VA Secretary Announces Intention to Expand Mental Health Care to Former Service Members With Other-than-Honorable Discharges

March 8, 2017

 

WASHINGTON – Department of Veterans Affairs Secretary Dr. David J. Shulkin while testifying in a House Veterans Affairs Committee hearing on March 7, 2017, announced his intention to expand provisions for urgent mental health care needs to former service members with other-than-honorable (OTH) administrative discharges.  This move marks the first time a VA Secretary has implemented an initiative specifically focused on expanding access to assist former OTH service members who are in mental health distress and may be at risk for suicide or other adverse behaviors.

“The president and I have made it clear that suicide prevention is one or our top priorities,” Shulkin said. “We know the rate of death by suicide among Veterans who do not use VA care is increasing at a greater rate than Veterans who use VA care. This is a national emergency that requires bold action. We must and we will do all that we can to help former service members who may be at risk. When we say even one Veteran suicide is one too many, we mean it.”

It is estimated that there are a little more than 500,000 former service members with OTH discharges. As part of the proposal, former OTH service members would be able to seek treatment at a VA emergency department, Vet Center or contact the Veterans Crisis Line.

“Our goal is simple: to save lives,” Shulkin continued. “Veterans who are in crisis should receive help immediately. Far too many Veterans have fallen victim to suicide, roughly 20 every day. Far too many families are left behind asking themselves what more could have been done. The time for action is now.”

Before finalizing the plan in early summer, Shulkin will meet with Congress, Veterans Service Organizations, and Department of Defense officials to determine the best way forward to get these Veterans the care they need.

“I look forward to working with leaders like Congressman Mike Coffman from Colorado, who has been a champion for OTH service members,” Shulkin added. I am grateful for his commitment to our nation’s Veterans and for helping me better understand the urgency of getting this right.”

Veterans in crisis should call the Veterans Crisis Line at 800-273-8255 (press 1), or text 838255.

VA Grants Full Practice Authority to Advance Practice Registered Nurses

VA Grants Full Practice Authority to Advance Practice Registered Nurses

Decision Follows Federal Register Notice That Netted More Than 200,000 Comments

December 14, 2016

WASHINGTON – The Department of Veterans Affairs (VA) today announced that it is amending provider regulations to permit full practice authority to three roles of VA advanced practice registered nurses (APRN) to practice to the full extent of their education, training, and certification, regardless of State restrictions that limit such full practice authority, except for applicable State restrictions on the authority to prescribe and administer controlled substances, when such APRNs are acting within the scope of their VA employment.

“Advanced practice registered nurses are valuable members of VA’s health care system,” said VA Under Secretary for Health Dr. David J. Shulkin. “Amending this regulation increases our capacity to provide timely, efficient, effective and safe primary care, aids VA in making the most efficient use of APRN staff capabilities, and provides a degree of much needed experience to alleviate the current access challenges that are affecting VA.”

In May 2016, VA announced its intentions, through a proposed rule, to grant full practice authority to four APRN roles.  Though VA does have some localized issues, we do not have immediate and broad access challenges in the area of anesthesia care across the full VA health care system that require full practice authority for all Certified Registered Nurse Anesthetists (CRNAs).  Therefore, VA will not finalize the provision including CRNAs in the final rule as one of the APRN roles that may be granted full practice authority at this time. VA will request comment on the question of whether there are current anesthesia care access issues for particular states or VA facilities and whether permitting CRNAs to practice to the full extent of their advanced authority would resolve these issues.

APRNs are clinicians with advanced degrees and training who provide primary, acute and specialty health care services; they complete masters, post-masters or doctoral degrees. There are four APRN roles: Certified Nurse Practitioner, Clinical Nurse Specialist, Certified Registered Nurse Anesthetist, and Certified Nurse Midwife.

“CRNAs provide an invaluable service to our Veterans,” Under Secretary for Health Shulkin continued. “Though CRNAs will not be included in VA’s full practice authority under this final rule, we are requesting comments on whether there are access issues or other unconsidered circumstances that might warrant their inclusion in a future rulemaking.  In the meantime, we owe it to Veterans to increase access to care in areas where we know we have immediate and broad access challenges.”

