VA launches ‘new and improved’ community care program for veterans

The U.S. Department of Veterans Affairs (VA) launched its new Enhanced Community Care Program for Veterans on June 6, 2019, implementing portions of the VA law on maintaining internal systems and strengthening integrated external networks of 2018 (MISSION Act), which terminates the Veterans Choice program and establishes a new community care program for veterans.

The MISSION Act will strengthen the VA health care system nationwide by giving veterans more health care options.

“The changes not only improve our ability to provide the health care veterans need, but also when and where they need it,” VA Secretary Robert Wilkie said. “It will also put veterans at the center of their care and provide options, including expanded telehealth and urgent care, so they can find balance in the system that’s right for them.”

Under the new Veterans Community Care Program, veterans can work with their VA healthcare provider or other VA staff to see if they are eligible to receive community care based on new criteria. Eligibility for community care does not require a Veteran to receive that care in the community; Veterans can still choose to have VA provide their care. Veterans can choose to receive care in the community if they meet one of the following six eligibility criteria:

1. A veteran needs a service that is not available at any VA medical facility.

2. A veteran lives in a U.S. state or territory without a full-service VA medical facility. Specifically, this would apply to veterans living in Alaska, Hawaii, New Hampshire and the US territories of Guam, American Samoa, Northern Mariana Islands and US Virgin Islands.

3. A veteran qualifies under the “grandfather’s disposition related to remote eligibility under the Veterans Choice program.

4. VA cannot provide care within certain designated access standards. Specific access standards are described below:

Driving time to a specific VA medical facility

o Average travel time of thirty minutes for non-institutional primary care, mental health and long-term care services.

o Average travel time of sixty minutes for specialist care.

Note: Travel times are calculated using geomapping software.

Appointment wait time at a specific VA medical facility

o Twenty days from the date of the request for primary care, mental health care, and non-institutional continuing care services, unless the veteran agrees to a later date in consultation with their VA health care provider .

o Twenty-eight days for specialty care from the date of the request, unless the veteran agrees to a later date in consultation with their VA health care provider.

5. The Veteran and referring clinician agree that it is in the Veteran’s best medical interest to receive community care based on defined factors.

6. VA has determined that a line of VA medical services is not providing care in a manner consistent with VA quality standards based on specific conditions.

In preparation for this historic initiative, senior VA leaders will visit more than 30 VA hospitals across the country to provide in-person deployment support.

The VA MISSION law:

• Strengthens VA’s ability to recruit and retain clinicians.

• Authorized “Anywhere to Anywhere” telehealth across state lines.

• Enables veterans to have increased access to community care.

• Establishes a new Urgent Care Benefit that eligible Veterans can access through the VA’s network of Urgent Care Providers in the community.

Each year, VA serves approximately 9 million enrolled veterans at 1,255 health care facilities across the country.

For more information, visit www.missionact.va.gov.

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