VA releases plan to consolidate community health care programs


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Every day at VA, we try new approaches to work smarter so that we can meet Veterans’ changing health care needs while drawing closer to achieving VA’s goal to deliver world-class health care to Veterans.

On October 30, 2015, VA delivered to Congress the department’s Plan to Consolidate Community Care Programs, its vision for the future outlining improvements for how VA will deliver health care to Veterans.  The plan outlines VA’s approach to adapt and evolve to meet the health care need of Veterans in the community. It is VA’s response to the bill passed in July 2015 after VA sought the opportunity to consolidate its multiple care in the community authorities and programs.  The plan seeks to consolidate and streamline existing community care programs into an integrated care delivery system and enhance the way VA partners with other federal health care providers, academic affiliates and community providers.  It simplifies community care and gives more Veterans access to the best care anywhere through a high performing network that keeps Veterans at the center of care.

VA is working with our partners in Congress to ensure VHA receives funding and authorities necessary to move forward with this plan. VA recognizes the problems happening right now.  The plan describes how we think VA can fix the problem and serves as a place where we can start discussions to define the future state of VA community care.

The plan strives to make it easier for Veterans and community providers to know how and when a Veteran can access community care. We are asking Congress to support these proposed changes so VA can increase Veterans’ access to care in the community and make it easier for community providers to help us in our goal.  We understand that a change of this size will take long-term commitment and support from our partners, like you. In the interim, VA continues to operate existing community care programs, including the Choice Program, while we also make improvements to access. VA reaffirms its long-term commitment to continually working to make improvements and plans to implement any congressionally approved changes gradually, responsibly, and transparently.

To learn more, visit this link to access the full report submitted to Congress.


Dr. David ShulkinDr. David J. Shulkin is Under Secretary of Health for the U.S. Department of Veterans Affairs.

 

Author

David Shulkin

Dr. David J. Shulkin served as the ninth Secretary of Veterans Affairs. Prior to his confirmation as secretary, Dr. Shulkin served as VA’s Under Secretary for Health for 18 months, leading the nation’s largest integrated health care system, with over 1,700 sites of care serving nearly nine million Veterans.

Comments

  1. Timothy Doherty    

    I would like to know if People at VA are asking questions of the patients and veterans who use the VA Facility’s. I can tell your congressman is not.
    I’ve written mine several times before I Received any answer
    I know of one big problem nobody brings up is VA Facilitates have a hard time communicating. I’ve been to three VA Hospital out west and for them to communicate with each other was I to 2 hours to get my records to them.

  2. Michael Van Strien    

    I have been in the V.A. System as a 100% Disabled Vet for 17 years. By and large my Doctors have been quite good. The System has been marginal to poor. I read the proposal from top to bottom in the most E-mail regarding “Consolidation.” All I can say is that it seems that it is producing a Top Heavy/Administration Heavy System…More of the same Operation!!! I tried to get three Doctor Appointments at the behest of my Private Neurologist following a T.I.A. on July 18 only to be put off until JANUARY. Can you see the epidemic issue we face? I need to see my psychiatrist, my primary care and an eye doctor BUT NO; I went first week of September, and first week of October to get and check on appointments but got put off to JANUARY! Reasons: Doctors are quitting, staff is short and so on and so forth!!! I really don’t care! I have PTSD and all I do is get angry at the poor management and staffing of the VA Health Care System! What needs to be done is to create a VA/Public Voucher System. This will cut off the HUGE HEAD of the system and the costs that are associated and provide the care needed immediately…quit associating mileage with care as in the current NEW system, ridiculous!!! Now I wait till January! Thank goodness on my Social Security Disability and VA Disability along with my wife’s secretarial pay we decided to pay for my Medicare Insurance so I can afford medical care—I have had to pay for one surgery and face another upcoming because the VA will not do them!!!! Thanks for the service for my Service!!! A Disabled, but Intelligent Vet !!!

  3. Olen Ray Jones Jr    

    The care I have received from the VA for the most par has been good (except for the doctor who gave a physical without touching me – strange) the great problem is the continual loss of personnel. A Vet gets a good doctor but because of the work load and unreasonable time limits that providers are given to care for their patients the good doctors are gone before you can have a follow-up. WE NEED BETTER FUNDING FROM D.C. AND NOT JUST EMPTY PROMISES. The idea of using community medical facilities is very good – let us see how it works.