All VA APRNs are required to obtain and maintain current national certification.

The final rulemaking establishes professional qualifications an individual must possess to be appointed as an APRN within VA, establishes the criteria under which VA may grant full practice authority to an APRN and defines the scope of full practice authority for each of the three roles of APRN. Certified Registered Nurse Anesthetists will not be included in VA’s full practice authority under this final rule.

VA is the nation’s largest employer of nurses; as of July 2016 its workforce of approximately 93,500 nurses (RNs, LPNs, NAs) includes approximately 5,769 APRNs

For more information about openings for nurses or other health care positions at VA, visit Vacareers@va.gov.

VA Announces Funding Opportunity for Community Partners Working to End Veteran Homelessness

WASHINGTON – Building on President Obama’s commitment to end Veteran homelessness, the Department of Veterans Affairs (VA) is announcing the availability of funding for non-profit organizations and other groups that serve Veterans through VA’s Supportive Services for Veteran Families (SSVF) program.  The SSVF program assists very low-income Veteran families who are homeless or at risk of becoming homeless.  These SSVF grants are available to current grantees seeking renewals and make new funding available for eight high-need communities.

VA relies on strong, targeted collaborations in key areas at federal and local levels and engages community partners to develop innovative and forward-thinking solutions that can lead to scalable and replicable models of service.  SSVF grantees currently operate in all 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, and Guam, working within their communities to end or prevent homelessness among Veteran families.

“One of the things you learn in the Army is you never leave a soldier behind,” said Secretary McDonald. “Unfortunately, we’ve left some people behind, and they’re our homeless Veterans.  VA is committed to achieving the goal of ending Veteran homelessness, and we won’t rest until every homeless Veteran has a place to call home.”

SSVF grantees typically serve Veterans with incomes below 30 percent of the area median income.  Grantees must follow the housing first approach, which centers on permanently housing homeless Veterans quickly without preconditions and providing supportive services as needed. Additional SSVF requirements are that grantees engage in outreach to find and serve Veterans in need, provide Veterans with case management, and assist them in obtaining VA and other public benefits.  SSVF served nearly 150,000 Veterans and their family members in fiscal year 2016.  As a result of these and other efforts, Veteran homelessness is down significantly since the launch of the Federal Strategic Plan to Prevent and End Homelessness in 2010.  Since 2010, homelessness among Veterans had dropped by 47 percent.

For more information about VA’s homeless programs, visit www.va.gov/homeless.  The Federal Register notice of funding availability may be found at: www.va.gov/homeless/ssvf/index.asp. The application deadline is February 3, 2017 at 4p.m. EST.

New Regulation Decreases Cost of Outpatient Medication Copay for Most Veterans

Washington – The Department of Veterans Affairs (VA) is amending its regulation on copayments for Veterans’ outpatient medications for non-service connected conditions. VA currently charges non-exempt Veterans either $8 or $9 for each 30-day or less supply of outpatient medication, and under current regulations, a calculation based on the medication of the Medical Consumer Price Index (CPI-P) would be used to determine the copayment amount in future years.

“Switching to a tiered system continues to keep outpatient medication costs low for Veterans,” said VA Under Secretary for Health Dr. David J. Shulkin. “Reducing their out-of-pocket costs encourages greater adherence to prescribed outpatient medications and reduces the risk of fragmented care that results when multiple pharmacies are used; another way that VA is providing better service to Veterans.”

This new regulation eliminates the formula used to calculate future rate increases and establishes three classes of outpatient medications identified as Tier 1, Preferred Generics; Tier 2, Non-Preferred Generics including over-the-counter medications; and Tier 3, Brand Name. Copayment amounts for each tier would be fixed and vary depending upon the class of outpatient medication in the tier.

