Veterans Administration: Structure and Services. Stephen Redmon, J.D., Ph.D. Staff Attorney VA Office of General Counsel

Transcription

1 Veterans Administration: Structure and Services Sean Clark, J.D. National Coordinator Veterans Justice Outreach Jessica Blue-Howells, LCSW National Director, Health Care for Reentry Veterans Stephen Redmon, J.D., Ph.D. Staff Attorney VA Office of General Counsel July 28, 2015

2 VA: Mission and I CARE Values Mission To fulfill President Lincoln's promise To care for him who shall have borne the battle, and for his widow, and his orphan by serving and honoring the men and women who are America s veterans. I CARE Values Integrity Commitment Advocacy Respect Excellence

3 What is Federal VA? United States Department of Veterans Affairs Veterans Health Administration 150 hospitals, 830 outpatient clinics, 370 Vet Centers Veterans Benefits Administration 57 Regional Offices Life Insurance, Home Loan, Disability Compensation, Pension, Education, Vocational Rehabilitation National Cemetery Administration 131 National Cemeteries Veteran Population 2013: estimated 21,973,000, median age 64 (male) 49 (female), 10% women (9/30/13) 2013: VHA had 8.96 million enrollees

4 National Cemetery Administration (NCA) Mission The National Cemetery Administration honors Veterans with final resting places in national shrines and with lasting tributes that commemorate their service to our Nation. Cemeteries 3.1 million gravesites in: 131 National cemeteries 33 soldiers lots/monument sites Burial Benefits (private cemetery) Headstone/marker, burial flag, Presidential Memorial Certificate 3 3

5 NCA (cont.) Eligibility for Burial in a National Cemetery Servicemember who died on active duty Veteran who was discharged under conditions other than dishonorable Reserve/National Guard members entitled to retired pay What to do: Contact the National Cemetery Scheduling Office Fax all discharge documentation to Follow-up with a phone call to Resources Locate a National Cemetery: Additional information: 4 4

6 Veterans Benefits Administration (VBA) Administers programs that provide financial and other forms of assistance to Veterans, their dependents, and survivors. Benefits include: - Veterans compensation - Veterans pension - Survivors benefits - Vocational rehabilitation and employment assistance - Education assistance - Home loan guaranties - Life insurance

7 VBA Regional Offices Seattle Anchorage Portland Reno Oakland Los Angeles San Diego Boise Salt Lake City Phoenix Ft. Harrison Cheyenne Denver Albuquerque Fargo Sioux Falls Lincoln Wichita St. Paul Muskogee Des Moines St. Louis Little Rock Milwaukee Chicago Detroit Indianapolis Louisville Nashville White River Jct. Cleveland Atlanta Montgomery Manchester Buffalo Pittsburgh Huntington Columbia DC Roanoke Togus Boston Providence Hartford Newark Philadelphia Wilmington Baltimore Winston Salem New York Houston WACO New Orleans Jackson St. Petersburg Eastern Area Southern Area Central Area Western Area Honolulu San Juan

8 VBA: Homeless/Incarcerated Veterans Outreach Coordinators (HVOC) At least one HVOC at every VBA Regional Office Outreach to homeless Veterans at homeless shelters, homeless Stand Downs, through state and local community partners and other areas where homeless Veterans may be located Processing claims for homeless Veterans and those at risk of homelessness to ensure they are expedited Outreach to justice-involved Veterans in Veterans treatment courts, prisons, and jails Outreach includes providing information and assistance on VA benefits and services such as discussing eligibility criteria and filing a compensation and/or pension claim. 7

9 VBA: Types of Benefits Note: More detailed information about each of these programs, including their eligibility requirements, is available at: Disability Compensation Tax-free payment Disability is service-connected Discharged under other than dishonorable conditions Pension Tax-free payment Wartime Veterans with limited or no income who are either: Aged 65 or older, or Permanently and totally disabled (non-service-connected)

