ access to care, knowledge of benefits available to them, equity of care received, and differences in care among veterans in separate socioeconomic and living areas. Also, a Likert-scale will be used to determine the extent of each individual’s belief about how Veteran’s health care is working. Lastly, there is a section for free response that encourages participants to explain their opinions and anything they may have experienced to influence said opinions.

The Veterans Health Administration is home to the United States’ largest integrated health care system consisting of 150 medical centers, nearly 1,400 community-based outpatient clinics, community living centers, Vet Centers and Domiciliary. Together these health care facilities and the more than 53,000 independent licensed health care practitioners who work within them provide comprehensive care to more than 8.3 million Veterans each year. VHA Medical Centers provide a wide range of services including traditional hospital-based services such as surgery, critical care, mental health, orthopedics, pharmacy, radiology and physical therapy. In addition, most of the medical centers offer additional medical and surgical specialty services including audiology & speech pathology, dermatology, dental, geriatrics, neurology, oncology, podiatry, prosthetics, urology, and vision

In the past few years there has been increasing discussion about how to provide adequate care for the increasing number of veterasn who are eligible for care through the Veterans’ healthcare administration (VHA). There are concerns is that the VHA is not providing the level of access, efficiency, and quality of care that veterans expect. Lee & Begley, (2016) suggest access to care for the veteran population may be resulting in poor health outcomes. In response to these concerns, the Veterans ' Access to Care through Choice, Accountability, and Transparency Act (VACAA) of 2014, also known as the Veterans Choice Act, was created to improve Veterans’ healthcare. The VACAA proposed to do this by expanding the number of options veterans have for receiving healthcare, by providing access for healthcare at non-VA care centers as well as providing for an increase in staffing at VA facilities (U. S. Department of Veterans Affairs, 2016).

VBA administers a wide variety of benefit programs authorized by Congress including Vocational rehabilitation and employment, Education service and GI Bill, Loan guarantee, Service-connected disability compensation, VA pension and fiduciary services, and VA life insurance. The following organizational chart depicts the current structure of the Veterans Benefits Administration. The Veterans Health Administration (VHA) serves the Veteran population and is responsible for providing a wide range of medical services by providing inpatient and outpatient care to 5.5 million veterans across the United States and its territories. The VHA operates one of the largest networks of health care facilities in the world. It includes 171 medical centers, 800+ outpatient clinics, 127 nursing homes and 196 Vietnam Veterans Outreach Centers. As well as, domiciliary residences, home health services, adult day care, residential care and respite care programs. In addition, the VHA helps support veterans' health care in non-VA hospitals (Choice Program) and is the country’s largest provider of graduate medical education. The following organizational chart depicts the current structure of the Veterans Health Administration. The National Cemetery Administration (NCA) provides burial space for Veterans and their eligible family members; maintains national cemeteries; marks Veterans’ graves with headstones, markers, and medallions; and administers grants for establishing or expanding state and tribal government Veteran cemeteries. The following organizational chart depicts the current structure of the National Cemetery

The Veterans Access, Choice, and Accountability Act of 2014 (H.R. 3230) have been put in place to provide funding as well as other services to veterans in any form of VA medical facilities. With this legislation, various programs have been established to provide funding and ensure care (Veterans Access, Choice, and Accountability Act of 2014, 2014).

The PAVE program at the Madison VA is a program that exists due to a National Directive (VHA DIRECTIVE 2012-020) from the Under Secretary for Health (Veterans Health Administration, 2012). The directive was crafted out of the Office of Rehabilitation Services and Office of Patient Care Services and outlines that a PAVE program be established and maintained at all VA medical facilities. The programs purpose is to expand scope of care and treatment provided to Veterans at risk for loss of limb, and reduce number of amputations (William S. Middleton Memorial Veterans Hopsital, 2014). The program works with all clinical specialties to ensure clinical management of patients who are risk. This program affirms the Mission, Vision and Values of

The U.S Department Veteran’s Affairs (VA) provides a wide range of benefits for our service members, veterans and their families. Some of these benefits include but are not limited to include compensation, disability, education, and home loans. Throughout this paper I will discuss these benefits and the eligibility required to receive them. Eligibility for most VA benefits is based on type of discharge received through the military which is normally all discharges under other than dishonorable conditions.

The Department of Veteran Affairs (VA) is responsible for providing vital services to Americas veterans. Such services include health care, benefit programs, and access to national cemeteries to former military personnel and their dependents. In this case well be discussing the health care system and how it pertains to our veterans. The health benefits provided by the VA should serve as ones’ sole source of health care or as a complement to an already existing plan. As with anything it has its pros and cons.

Veteran has four admission and discharges in CAVHS in her record: June 2012 (3K); August 2012 (3K); March 2014 (SICU); July 2014 (3K). She has also received care from Biloxi and Texas VAMC 's in the past. Veteran served in the US Army between October/2004 to March/2004, with an Entry Level Separation (ELS- Medical) discharge and her highest rank were an E-3. Veteran reported she received an injury while

In 2014, Congress created the $10 billion Choice Plan, which allowed veterans to go to a private doctor if they lived more than 40 miles from a veterans hospital or could not get an appointment within 30 days. It spent another $5 billion to hire and train more health care workers. While the Choice Plan has been used by thousands of veterans, its rollout was plagued by billing delays, with the overall time veterans had to wait for care increasing”

Veterans are no longer confined to only the Veterans Affairs hospital for treatment. Instead, Cohen Veterans Network (CVN), a private program for military veterans, will ensure that veterans do not have to pay for any of their treatments. Cohen Veterans Network relies on public donations and efforts to provide treatment to veterans and does not depend on the government for any excess funds.

Service Delivery – VA provides a broad range of the quality and accessibility of primary care, specialized care, related medical and social benefits through a nationwide network for Veterans and their eligible beneficiaries, such as vocational rehabilitation, service members' group life insurance, traumatic injury protection, the Post-9/11 GI-Bill, the VA home loan programs, and

Primary Care is a large service, thus in order to meet the medical needs of each veteran it is imperative to have the ability to make adjustments in “real-time”. To achieve these goals it is essential that the Primary Care Service expand and adapt the Group Practice Manager (GPM) approach. Furthermore, this approach is specifically designed for the Primary Care Service to maximize veteran care while meeting the standards of the Hampton VA Medical Center.

The veteran’s strengths are: his willingness to participate in socialized/recreational activities, continue coming to his scheduled appointments in the GeriPACT clinic and admitting that he has learning disability. Some of the resources that are available to the veteran are geriatric healthcare providers (e.g., Psych, social work, nurses, and MDs), ADHC, MHC, and PACT.