These copayment amounts will be effective February 27, 2017:

$5 for a 30-day or less supply – Tier 1 outpatient medication

$8 for a 30-day or less supply – Tier 2 outpatient medication

$11 for a 30-day or less supply – Tier 3 outpatient medication

These changes apply to Veterans without a service-connected condition, or Veterans with a disability rated less than 50 percent who are receiving outpatient treatment for a non-service connected condition, and whose annual income exceeds the limit set by law. Medication copayments do not apply to former Prisoners of War, catastrophically disabled Veterans, or those covered by other exceptions as set by law.

Copayments stop each calendar year for Veterans in Priority Groups 2-8 once a $700 cap is reached.

More information on the new tiered medication copayment can be found here.

VA Letter to the Editor of USA Today Addressing Alleged Secret List

 

Letter to the Editor of USA Today, Dated December 8, 2016

For more than a month we have been working with a USA Today reporter on a story looking closely at our internal quality improvement tool called Strategic Analytics for Improvement and Learning (SAIL) and the rankings it uses to help our facilities improve. The story posted online last night completely missed the point of this remarkable and helpful improvement process and serves only to mislead and confuse Veterans and the American public.
There simply is no “secret” list.  We publish the SAIL data regularly.  The relative ratings – using one to five stars – are not published but are used only to help us focus on improving care.  The relative ratings are used by our Veterans Health Administration and all of the facilities as tools to improve. SAIL is the most powerful and positive tool we have.
Relative ratings are not the equivalent of the weekly NFL standings. It is possible for a hospital to improve and still not climb. Since the ratings are relative, during rating periods organizations will receive ratings, one to five stars, even if every facility improves.  To be clear, no VA medical facility is bad or failing. 
Even more simply put, this internal process keeps VA from the “everyone gets a blue ribbon” syndrome. It may be counterintuitive to the uninformed, but it works.  The great stay great, the good get better.
What concerns all of us at VA is that USA TODAY has a consistent narrative of negativity in their news of VA. We have participated in editorial boards and spent hundreds of hours over the years to explain complex issues and provide data to USA TODAY reporters.  Nonetheless, the outstanding and historic progress VA has made in transformation over the past two years is consistently ignored by USA Today.
The transformation of VA, the nation’s largest civilian agency is a big news story.
We have done our best to tell the truth about VA’s story of change – of creating a culture of continuous improvement and transparency, of measuring the right data that best capture health care quality and access, and how we use these measurements to deploy national resources to those facilities that need help and assist medical centers before their rankings drop. Others have helped to tell our story, like Harvard Business School in their most recent case study that was most complimentary.
USA Today’s use of the word “secret” in the headline is egregious hyperbole. It is clear that its intent is to have entertainment value to draw in readers. It is a disservice to those same readers because it immediately creates the image that one-star facilities, in particular, are substandard. We accept – and even relish – that because we are a government department, we are held to a higher standard for reporting to our Veterans.  We have our fair share of challenges, yet VA remains one of the top medical providers in the country. Over 80% of Veterans are satisfied with their care and VA leads the way in many areas of medicine. Our employees, many of whom are Veterans themselves, work incredibly hard to provide Veterans the care and services they deserve.
USA TODAY has the right to publish as desired but in this case the paper is simply getting it wrong. Further, gathering and formatting a story for multiple papers in your chain to simply fill in the blanks – while convenient – is insufficient reason to cause unwarranted distress to our nation’s Veterans, could dissuade Veterans from coming to VA for care, and ultimately produce bad Veteran outcomes. They deserve better than that.
Sincerely,

Rounds, Klobuchar Urge VA Compliance with 2010 ECFA Law that Protects Veterans from Exorbitant ER Bills

December 9, 2016

Washington, DC – Led by U.S. Sens. Mike Rounds (R-S.D.) and Amy Klobuchar (D-Minn.), 22 senators, including six from the Senate Veterans’ Affairs Committee, wrote to U.S. Department of Veterans Affairs (VA) Secretary Robert McDonald to urge him to comply with the Emergency Care Fairness Act (ECFA). The ECFA was enacted in 2010 and directed the VA to cover veterans with private health insurance when that insurance doesn’t cover the full amount of non-VA emergency care. Yet since 2010, the VA has not complied with the law, denying hundreds of thousands of veterans’ reimbursement claims for emergency care.