10 VBA: Types of Benefits (cont.) Education and Training Post-9/11 GI Bill (Financial assistance: tuition and fees, books, supplies, housing allowance) Montgomery GI Bill Reserve Educational Assistance Program Home Loans VA-issued loans (no down payment or mortgage insurance premiums) VA-guaranteed loans (private lenders) Home loan refinancing Specially Adapted Housing Grants (severely disabled Veterans)

11 VBA: Types of Benefits (cont.) Life Insurance Vocational Rehabilitation and Employment Veterans with service-connected disabilities VA provides career path evaluation, vocational counseling, job-search assistance Dependents/Survivors Dependency and Indemnity Compensation Monthly benefit paid to surviving spouse/children Eligibility: Servicemember died on active duty, from a service-connected disability, or was rated totally disabled at time of death Survivors Pension - a monthly tax-free benefit payable to the un-remarried surviving spouse and/or child(ren) of a deceased Veteran with wartime service who meet the income threshold Surviving spouses and children also eligible for reimbursement of medical costs, financial assistance to pursue education and training

12 VBA: Applying for Benefits Online By Phone VETS (8387) Completed form sent to Veteran for verification and signature In Person Nearest Regional Office Nearest VA medical center or clinic Working with an accredited Veterans Service Organization representative, attorney, or claims agent VSO offices in VA medical centers and Regional Offices VA Office of General Counsel s list of accredited reps: Questions? VBA National Call Center:

13 Veterans Health Administration (VHA) Mission Honor America s Veterans by providing exceptional health care that improves their health and well-being. 12

14 Veterans Health Administration: General Healthcare is the largest component of VA s services VA s medical system is comprised of a network of hospitals, outpatient clinics, Vet Centers, nursing homes, and residential treatment facilities VA offers comprehensive medical and mental health services to Veterans who qualify for medical benefits 13

15 VHA Organization Regional: Local: Organized into 21 Veterans Integrated Service Networks (VISNs) Budgetary, Planning, and Accountability Unit of Veterans health care system VISN or Regional Care Services Examples: Polytrauma, Domiciliary, Vision Impairment 150 Medical Centers with multiple campuses, community-based outpatient clinics more than 1400 total sites VA Health Care Systems (multiple Medical Centers) Affiliation with over 10 academic health systems (trained 65% of US physicians) Where is the Nearest Medical Center or other Health Care Facility? Use the Facility Locator to find VA medical facilities 14

16 Reaching Out In 2010, VHA hosted or attended more than 4,400 outreach events across the Nation. VHA personally met with 750,000+ Veterans 207,000+ family members VHA instantly enrolled Nearly 32,000 of those Veterans OEF/OIF/OND Post-Deployment Assessments Military, Guard, Reserve contact 15 Community contact (e.g. college)

17 Reaching Rural Veterans VA estimates approximately 43% of all Veterans live in rural areas. VA continues to expand health access to rural Veterans through: Fee basis care Rural health care partnerships Home-based telehealth Mobile health clinics 16

18 Health Care Delivery Model Patient-Centered Team Care Continuous Improvement Data-Driven, Evidence-Based Value Prevention / Population Health 17

19 Veterans Health Administration: Services Primary Care Specialty and Inpatient Care Preventive Health Care Pharmacy Benefits Emergency Care Diagnosis and Treatment for Mental Health and Substance Abuse Surgical Care and Organ Transplantation Rehabilitation Nursing Home Care Respite and Hospice Care Readjustment Counseling Blind Rehabilitation Services Dental (with specific eligibility criteria) Maternity Care 18

20 Veterans Health Administration: Mental Health Services Assessment, diagnosis and treatment of mental health issues Services offered in inpatient, residential, and outpatient settings Evidence-based treatments offered for specific conditions and problems including: Anxiety Bipolar Disorder Depression Military Sexual Trauma Posttraumatic Stress Disorder Schizophrenia Suicide Prevention Core principles: mental health care is an integral component of overall health care, mental health services must be recovery-oriented 19

