Access to VA Health Care for OIF OEF Service Members

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Access to VA Health Care for OIF OEF Service
Members
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Our Goal

• To assist with the transition from active duty to
  civilian life
• To provide a comprehensive approach to the care
  of our newest veterans, the men women who
  served in support of Operation Iraqi Freedom
  Operation Enduring Freedom

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Statistics

• 751,273 OIF and OEF veterans have left active
  duty and have become eligible for VA health care
  since FY2002
• 48 (362,237) Former Active Duty members
• 52 (389,036) Reserve National Guard
• 35 (263,909) have obtained VA healthcare
  following separation
• 96 on an outpatient basis
• 4 have been hospitalized at least once at a VA
  healthcare facility

Source VHA Office of Public Health
Environmental Hazards October 2007
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Characteristics of Users

• Gender
• 88 Male
• 12 Female
• Age

• Branch of Service
• Rank
• 92 - Enlisted
• 8 - Officer

Source VHA Office of Public Health
Environmental Hazards October 2007
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Users in New York
Total 30,163
Source VSSC Data January, 2008
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Apply / Enroll VA Medical Care

• Application for Enrollment
• 10-10 EZ
• Obtain and submit on-line at www.1010ez.med.va.gov
  
• Mail or take application to your local VA Medical
  Center
• Letter will be sent notifying you of enrollment
  decision
• Certain veterans need to submit household income
  information to determine if co-pay is applicable
  for treatment of non-combat related care and to
  determine their priority for enrollment

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Basic Eligibility for Medical Benefits - Veterans

• A veteran is a person who
• Served in the active military
• Discharged or released under conditions other
  than dishonorable
• Including
• Former or current Reservists if they served for
  the full period for which they were called
  (excludes training purposes)
• Former or current National Guard members if
  activated / mobilized under Federal Executive
  Orders

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Special Considerations

• Public Law 105-368 authorized VA to provide
  cost-free care for conditions potentially related
  to combat service for up to two years following
  discharge or release from active duty.
• President Bush Signs H.R. 4986, the National
  Defense Authorization Act for Fiscal Year 2008
  into Law 1/28/08 extends two year
  post-discharge to five years
• Priority Group 6 (if not qualified for a higher
  priority group assignment)
• 6 month dual eligibility status (coverage by
  TriCare)
• 90 day eligibility for dental services

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Whos Eligible

• Veterans including activated Reservists
  National Guard Members
• Served on active duty in a theater of combat
  operations during a period of war after the Gulf
  War
• Or
• Served in combat against a hostile force during a
  period of hostilities
• After November 11, 1998
• Discharged under other than dishonorable
  conditions

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Post Two-Year Combat Eligibility

• Combat veterans will remain enrolled at the end
  of the two-year period
• VA will reassess PG 6 combat veterans to
  determine appropriate priority group assignment
• If no special eligibility factors exist,
  enrollment will continue at a lower priority
  level (PG7 or 8) in accordance with income level
• ALL applicable co-pay charges will apply
• Veterans are notified of all status changes
• Enrollment guidance for new law pending

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Post Two-Year Combat Eligibility

• Combat veterans who do not enroll within the two
  year post discharge period remain eligible to
  enroll based on other factors such as
• Compensable service-connected rating
• POW or Purple Heart recipient
• VA Pension
• Catastrophic disability determination
• Financial status
• However, if application is made after January 16,
  2003, and veteran is assigned PG 8, enrollment
  will be denied based on 2003 Enrollment
  Restriction

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Copay Requirements Combat Veterans

• Exemption from co-pay (regardless of income
  level), for conditions possibly related to combat
  military service during two-year post discharge
  period
• Exclusion examples
• Conditions not related to service such as cold or
  flu
• Conditions that occurred after service such as a
  broken limb
• Conditions that pre-existed entry in service such
  as a congenital problem

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Services

• Outreach to recently discharged active duty
  service members and families
• Seamless Transition Clinics to coordinate the
  care of OIF/OEF
• Timely referral for necessary clinical services
• Same day referral for mental health services
• Case management
• Polytrauma Clinical Support Teams