Earlier this year, a federal court ordered the VA to write regulations that comply with the ECFA. In addition to urging the VA to comply with the law, the senators also requested that the agency fix its mistake and re-open all previously denied claims.

“Congress’s clear intent in passing the ECFA was to expand veteran eligibility for reimbursement for emergency treatment furnished to veterans in non-department facilities,” wrote the senators. “Specifically, congressional intent was to require the VA to act as a secondary payer for emergency treatment costs not covered by the veteran’s third-party insurance. It is evident that the VA has ignored congressional intent. Most troubling is the fact that those who are most affected by the VA’s non-compliance with the ECFA are our elderly veterans, many of whom are living on fixed incomes and have limited resources to pay medical bills.”

In addition to Rounds and Klobuchar, the letter was signed by Sens. Chuck Grassley (R-Iowa), Claire McCaskill (D-Mo.), Mark Kirk (R-Ill.), Jon Tester (D-Mont.), John Boozman (R-Ark.), Sherrod Brown (D-Ohio), Steve Daines (R-Mont.), Patty Murray (D-Wash.), Shelley Moore Capito (R-W.Va.), Tammy Baldwin (D-Wisc.), Jim Inhofe (R-Okla.), Elizabeth Warren (D-Mass.), Jerry Moran (R-Kan.), Kirsten Gillibrand (D-N.Y.), Joni Ernst (R-Iowa), Brian Schatz (D-Hawaii), Kelly Ayotte (R-N.H.), Al Franken (D-Minn.), John Cornyn (R-Texas) and Jeff Merkley (D-Ore.). The letter is supported by The American Legion, Veterans of Foreign Wars, Disabled American Veterans and the Paralyzed Veterans of America.

Full text of the letter is below:

The Honorable Robert McDonald
Secretary of Veterans Affairs
Department of Veterans Affairs
810 Vermont Avenue, NW
Washington, D.C. 20420

Dear Secretary McDonald:

We write today to express our support for the Veterans Emergency Care Fairness Act of 2009 (ECFA). Six years after enactment of the ECFA, our nation’s veterans continue to bear the burden of emergency treatment costs not covered by veterans’ third-party insurance. The U.S. Department of Veterans Affairs’ (VA) continued denial of these claims is deeply troubling.

Congress’s clear intent in passing the ECFA was to expand veteran eligibility for reimbursement for emergency treatment furnished to veterans in non-department facilities. Specifically, congressional intent was to require the VA to act as a secondary payer for emergency treatment costs not covered by the veteran’s third-party insurance. It is evident that the VA has ignored congressional intent. Most troubling is the fact that those who are most affected by the VA’s non-compliance with the ECFA are our elderly veterans, many of whom are living on fixed incomes and have limited resources to pay medical bills. Often, these veterans find themselves dealing with collection agencies as a result of emergency care received in the community. This potentially increases stress for these veterans, causes them to lose faith in the VA and keeps them from seeking future medical attention out of fear of acquiring additional medical bills for which they would be financially responsible. 

As you are aware, on April 8, 2016, in the case of “Staab v. Secretary McDonald,” the United States Court of Appeals for Veterans Claims  agreed with the appellant’s contention that the VA’s application of 38 U.S.C. § 1725 frustrates the intent of Congress to reimburse veterans who are not wholly covered by a health-plan contract or other third-party recourse. In its decision, the court ruled that “Congress clearly intended that the VA be responsible for the cost of the emergency treatment which exceeds the amount payable or paid by the third-party insurer.” The court further found the VA’s regulations regarding the ECFA to be invalid and wholly inconsistent with the statute. As a result, the court ruled that 38 C.F.R.     § 17.1002(f) is held invalid and directed it to be set aside.

