Veterans health and VA’s new Mission Act

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On A Mission: Charles Green, chief Of Community Outreach for Greater Los Angeles VA Healthcare, gave a detailed briefing at the July 16 Coffee4vets about the details of the VA Mission Act. The Mission Act replaces VA Choice, with the stated purpose of providing improved Community Care access for veterans enrolled in VA Healthcare. Green shared details on eligibility criteria, who does -- or does not -- have co-pays, and more. (Courtesy photograph)

Charles Green, after 26 years in the Army, is the chief of community outreach for Greater Los Angeles Veterans Healthcare Administration — that part of the VA tasked with the mission requirement of health care for the 9.2 million veterans enrolled in VA.

Those numbers matter. When you consider that there are 18.2 million U.S. veterans, and 9.2 million are enrolled in VA healthcare, it means that the government’s second-largest agency, with more than 300,000 employees is reaching only about half of its designated care population.

This week, Green reached out to about 100 veterans to talk to them about the Mission Act. The Mission Act is the biggest piece of legislation, with the most money attached to it, that will impact the lives of veterans for years, perhaps decades, to come.

Cost of the program over five years is estimated by the Congressional Budget Office at $52 billion, a little more than $10 billion a year.

What does it do? It expands veterans’ ability to get care from community health providers outside of the VA in the event the veteran cannot access a VA health care facility, or cannot get a timely appointment.

The act is intended to expand access for veterans to local Urgent Care, and to expand access to mental health services.

“This is really about what is going to be important to you,” Green told the group of dozens of veterans and their spouses. “Access to care, care in the community and care for you.”

In disclosure, my employer, High Desert Medical Group, is designated as one of the VA’s Authorized Community Care providers, through its Urgent Care, open from 6 a.m. to 11 p.m. every day except Sunday. Veterans who are enrolled in VA healthcare are eligible for services of a non-emergency nature. When their VA healthcare facility is identified, and their VA insurance coverage is verified, they can receive Urgent Care.

To find providers in the Community Care network, Green encouraged VA-enrolled veterans to go to www.va.gov. Once there, they can put in their Zip Code and find out which providers are in the Community Care network.

“If you pick outside of the network, you will pay,” he said.

The MISSION Act consolidates VA’s numerous community care programs, including Veterans Choice, into a new program that is easier to navigate for Veterans and their families, community providers, and VA employees, the organization’s statement said.

Ways that will establish eligibility include: services that are not available at VA, such as maternity care, or certain specialties. Also, the Mission Act provides for care when outside care is in the medical best interest of the veteran – for example, a cancer specialty that is outside VA’s services. Under the previous Choice program, community care was made available if appointments couldn’t be made in 30 days, or the VA facility was more than 40 miles away. Under the Mission Act, it will be a 30-minute drive, and appointment waits longer than 28 days. “So, we have reduced it,” Green said.

As part of this process, VA is establishing access standards and standards for quality that will apply to VA facilities and community providers. Veterans who access community care can expect a familiar process with several improvements through a new urgent care benefit, expanded eligibility criteria, and improved quality of care.  Community providers can expect their interaction with VA will get easier with new IT systems, better communications, and more timely payments.

At Tuesday’s meeting, several veterans raised complaints about access to service at the VA’s Community Based Outpatient Clinic. Complaints were about scarcity of service, and inability to be seen.

“Don’t take no for an answer, ask to speak to the site manager, and I am going to give you my phone number so we can speak about the issue,” Green responded.

He also said he would ask for complaints to be routed through leadership of the Coffee4Vets non-profit, and that he would research and try to address them.

“I want to bring this up,” Green said. “The past is the past. The Mission Act has replaced Choice.” He added that veterans, to qualify for Mission Act care, need to have been seen at a VA facility within the last 24 months. To be seen, veterans need a VA Veterans I.D. card, or their DD-214 military record.

The Mission Act is replacement for what was called the VA Choice Program. Choice was a response to scandals at the VA Healthcare Center in Phoenix, Ariz., and other VA Medical Centers where veterans were having long waits, in excess of 30 days, to be seen. Choice was a response to that. There was difficulty in administering the program. Congress approved the Mission Act to replace VA Choice. The legislation was signed into law in June 2018 by President Trump.

Critics of the Mission Act have feared it is part of a long-term effort to “privatize” VA care. VA Secretary Robert Wilkie has denied that assertion, saying that a $220 billion VA budget does not look like privatization to him. That said, critics, including Democrats who voted to approve the Mission Act, are concerned that other VA programs will have funds taken from them — from research, mental health and other areas – in order to fully fund the Mission Act.

For full details about the Mission Act and the changes it will usher in for veterans health care, Green encouraged the vets to go online and find answers at www.va.gov.

Editor’s note: Dennis Anderson is a Licensed Clinical Social Worker at High Desert Medical Group, where he works on veterans and community mental health issues. An Army veteran of the Cold War, he deployed as an embedded journalist with the first California National Guard unit sent to Iraq.