Shrinking funds means less access to local care for veterans
July 3, 2015
Craig — Veterans will have a little less choice about when they can utilize their Choice card after Congress and the U.S. Department of Veterans Affairs redefined certain health care protocols laid down by the Veterans Access, Choice and Accountability Act of 2014.
The new protocol aims to keep more of veterans' care within the VA system due to growing demand and shrinking funds for non-VA care.
"There have been 2.7 million more appointments this year than last year, VA-wide," according to Paul Sweeney, chief of customer relations and public affairs for the Grand Junction VA Medical Center. "The non-VA dollars (for care outside the VA system) are pretty much exhausted, so we can no longer just write consults into our community."
A veteran in need of specialty care not provided by his local VA facility must now be referred, in most cases, to a regional VA hospital rather than a local, non-VA provider, an option that was originally afforded by the Choice Act.
Craig veteran Gar Williams raised concerns about added delays associated with the referrals to regional hospitals and that delays would go unaccounted for under the Choice Act's 30-day waitlist limit for an appointment.
Sweeney said there are rules defining how long an inter-facility consult can remain in limbo, however, before a patient is scheduled for an appointment.
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"All internal VA consults should remain in pending status no more than 7 days," according to written procedures provided by Sweeney. "There are a few exceptions, such as prosthetics consults, which may remain pending for longer than 7 days."
Prosthetics is a category that includes a wide range of medical items such as eyeglasses, hearing aids, canes, crutches and even certain types of implants, Sweeney explained, bringing a wider variety of timing considerations into play.
The nearest major medical facility for Northwest Colorado veterans is in Grand Junction, a 2.5-hour drive from Craig. Rural veterans automatically qualify for a "Choice card" under the Choice Act if they live more than 40 miles from the nearest point of care, which has been redefined by Congress as a VA clinic with at least one primary care provider on-site.
Qualifying veterans who opt into the Choice program are able to utilize pre-authorized non-VA providers closer to home, and are not necessarily subject to the new inter-facility consult requirements, according to Sweeney.
The new protocol will apply largely to veterans who rely on care through the GJVAMC or VA system. A Grand Junction veteran in need of specialty care not available at the GJVAMC, for example, would be referred to either the Salt Lake City or Denver VA Health Care System instead of a local, non-VA provider. Both regional hospitals are a few hours from Craig, and some veterans may have to travel on their own dime.
"If we can meet the needs in-house, we have to do an inter-facility consult," Sweeney said. "Some people are eligible for travel pay and some are not. You either have to be being seen for service-connected disability or you have to be 30-percent-rated service-connected disability."
If the regional VA hospital is not able to schedule a veteran within the clinically desired date (dependent on the veteran's particular condition), then it is responsible for placing the vet on the Veterans Choice List, enabling them to choose a non-VA provider.
The changes are part of the continuing evolution of the Choice program, Sweeney said.
"Congress put (the Choice Act) together very quickly to meet the urgent need and Congress gave the VA 90 days to put the system in place, so we knew it would need refining," Sweeney said. "We're still working out a lot of the program and Congress is still making changes."
Veterans who are concerned about the changes can contact Sweeney or a patient advocate, he said, write to GJVAMC Director Marc Magill or contact their congressman. All three congressional representatives for the Western Slope have already been made aware of the changes, he said, and Grand Junction VA administrators are primarily concerned with ensuring veterans receive the care they need when they need it.
"I do question the policies coming out of Washington preventing veterans from getting great care," said U.S. Rep. Scott Tipton, R-Colorado, District 3, in response to a question from Williams at a town hall meeting Monday. "If I had it my way, you would just have care, and could go wherever you want and get your care where you need."
Contact Lauren Blair at 970-875-1794 or lblair@CraigDailyPress.com.