Based upon this ruling, we strongly urge you to bring the VA into compliance with P.L. 111-137 and to amend any policy, regulation or other barrier that results in denial of veterans’ claims for reimbursement for non-department emergency care.  We further urge you to re-open all previous claims of veterans that were denied because of the VA’s non-compliance with congressional intent and the law. 

Thank you for your attention to our concerns regarding this important issue. We look forward to working closely with you to fully serve the veterans of our great nation. 

Sincerely,

VA and Stanford to Pursue the Nation’s First Hadron Center

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VA and Stanford to Pursue the Nation’s First Hadron Center

Goal for the center will be to treat Veteran and non-Veteran patients using Hadron therapy

Washington, DC – The U.S. Department of Veterans Affairs (VA) and Stanford Medicine announced today that they are collaborating to establish the nation’s first Hadron Center in Palo Alto, CA, for the benefit of Veteran and non-Veteran cancer patients who could benefit from Hadron therapy.

VA maintains a strong academic and research affiliation with Stanford Medicine. This long-standing partnership has enabled the VA Palo Alto Health Care System (VAPAHCS) to offer an exceptional breadth of medical services to Veterans. Now, VA and Stanford University are looking to expand and enhance this affiliation through new collaborative efforts around the Hadron Center and particle beam therapy for Veteran and non-Veteran patients with cancer.

During his 2016 State of the Union Address, President Obama called on Vice President Biden to lead a new, national Cancer Moonshot, focused on making a decade’s worth of progress in preventing, diagnosing, and treating cancer in five years – ultimately striving to end cancer as we know it. After meeting with experts across the country and the world, Vice President Biden identified areas of focus for the Cancer Moonshot – based on barriers to progress and opportunities for improving patient outcomes – and announced a first wave of accomplishments at the Cancer Moonshot Summit on June 29, 2016 at Howard University in Washington, DC.

Today, Vice President Biden is releasing the final report of the Cancer Moonshot Task Force, along with his own Executive Findings, after traveling to many of the major nerve centers in the cancer community. He will also unveil a new set of Federal actions, private sector actions, and collaborative partnerships to further advance the goals of the Cancer Moonshot Task Force, including the Hadron Center.

“We are excited to further expand our current partnership with Stanford Medicine, and explore ways to continue leading Veterans health care into the 21st century. The state-of-the-art Hadron Center would not only improve the lives of those affected by cancer, but further demonstrate VA’s ability to partner toward pioneering innovation and exceptional health care,” said VA Secretary Robert A. McDonald.

In addition to the Hadron Center, other efforts are underway to support the Cancer Moonshot Task Force: the Prostate Cancer Foundation (PCF) made a contribution of $50 million dollars to VA for precision oncology research over the next 5 years; the IBM Watson Million Veteran Initiative will provide 10,000 diagnostic and cancer treatment analyses over the next 2 years; and VA and PCF will host  a national oncology summit, “Launch Pad: Pathways to InnoVAtion,” on November 29.

“These efforts  underscore VA’s dedication and ability to work with private sector leaders and innovative academic institutions, like Stanford University, toward improving Veteran access to leading edge technology,” said VA Senior Advisor to the Secretary for Strategic Partnerships, Matthew S. Collier.

The Hadron Center is anticipated to be a clinical facility, designed to deliver particle radiation beam therapy for the treatment of cancer patients. Presently, the most common radiation beams used for cancer treatment are photons and electrons, which are easy to target to a tumor but can result in damage to normal tissue. Particle beam radiotherapy, on the other hand, uses beams of charged particles such as proton, helium, carbon or other ions to allow more precise targeting anywhere inside the patient’s body, resulting in less damage to normal tissue. Particle beam therapy can be more effective at killing radiation-resistant tumors that are difficult to treat using conventional radiation therapy. Judicious and innovative application of particle therapy can result in improved cure rates for cancer.

“Through our Precision Health vision, Stanford Medicine is committed to providing more personalized health care that is tailored to each individual,” said Lloyd Minor, MD, dean of the Stanford University School of Medicine. “Planning for the Hadron Center embodies this commitment, as we seek to identify optimal ways to offer targeted treatment that both reduces harm and promotes healing.”