  4. kay rumsey    

    My husband goes to the Rock Hill, SC Regional VA Clinic and has been a patient there since they opened and his doctor quit last year. She was a great Doctor but they have not replaced her. Each time you call we will have one in 2 weeks and it has will be a year in Dec of this year. He has tests and scans made at Dorn in Columbia by specialty doctors and the results go to the PCP and when you don’t have one you get no results. I hope Trump wins and his plan unveiled in VA is all Vets go to their local doctors and hospitals and take the burdens off families. I wish the election was this month instead of next year and he becomes the next president. I believe he can do the job this country needs. As for compensation and benefits claims and appeals it takes years even though they tell you 30 days. They are the slowest part of the VA. They review one disability for years and do their best to discourage you when you talk with them hoping you will just forget about it. These soldiers did not forget their country when needed and they should not be forgotten now. Vietnam Vets are always at the bottom of the stack or it sure seems they are. If they had of received treatment when they come home they may be living normal lives today but they were forgotten about at that time and the sad part is most of them were drafted with no choice. My husband joined at the tender age of 17 with Mom’s signature and received his draft papers the day he was leaving out for Vietnam so he would not of had a choice.

    1. DannyG    

      This is exactly the kind of attitude the gov’t wants! They want us to GIVE UP. What if “we” had given up in Vietnam, Granada, the Falklands, Iraq, or Afghanistan; how would they have liked that ?! DON’T GIVE UP! Don’t let the gov’t go back on MORE of their promises. Many of our brothers and sisters that gave up their own lives to protect others did so thinking we would be taken care of. DON’T LET THEM DIE IN VAIN ! My country may not owe me anything, but the gov’t owes me one thing – KEPT PROMISES!
      Ms. Rumsey, NO disrespect, just a difference of opinion.

  5. Nancy Bauer    

    I have been referred to the Choice Program 3 times: First one they did not pay the civilian doctor, second one started a treatment program for another problem but only gave me 2 visits, and the third time the have referred me for an MRI since I can not get one here until December 2nd. Now the third incident I still in pain from it , the second incident if the VA will not renew the medicine the Choice doctor put me on then watch out because the withdrawal symptoms are bad and the first one well they just now paid the June appointments so all the injections my back received were wasted money and they would have to start from scratch.

    I have learned the VA doctors do not care, they know I have fall my left side just give out, I have told them I have incontinence, they are not interested in finding out why this is happening. I have fibromyalgia (yes it is a real disease) and Chronic fatigue (yes it too is a real disease) they tell me to get out get exercise, sleep more, after working on my feet 80% of the day and I average 3 to 4 hours sleep a night. I am tired I can not function they give me fish oil – they can bite my butt on that it is not going to help with anything.

    I asked to be assigned to the women s clinic as I prefer a female doctor so they send me to a male doctor, then I do not receive travel pay because it is not service connected but we do not have a women s clinic in town. Now I have a very small clinic ¼ mile from my front door and a huge Navy hospital is where the clinic is located. For the love of ice cream they need to utilize the sources around us not civilian doctors as first line of action use the active duty docs. The one thing that really irritates me is dependents are receiving better care than I am they did not serve active duty!

  6. Mike Walton    

    Hopefully the VA can gain the “partnership” with active military bases. Here we have a VA Clinic just off base and a major A.F. Hospital within less than a half mile. Their P.T. area is extremely well equipped. However, veterans have to drive 74 (+) miles to have P.T. or cortisone shots or “EMG” (or other scans) for example.. Of course none of these are scheduled on the same day nor is there assistance for travel for many. Also, due to the large number of veterans having to go from all over an area, the V.A. JACC facility is over capacity and appointments are out up to 3 months (they keep slipping them out in some cases).

    1. DannyG    

      Mr. Walton, if you are eligible for travel pay, you should be reimbursed for any appts VA sets you up for.

  7. Randy    

    Why not let us Veterans living close to a Base or Fort use these for our care.

