This is an inside look into the policies regarding healthcare services for wounded soldiers returning home from war.
The majority of Veterans Hospitals in Missouri in Missouri are federal facilities under the policies of the Department of Veterans Affairs (VA). As a federal facility, they adhere to federal policies related to provision of healthcare services, hiring of staff, privacy and confidentiality regulations, etc. Currently, there are no other comparable state facility or system that can deliver the care and treatment provided to Veterans with the efficiency, cost-effectiveness and commitment to service.
There are 5 main VA Medical Centers in the state of Missouri and many other community based outpatient clinics. Our group was able to reach Mr. Stephen L. Gaither, the Public Affairs Officer at the Harry S. Truman Memorial Veterans’ Hospital in Columbia, Missouri, in order to find further information on the policies in place for those who need healthcare services upon returning home.
Referral Policy
The Department of Veterans Affairs (VA) healthcare system provides care and treatment to eligible Veterans. (Approximately six million are receiving VA health care services at the present time.) There is a formal enrollment system, with eight different priority groups, which requires a Veteran to complete an application form along with evidence of their active duty military service (usually a discharge certificate, DD-Form 214). On top of the regular enrollment system, the U.S. Congress authorized special eligibility for returned combat Veterans to receive up to five years of health care services at VA healthcare facilities at no cost for any conditions related to their service in a combat arena. Depending upon the nature of the individual’s health problems and whether or not those conditions are deemed to be service-related, a significant number of those combat Veterans will be able to continue to receive VA health care services beyond the five-year period.
Benefits of the VA Healthcare
The VA healthcare system is the largest comprehensive, integrated healthcare delivery system in the country with more than 1,400 sites of care. Once an individual has left active duty military service, the VA healthcare system is an attractive option for many. In fact, about 53% of eligible returned combat Veterans are using VA health care services. That is the highest market penetration for any group of war Veterans in our nation’s history.
There are many factors that affect an individual’s decision to use VA health care benefits including (1) the comprehensive range of high quality services available; (2) dedicated health care professionals who know and understand the health issues of the Veteran population; (3) the cost of care provided; (4) a very high rate of patient satisfaction compared to other healthcare systems; (5) the ease of mobility reinforced by VA’s computerized patient record system in which a VA provider can access a Veteran’s medical record with a few clicks of a computer mouse; and (6) the sense of camaraderie in being in a place for and with fellow Veterans.
The range and amount of care provided, either on an inpatient or outpatient basis, is solely dependent upon the individual health care needs of the Veteran. Once enrolled, each Veteran is assigned to a primary care provider and primary care team that is responsible for managing the health and care of that Veteran. Referrals to behavioral health and specialty care services are made by the primary care provider.
Policies Regarding PTSD or TBI
As a comprehensive healthcare delivery system, VA is able to provide appropriate care to Veterans with PTSD and TBI from properly trained, credentialed professionals. Oftentimes, these services are provided across the organization, i.e., psychologists, psychiatrists, other mental health treatment professionals and physical rehabilitation providers work collaboratively with the Veteran.
Funding & Insurance
Approximately 90% of the VA healthcare system’s funding comes from annual allocations from the Congress to the Department of Veterans Affairs. About 10% of each medical center’s operating budget comes from third party payers and patient co-payments.
Veterans can choose to purchase their own private health insurance (or to be covered by a spouse’s policy). VA will bill the third-party insurance for care of non service-related injuries or illnesses. Veterans in the lowest priority groups are charged a copay, equivalent to a Medicate deductible, for care of non service-connected injuries or illnesses. For example, the co-pay for a primary care visit is $15 while a co-pay for a specialty care visit is $50. Likewise, Veterans are charged a co-pay of either $8 or $9 for a 30-day supply of medication for non service-related injuries or illnesses.
Occupational Therapy in VA Healthcare
Occupational Therapy is currently co-located in the hospital with the Physical Therapy department. Both Physical and Occupational Therapy are under the Physical Medicine and Rehabilitation Section in the clinical support service line, but will be shifted into a new Rehabilitation Service at the beginning of January. Occupational therapists treat Veterans who are referred to them by other providers in the facility. Occupational therapy services are considered to be an important part of the full array of treatment modalities afforded any Veteran receiving care at this hospital. If occupational therapy is clinically indicated, the referral is made regardless if the Veteran has been in combat or not, or if the Veteran's injuries and illnesses are directly related to military service. Those may be factors related to a Veteran's eligibility, but once a Veteran is enrolled, all healthcare services are available for access to them.
Changing Policy
Funding from the U.S. Congress is a dynamic process and, historically, has changed – sometimes rather dramatically. Over the last 6-7 years, there has been unprecedented congressional support of VA healthcare. Given the current environment in Washington, that situation may be changing. Policies do change for a variety of reasons, but financial resources are a very important factor. Other factors include eligibility reform (the last major reform took place in 1996), philosophical transformations (VA transformed itself from a hospital-based system into a comprehensive, healthcare delivery system in the mid-1990s) and reactions to accrediting and oversight organizations.
In 2009, President Obama passed the Veterans Health Care Budget Reform and Transparency Act of 2009. WIth the passing of this Act, it allowed the Department of Veterans Affairs to budget and plan ahead for managing care for veterans. This bill can be accessed here.
Final Note
As mentioned above, it is important for many of the Veterans to receive healthcare services, including occupational therapy from federal facilities. Although U.S. Congress has been supportive of VA healthcare, it is important that we continue to make efforts to get more funding available for these facilities to help Veterans improve their quality of life through the healthcare services they receive.