This project would be the first of its kind in the nation and serves as an excellent example of public-private collaboration to further research and clinical care, using cutting-edge cancer therapy.

The Hadron Center would significantly complement VAPAHCS’s mission to provide the most advanced care for Veterans, by offering those with cancer access to Hadron therapy treatments and participation in clinical trials.

NEARLY 50-PERCENT DECLINE IN VETERAN HOMELESSNESS

 

WASHINGTON – The U.S. Department of Housing and Urban Development (HUD), U.S. Department of Veterans Affairs (VA), and the U.S. Interagency Council on Homelessness (USICH) today announced the number of veterans experiencing homelessness in the United States has been cut nearly in half since 2010.  The data revealed a 17-percent decrease in veteran homelessness between January 2015 and January 2016—quadruple the previous year’s annual decline—and a 47-percent decrease since 2010.

Through HUD’s annual Point-in-Time (PIT) estimate of America’s homeless population, communities across the country reported that fewer than 40,000 veterans were experiencing homelessness on a given night in January 2016. The January 2016 estimate found just over 13,000 unsheltered homeless veterans living on their streets, a 56-percent decrease since 2010. View local estimates of veteran homelessness.

This significant progress is a result of the partnership among HUD, VA, USICH, and other federal, state and local partners. These critical partnerships were sparked by the 2010 launch of Opening Doors, the first-ever strategic plan to prevent and end homelessness. The initiative’s success among veterans can also be attributed to the effectiveness of the HUD-VA Supportive Housing (HUD-VASH) Program, which combines HUD rental assistance with case management and clinical services provided by the VA. Since 2008, more than 85,000 vouchers have been awarded and more than 114,000 homeless veterans have been served through the HUD-VASH program.

“We have an absolute duty to ensure those who’ve worn our nation’s uniform have a place to call home,” said HUD Secretary Julián Castro.  “While we’ve made remarkable progress toward ending veteran homelessness, we still have work to do to make certain we answer the call of our veterans just as they answered the call of our nation.”

“The dramatic decline in Veteran homelessness is the result of the Obama administration’s investments in permanent supportive housing solutions such as HUD-VASH and Supportive Services for Veteran Families (SSVF) programs, extensive community partnerships, coordinated data and outreach, and other proven strategies that put Veterans first,” said VA Secretary Robert A. McDonald. “Although this achievement is noteworthy, we will not rest until every Veteran in need is permanently housed.”

“Together, we are proving that it is possible to solve one of the most complex challenges our country faces,” said Matthew Doherty, Executive Director of the U.S. Interagency Council on Homelessness. “This progress should give us confidence that when we find new ways to work together and when we set bold goals and hold ourselves accountable, nothing is unsolvable.”

In 2014, First Lady Michelle Obama launched the Mayors Challenge to End Veteran Homelessness with the goal of accelerating progress toward the ambitious national goal of ending veteran homelessness. More than 880 mayors, governors, and other local officials have joined the challenge and committed to ending veteran homelessness in their communities. To date, 27 communities and two states have effectively ended veteran homelessness, serving as models for others across the nation.

HUD and VA have a wide range of programs that prevent and end homelessness among veterans, including health care, housing solutions, job training and education. In FY 2015, these programs helped more than 157,000 people—including 99,000 veterans and 34,000 children—secure or remain in permanent housing. Since 2010, more than 360,000 veterans and their families have been permanently housed, rapidly rehoused or prevented from becoming homeless through programs administered by HUD and VA.

More information about VA’s homeless programs is available at www.va.gov/homeless. More information about HUD’s programs is available here or by calling the HUDVET National Hotline at (877) 424-3838. Veterans who are homeless or at imminent risk of becoming homeless should contact their local VA Medical Center and ask to speak to a homeless coordinator or call 1-877-4AID-VET.