  8. John Bjorge    

    First off I would like to say that I have never had any problems or delays gaining access to health care through the CBOC in Mount Vernon, Washington.
    That being said I have had a problem getting a valid interpretation of my Medical problems I have as a result of injuries while on active duty. I am not and have never been the type of person who ran to sick call for every little pain I had. However I slipped off an aircraft in 34 degree weather in Jan. 1980 and the entry in my medical record states “Landed on right shoulder”. So my claim has been denied for problems with my right hip. The board has admitted I have a problem but they are not willing to say it is “Service connected”. This is and will continue to be one of the biggest short comings of the VA system.
    Why is it that our active duty medical record is the Bible for evaluation of a medical problem. Yet it is not looked at in it’s entirety but instead the Doctor or Corpsman who made the entry is always right. If the entry was not made correctly or completely as to the problem the active duty member was never able to correct it. If the active duty member continued to have problems and informed the doctor at another visit for another reason it was not always recorded. If the record does not relate all the issues at the time it can not be evaluated by the review board.

  9. richard w maggard    

    I think on the most part the VA administration does great. I only wish that our local medical facilities could work more with them. I was in Vietnam, and now have severe copd from Agent Orange. I have been hospitalized in my local town(, due to the fact that I am 3 miles away from a VA hospital) and all 3 times I ask them if they could use my VA and card and they say no. I feel with the breathing problems that it should be considered emergency. I am hoping that one day they can work together on this.

  10. Gerald NIdy    

    #1 way to IMMEDIATELY improve Choice Care? Terminate the contract with the incompetent contractor, Health Net! It took them 6 weeks to tell me they couldn’t find a doctor within 50 miles of me to conduct my particular procedure. It took me ONE phone call to identify a provider at a major hospital within 30 miles of me. Furthermore, the only reason I am on Choice Care in this case is because the VA does NOT have the equipment at Dorn Hospital in Columbia! Maybe someone should look into that.

    I have been involved with the VA for about 4-5 years. Great people for the most part doing what they can with what they have to work with. As can be drawn from most of the comments, it always leads back to Washington and this administration in particular and Congress . Think long and hard about that when you go to vote!

  11. James D. Mattox    

    I have been trying to get in Rome clinic for over a year, they keep telling me they re not accepting new patients. Driving twice as far now??? Spent 2 years in Army 1972-1974 last of the draft!! When can we expect something in ROME???????

  12. Carol    

    The author said the same thing 20 different ways— without saying a thing. That said I am VERY grateful for VA Medicine!

  13. DannyG    

    I’m skeptical. To me, it sounds like the gov’t is one step closer to breaking yet another promise! I mean, WTH!? Your president seems so big on gov’t handouts, & the politicians want to take away OUR PROMISED, EARNED, & NOW ENDANGERED BENEFITS, then start paying the DRs that participate in CHOICE, & make it so that ANY Disabled American Veteran can call & make an appt with ANY Dr they choose, knowing the bill will be paid.
    We send billions of dollars to oil-rich countries, spend millions on people who broke the law the second they came here, & allow Federal officials to prosper while they laugh as We, The People, are called “too stupid. ..” by a gov’t -paid millionaire, that nobody knows!
    Fed up, sick & tired, or just a grumpy old vet? ?.. Worse Yet; I’m all 3, & then some!
    IT’S TIME TO TAKE CARE OF AMERICA, AMERICANS, & AMERICA’S BUSINESS !!
    okay, i’m done now

    1. Everett Holstein    

      I hear you Danny!
      The Prez is too busy playing golf to take a real look at those who do nothing but sit at home smoking dope or chasing skirts, yet have better care and finances than we who sacrificed the best years of our lives have.
      Then when he does stop to take a look at a problem it is simply because it offers a good photo op and stirs up hate and violence.

    2. William Dozier    

      I use the choice program and find it easier and more timely to just use the VA even when the appointment is well beyond te 30 day requirement. The choice program is not working VA should contact veterans attempting to use the program and inquire about their experiences

  14. Vernon Cole    

    Been using the VA since 1980. I am very happy with it. Private Doctors could learn something from the VA. A 9 o’clock appointment means 9 o’clock and not 11 like is done at A private doctors.
    The VA does need to improve it’s claims and appeals process. There is no way an appeal or claim should take more than a few months. The appeals could be cut way down if the VA would follow the law and it’s own ratings requirement. Why do they get so many claims wrong the first time?