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Outreach Activities

• Community Activities
• Welcome Home Celebrations
• Job Fairs NY Times, Military Stars, Fleet Week
• City University of New York
• Veteran Information Days

• Mailings
• Welcome Home Letter to all newly enrolled OEF/OIF
  veterans
• Reserve/National Guard/Active duty
• Pre/post Deployment Briefings
• Transition Assistance Program
• Family support groups
• PDHRAs

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OIF OEF Seamless Transition Support Teams

• Team members
• Physician
• Nurse
• Social Work Case Manager
• Transition Patient Advocate
• Readjustment Psychologist
• Program Support Staff
• Benefit Counselors
• NYS Division of Veterans Affairs
• NYS Department of Labor

• Function
• To coordinate and provide healthcare and other
  benefit needs of all OEF/OIF veterans and active
  duty service members
• Oversee access to care
• Referrals for treatment services
• Persian Gulf Exams

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Polytrauma Support Team

• To provide specialized medical treatment to
  veterans identified as having serious physical
  traumatic injury or traumatic brain injury
• Team members physiatrist, physical therapist,
  occupational therapist, speech pathologist,
  psychologist, social work case manager, orthotist
  /prosthetist, vocational rehabilitation

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Polytrauma Support Team
Did you have any of the following injuries during
your deployment? Bullet, Fragments, Vehicular-
including airplane, Fall, Blast (IED, RPG,
landmine, grenade, etc.) Are you currently
experiencing any of the following problems that
you think might be related to a possible head
injury or concussion? Headache, dizziness, memory
problems, balance problems, ringing in the ears,
irritability, sleep problems, blurred vision,
etc. Did any injury received while you were
deployed result in any of the following? -Being
dazed, confused or seeing stars? -Not remembering
your specific injury? -Loosing consciousness-being
knocked out for less than a minute? -Losing
consciousness for 1-20 minutes? -Losing
consciousness for longer than 20 minutes? -Having
any symptoms of concussion after an injury i.e.
headache, dizziness, blurred vision,
irritability, etc.  Program Information Our aim
is to help you improve function so you can manage
at home and in the workplace. We involve your
family or others you choose.
Did you suffer any injuries during your
deployment? Are you experiencing any problems
that could be related to a head injury?
Comprehensive BRAIN INJURY ASSESSMENT Program
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Referrals for Service
Any potential source of referral outreach, ER,
etc.
Outreach
Vet Centers
OIF/OEF Seamless Transition Support Team
DOD Walk-in
Transition Pt Advocate
Military Treatment Facilities
Military Treatment Facilities
Polytrauma Clinical Support Team
Neurosurgery
Neurology
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Mental Health Services
Perhaps you ? are more forgetful ? have
nightmares ? feel more irritable ? have trouble
sleeping ? find it hard to get back to work ?
find it hard to concentrate ? drink more than you
did before deploying ? have memories of your
deployment that bother you ? dont feel
different, but your friends and family say youve
changed ? arent as happy to be back with your
family as you thought you would be These
reactions are normal, but they can have a big
effect on your life. We can help.
You Wouldnt Approach a Military Operation
Alone, Dont Do This Alone Either

U.S. Army, Sgt.1st Class Johancharles Van Boers
Coming home after being in a combat zone always
involves adjustment
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Academic Partnerships

• Research Activities
• In vitro model of TBI to study the acute
  effects of neurotrauma on cortical
  physiology
• Cardiovascular and immune system consequences of
  acute and chronic TBI
• Cognitive dysfunction in vascular dementia

• Clinical Support
• Behavioral Rehabilitation
• Cognitive Rehabilitation
• TBI Clinic

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A Message To Returning Veterans
Coming home is not always easy.

• Everyone who goes to war comes back deeply
  affected.
• This can take many forms including anxiety,
  sleeplessness, changes in family relationships
  and problems at work.
• Speaking to others who understand can speed up
  getting your life back on track.

Talk to any of ourhealth care providers
We understand. We can help.
NY/NJ Veterans Integrated Service Network (VISN) 3
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Our Commitment

• To care for him who shall have borne the battle,
  and for his widow, and his orphan to do all
  which may achieve and cherish a just and lasting
  peace, among ourselves, and with all nations.
• - Abraham Lincoln, 1865