VA Schedules 2 Million Appointments Using Veterans Choice Program

Improvements made in increasing access to Community Care, but more work to be done

WASHINGTON – The Department of Veterans Affairs’ (VA) Veterans Choice Program (VCP) has reached a key milestone in improving access to health care for Veterans. More than two million appointments have been scheduled through the program.

“While two million appointments have been scheduled using the Choice Program and we are making progress, we will not rest until all Veterans who choose VA to be their healthcare provider are receiving the care they need, when they need it,” said VA Secretary Robert McDonald.  “We will continue to make strides towards an integrated care network, and I urge Congress to enact our Plan to Consolidate Community Care so we can continue to build upon our progress.”

The Choice Act, which included the VCP, was passed in August 2014 to help Veterans access timely health care both within VA and the community. VA was required to implement a new, national program in just 90 days, with new requirements that complicated the way VA provides community care. VA recognized many of these challenges very early in the implementation of the program and VA and all our stakeholders have been working together to make needed changes while implementing this new nationwide program.

VA has outlined a path to improve community care and create a program that is easy to understand, simple to administer, and meets the needs of Veterans, community providers, and VA staff. VA submitted this plan to Congress in October 2015.

Within the Plan are several legislative proposals that VA and Congress need to work on together to improve the experiences for Veterans and community providers.

  • The first proposal would increase Veterans’ access to community care providers by allowing VA to enter into agreements with local community providers.
  • The second would streamline when and how much VA pays for health care services by having VA be the primary payer.
  • The third fix would allow VA to more accurately account for healthcare purchased in the community.
  • Finally, the last request is for funding and funding flexibility to improve access to care, reimburse the cost of emergency treatment, and create value-based payment models to best serve Veterans that need community care.

“VA is developing innovative ideas and solutions to enhance the Veterans experience and strengthen partnerships with community providers” said Dr. Baligh Yehia, Assistant Deputy Undersecretary for Health, Community Care.  “The Choice Program of today is a very different program than the one rolled out in November 2014. Many improvements have been made and we continue to work to deliver care to Veterans where and when they need it.”

VCP PROGRESS TO DATE

  • Over 2 million appointments scheduled using the VCP significantly increases Veterans access to care.
  • Since the start of VCP we have seen a dramatic increase in utilization.  From October 2015 to March 2016 VCP authorizations for care have increased 103 percent.
  • Over the course of the last 12 months, the Choice Provider Network has grown by 85 percent. The network now has over 350,000 providers and facilities.
  • Improved timeliness of payments to community providers by removing the requirement that VA receive the Veteran’s entire medical record prior to payment.
  • Reduced administrative burden for medical record submission for community providers by streamlining the documentation required.
  • To enhance care coordination for Veterans, we have embedded contractor staff with VA staff at select locations.
  • Created dedicated teams from across the county to deliver community care improvements.
  • VA has also partnered with Congress to change laws to improve the community care experience by:
    • Removing the enrollment date requirement for Choice, allowing more Veterans to receive community care.
    • Implementing criteria of 40-mile driving distance from medical facility with primary care physician to increase number of Veterans accessing the program
    • Implementing the unusual or excessive burden criteria to increase access for Veterans that do not meet other eligibility criteria.
    • Expanding the episode of care authorization from 60 days to up to one year to reduce the administrative burdens of Veterans, community providers, and VA staff.

 “VA needs Congress’s continued support to keep driving progress forward,” added VA Secretary Robert McDonald. “Several legislative barriers remain which inhibit improvements outlined in ourPlan to Consolidate Community Care Programs.

VA Conducts Nation’s Largest Analysis of Veteran Suicide

VA Conducts Nation’s Largest Analysis of Veteran Suicide

WASHINGTON — The Department of Veterans Affairs (VA) has undertaken the most comprehensive analysis of Veteran suicide rates in the U.S., examining over 55 million Veteran records from 1979 to 2014 from every state in the nation. The effort extends VA’s knowledge from the previous report issued in 2010, which examined  three million  Veteran records from 20 states were available.  Based on the data from 2010, VA estimated the number of Veteran deaths by suicide averaged 22 per day.  The current analysis indicates that in 2014, an average of 20 Veterans a day died from suicide.