    1. Everett Holstein    

      What planet is your VA clinic on?

  15. Audrey williamson    

    How about getting a choice pharmacy program. Since being disabled and not able work, I lost my insurance. My hormone replacement med (took me forever to find one that worked) I was taking is not available at the VA pharmacy. The generic has side affects, causing me to get welts and a itching rash on my face. Their dermatology dept refuses to prescribe it, so I now have to pay my civilian doctor up front, $149 and $86 mth for acne antibiotic to control it. Totally ridiculous.

  16. Roland Van Deusen    

    Want the rest of VA Behavioral Health to feel free to use/post/share my two minute YouTube video, “TO VETERANS WITH INVISIBLE WOUNDS”. used by the VA’s National Center for PTSD, the VA’s nationwide suicide prevention program, the Army’s most deployed division, and PSYCHIATRIC TIMES, the leading online mental health journal. This is verifiable at my email address. You’re all welcome to it, gratis. Encourages troubled vets to seek help, and is a tool for their families, friends, and counselors.

  17. Clemons H Cole    

    How could it take 3 years to process a claim ???

    1. Richard Simmons    

      Don’t feel bad I have had a claim in for 4 years and checked on it 4 months ago and was told it would be at least another 3 years it was hung up in the back log and back log is short staffed. Was told it would be quicker to refill. They have more staff on new claims. Also get your congressman and senator involved a phone call from them will speed things up. I am processing new claim now.

  18. Michael golden    

    I hope they improve something. Took 4 months to get an infected tooth extracted.

    1. Everett Holstein    

      You aren’t alone! Our local OPC has one dentist, one hygienist, and one tech. I was supposed to get a broken filling replaced in, I think, May of 2015, but the day of the appointment I got a call telling me the tech call out sick, so I was rescheduled for August or September, but again someone was out due to a family matter, so my second resched was for today, but at 0900 I got another call telling me the dentist called out sick and his next available appointment isn’t until mid January of 2016.
      I gave up and signed up for Delta Dental through the VA. Now I can go see my old dentist on the outside, but there is a co-pay and the $33.32 per month premium.
      I tried to use the Choice program, because it says if we have to wait more than 30 days for an appointment we are eligible, but of course, when I tried to get authorization I got shot down, because we have a dental clinic here.
      I also got a bill from the outside provider for my allergy shots, because the VA hasn’t renewed my authorization for the serial injections. This is the second time this has happened, so I told the clinic I wouldn’t be back. The delay ends up setting me back in the process and I have to end up taking more shots, which they have to pay for, so it would make sense that they would be in a hurry to approve them so they wouldn’t have to pay for the make up shots.
      My VA eyeglasses broke on a Friday night and, due to other outside appointments I couldn’t get to the optician until Wednesday morning at which time the snippy young lady at the window advised me that the warranty expired on that Monday so I would have to purchase new frames. I tried to explain the sequence of events, but she just wasn’t interested. Totally rude! I mean two days??? Besides, she would’ve told me the same thing even if I did make it in there on that Monday, because that was the expiration date. Ever hear of a “COURTESY WARRANTY?”
      I have tried to be understanding due to staffing issues, but I am just baffled by the lack of kindness, and professionalism.
      Don’t get me wrong, there are good clinics in the VA, but for every good one, it seems there are five bad ones. Most of the good ones, I have noticed, involve VA staff who are veterans themselves. Seems like I only have trouble when I am dealing with non veteran providers and staff. They act as if they are doing me a favor for doing their job, which exists only because of us veterans.
      Anyway, that’s my two cents worth. Even with all of this said, I thank God I have the VA. I just wish they could staff it with 100% veteran providers and staff. People with a shared understaning of military life, who have walked the same miles, in the same kind of shoes I walked in.

  19. James Kallsen    

    First off I want to thank you for all you do for veterans
    That said I’m having a problem accessing some records for the va Loma Linda California now I’ve got all the records of my medical issues but I had a meeting with vocational rehabilitation and I would also like to get the notes and minutes from that encounter and I can’t seem to get them from anybody can you help I think this is an issue for some soldiers who have other than medical problems that they’re dealing with the VA on thanks for the help I appreciate and thanks for all you do for the veterans

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