We would like to thank Mr. Stephen L. Gaither for the information provided for this page.
The majority of Veterans Hospitals in Missouri in Missouri are federal facilities under the policies of the Department of Veterans Affairs (VA). As a federal facility, they adhere to federal policies related to provision of healthcare services, hiring of staff, privacy and confidentiality regulations, etc. Currently, there are no other comparable state facility or system that can deliver the care and treatment provided to Veterans with the efficiency, cost-effectiveness and commitment to service.
There are 5 main VA Medical Centers in the state of Missouri and many other community based outpatient clinics. Our group was able to reach Mr. Stephen L. Gaither, the Public Affairs Officer at the Harry S. Truman Memorial Veterans’ Hospital in Columbia, Missouri, in order to find further information on the policies in place for those who need healthcare services upon returning home.
Referral Policy
The Department of Veterans Affairs (VA) healthcare system provides care and treatment to eligible Veterans. (Approximately six million are receiving VA health care services at the present time.) There is a formal enrollment system, with eight different priority groups, which requires a Veteran to complete an application form along with evidence of their active duty military service (usually a discharge certificate, DD-Form 214). On top of the regular enrollment system, the U.S. Congress authorized special eligibility for returned combat Veterans to receive up to five years of health care services at VA healthcare facilities at no cost for any conditions related to their service in a combat arena. Depending upon the nature of the individual’s health problems and whether or not those conditions are deemed to be service-related, a significant number of those combat Veterans will be able to continue to receive VA health care services beyond the five-year period.
Benefits of the VA Healthcare
The VA healthcare system is the largest comprehensive, integrated healthcare delivery system in the country with more than 1,400 sites of care. Once an individual has left active duty military service, the VA healthcare system is an attractive option for many. In fact, about 53% of eligible returned combat Veterans are using VA health care services. That is the highest market penetration for any group of war Veterans in our nation’s history.
There are many factors that affect an individual’s decision to use VA health care benefits including (1) the comprehensive range of high quality services available; (2) dedicated health care professionals who know and understand the health issues of the Veteran population; (3) the cost of care provided; (4) a very high rate of patient satisfaction compared to other healthcare systems; (5) the ease of mobility reinforced by VA’s computerized patient record system in which a VA provider can access a Veteran’s medical record with a few clicks of a computer mouse; and (6) the sense of camaraderie in being in a place for and with fellow Veterans.
The range and amount of care provided, either on an inpatient or outpatient basis, is solely dependent upon the individual health care needs of the Veteran. Once enrolled, each Veteran is assigned to a primary care provider and primary care team that is responsible for managing the health and care of that Veteran. Referrals to behavioral health and specialty care services are made by the primary care provider.
Policies Regarding PTSD or TBI
As a comprehensive healthcare delivery system, VA is able to provide appropriate care to Veterans with PTSD and TBI from properly trained, credentialed professionals. Oftentimes, these services are provided across the organization, i.e., psychologists, psychiatrists, other mental health treatment professionals and physical rehabilitation providers work collaboratively with the Veteran.
Funding & Insurance
Approximately 90% of the VA healthcare system’s funding comes from annual allocations from the Congress to the Department of Veterans Affairs. About 10% of each medical center’s operating budget comes from third party payers and patient co-payments.
Veterans can choose to purchase their own private health insurance (or to be covered by a spouse’s policy). VA will bill the third-party insurance for care of non service-related injuries or illnesses. Veterans in the lowest priority groups are charged a copay, equivalent to a Medicate deductible, for care of non service-connected injuries or illnesses. For example, the co-pay for a primary care visit is $15 while a co-pay for a specialty care visit is $50. Likewise, Veterans are charged a co-pay of either $8 or $9 for a 30-day supply of medication for non service-related injuries or illnesses.
Occupational Therapy in VA Healthcare
Occupational Therapy is currently co-located in the hospital with the Physical Therapy department. Both Physical and Occupational Therapy are under the Physical Medicine and Rehabilitation Section in the clinical support service line, but will be shifted into a new Rehabilitation Service at the beginning of January. Occupational therapists treat Veterans who are referred to them by other providers in the facility. Occupational therapy services are considered to be an important part of the full array of treatment modalities afforded any Veteran receiving care at this hospital. If occupational therapy is clinically indicated, the referral is made regardless if the Veteran has been in combat or not, or if the Veteran's injuries and illnesses are directly related to military service. Those may be factors related to a Veteran's eligibility, but once a Veteran is enrolled, all healthcare services are available for access to them.
Changing Policy
Funding from the U.S. Congress is a dynamic process and, historically, has changed – sometimes rather dramatically. Over the last 6-7 years, there has been unprecedented congressional support of VA healthcare. Given the current environment in Washington, that situation may be changing. Policies do change for a variety of reasons, but financial resources are a very important factor. Other factors include eligibility reform (the last major reform took place in 1996), philosophical transformations (VA transformed itself from a hospital-based system into a comprehensive, healthcare delivery system in the mid-1990s) and reactions to accrediting and oversight organizations.
In 2009, President Obama passed the Veterans Health Care Budget Reform and Transparency Act of 2009. WIth the passing of this Act, it allowed the Department of Veterans Affairs to budget and plan ahead for managing care for veterans. This bill can be accessed here.
Final Note
As mentioned above, it is important for many of the Veterans to receive healthcare services, including occupational therapy from federal facilities. Although U.S. Congress has been supportive of VA healthcare, it is important that we continue to make efforts to get more funding available for these facilities to help Veterans improve their quality of life through the healthcare services they receive.
We would like to thank Mr. Stephen L. Gaither for the information provided for this page.