21 Veterans Health Administration: Substance Use Disorder Services Case finding, assessment, diagnosis and treatment of Substance Use Disorders, including tobacco use Services provided in specialty clinics, primary care, and integrated into mental health services Includes medically supervised withdrawal management in both ambulatory and inpatient settings Intensive Substance Use Disorder (SUD) services available in outpatient and residential settings Pharmacotherapy: opioid agonist treatment (methadone, buprenorphine) and for alcohol use Evidence based interventions: motivational enhancement therapy, cognitive behavioral therapy for relapse prevention, 12-step facilitation counseling, contingency management, SUD-focused behavioral couples counseling or family therapy. 20

22 Readjustment Counseling Service Vet Centers Eligibility: Veteran or family member served in a combat zone and received a military campaign ribbon Services: Readjustment counseling for Veterans and their families Individual and group counseling Family counseling for military-related issues Bereavement counseling for families who experience an active duty death Military sexual trauma counseling and referral Outreach and education at community events Substance abuse assessment and referral Employment assessment and referral VBA benefits explanation and referral Screening and referral for medical issues Organized as part of VHA, but separate from VHA health care system 21

23 Ending Veteran Homelessness One of VA s top priorities is ending Veteran homelessness by the end of 2015 The goal is a systematic end to homelessness with no Veterans sleeping on the street and every Veteran with access to permanent housing VA is the largest single provider of homeless services in the Nation VA offers a wide array of interventions designed to find homeless Veterans, engage them in services, find pathways to permanent housing, and prevent homelessness from occurring 22

24 VHA Homeless Programs Health Care for Homeless Veterans (HCHV)* Community Resource and Referral Center (CRRC) Grant and Per Diem Program (GPD)** Supportive Services for Veteran Families (SSVF)** Domiciliary Care for Homeless Veterans (DCHV) Housing and Urban Development-VA Supported Housing (HUD-VASH) Homeless-Patient Aligned Care Teams (H-PACT) Veterans Justice Outreach (VJO) Health Care for Reentry Veterans (HCRV) Community Homelessness Assessment, Local Education and Networking Groups (CHALENG) *At some sites HCHV includes contract residential treatment services with contracts funding community providers **VA provides grants to eligible community providers; community providers offer services 23

25 Employment Employment Preparation and Placement Vocational Rehabilitation Compensated Work Therapy (CWT) Homeless Veterans Supported Employment Program (HVSEP) Dept of Labor Partnership Programs

26 Mission and Vision Veterans Justice Programs MISSION To partner with the criminal justice system to identify Veterans who would benefit from treatment as an alternative to incarceration. VJO will ensure access to exceptional care, tailored to individual needs, for justice-involved Veterans by linking each Veteran to a VA and community services that will prevent homelessness, improve social and clinical outcomes, facilitate recovery and end Veterans cyclical contact with the criminal justice system. VISION Every justice-involved Veteran will have access to the health care and other benefits necessary to pursue and realize a full, meaningful life as a self-reliant, positively contributing member of the community.

27 Serving Justice-Involved Veterans Healthcare for Reentry Veterans (Veterans incarcerated in prison facilities) Outreach and pre-release eligibility determination and assessment for treatment Referral and linkages to medical, psychiatric, and social services, including employment services upon release Short term case management assistance upon release Veterans Justice Outreach (Veterans interfacing with front end of justice system) Jail outreach and associated eligibility determination, assessment, & treatment linkage Education of and liaison with VA and community law enforcement Liaison with court system and staffing of collaborative treatment courts Short term case management as indicated Linkage to ancillary support (e.g. child support services, legal assistance)

28 C0gnitive Risk Addressing Issues That Contribute to Veteran s Involvement in Justice System Personality Features and Disorders Criminogenic Thinking Motivation for and Engagement in Treatment Offense-specific issues (e.g. IPV, DWI)

29 Limits on VA Authorization Release of Information Not Authorized to Provide Custodial Care No Locked Residential Facilities Not Authorized to Provide Care While Veteran is Incarcerated

30 MyVA: Putting Veterans First

31 For Additional Information Veterans Justice Outreach Specialists Jessica Blue-Howells, LCSW Sean Clark, J.D. National Coordinator, HCRV National Coordinator, VJO , ext ext Stephen Redmon, J.D., Ph.D. Staff Attorney, VA Office of General Counsel