“One Veteran suicide is one too many, and this collaborative effort provides both updated and comprehensive data that allows us to make better informed decisions on how to prevent this national tragedy,” said VA Under Secretary for Health, Dr. David J. Shulkin. “We as a nation must focus on bringing the number of Veteran suicides to zero.”

The  final report will be publicly released later this month.  Key findings of the analysis will include:

  • 65% of all Veterans who died from suicide in 2014 were 50 years of age or older.
  • Veterans accounted for 18% of all deaths from suicide among U.S. adults. This is a decrease from 22% in 2010.
  • Since 2001, U.S. adult civilian suicides increased 23%, while Veteran suicides increased 32% in the same time period.  After controlling for age and gender, this makes the risk of suicide 21% greater for Veterans.
  • Since 2001, the rate of suicide among US Veterans who use VA services increased by 8.8%, while the rate of suicide among Veterans who do not use VA services increased by 38.6%.
    • In the same time period, the rate of suicide among male Veterans who use VA services increased 11%, while the rate of suicide increased 35% among male Veterans who do not use VA services.
    • In the same time period, the rate of suicide among female Veterans who use VA services increased 4.6%, while the rate of suicide increased 98% among female Veterans who do not use VA services.

Please also see our Suicide Prevention Fact Sheet at the following link:http://www.va.gov/opa/publications/factsheets/Suicide_Prevention_FactSheet_New_VA_Stats_070616_1400.pdf

VA is aggressively undertaking a number of new measures to prevent suicide, including:

  • Ensuring same-day access for Veterans with urgent mental health needs at over 1,000 points of care by the end of calendar year 2016. In fiscal year 2015, more than 1.6 million Veterans received mental health treatment from VA, including at over 150 medical centers, 820 community-based outpatient clinics and  300 Vet Centers that provide readjustment counseling.  Veterans also enter VA health care through the Veterans Crisis Line, VA staff on college and university campuses, or other outreach points.

Using predictive modeling to determine which Veterans may be at highest risk of suicide, so providers can intervene early. Veterans in the top 0.1% of risk, who have a 43-fold increased risk of death from suicide within a month, can be identified before clinical signs of suicide are evident in order to save lives before a crisis occurs.

  • Expanding telemental health care by establishing four new regional telemental health hubs across the VA healthcare system.
  • Hiring over 60 new crisis intervention responders for the Veterans Crisis Line. Each responder receives intensive training on a wide variety of topics in crisis intervention, substance use disorders, screening, brief intervention, and referral to treatment.
  • Building new collaborations between Veteran programs in VA and those working in community settings, such as Give an Hour, Psych Armor Institute, University of Michigan’s Peer Advisors for Veterans Education Program (PAVE), and the Cohen Veterans Network.
  • Creating stronger inter-agency (e.g. Substance Abuse and Mental Health Services Administration, Department of Defense, National Institutes of Health) and new public-private partnerships (e.g., Johnson & Johnson Healthcare System, Bristol Myers Squibb Foundation, Walgreen’s, and many more) focused on preventing suicide among Veterans.

Many of these efforts were catalyzed by VA’s February 2016 Preventing Veteran Suicide—A Call to Action summit, which focused on improving mental health care access for Veterans across the nation and increasing resources for the VA Suicide Prevention Program.

Suicide is an issue that affects all Americans.  Recent Centers for Disease Control and Prevention (CDC) data reported in April 2016  that from 1999 through 2014 (the most recent year with data available from CDC), suicide rates increased 24 % in the general population for both males and females.

VA has implemented comprehensive, broad ranging suicide prevention initiatives, including a toll-free Veterans Crisis Line, placement of Suicide Prevention Coordinators at all VA Medical Centers and large outpatient facilities, and improvements in case management and tracking.  Immediate help is available at www.VeteransCrisisLine.net or by calling the Crisis Line at 1-800-273-8255 (press 1) or texting 838255.