VA Health Care priority changes

[Gimpy]

If you are on the VA's news mail list, then you may already have the
article about "Priority Care" for service connected veterans?

Below is first: the article, and then second: the Directive
mentioned in the article.


###### VA Article #####

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address:
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Disabled Veterans Get Health Care Priority from VA

WASHINGTON (Jan. 2, 2004) - All veterans with service-connected
medical
problems will receive priority access to health care from the
Department of
Veterans Affairs (VA) under a new directive.

"Caring for veterans with service-connected medical problems is a
major
reason VA exists," said Secretary of Veterans Affairs Anthony J.
Principi.
"This directive should ease the minds of veterans who no longer have
to wait
for health care appointments."

The new directive provides that all veterans requiring care for a
service-connected disability -- regardless of the extent of their
injury --
must be scheduled for a primary care evaluation within 30 days of
their
request for care. If a VA facility is unable to schedule an
appointment
within 30 days, it must arrange for care at another VA facility, at a
contract facility or through a sharing agreement.

The directive covers hospitalization and outpatient care. It does
not apply
to care for medical problems not related to a service-connected
disability.
However, veterans needing emergency care will be treated immediately.

The new provision is an extension of rules that took effect in
October 2002
for severely disabled veterans. Under the earlier rule, priority
access to
health care went to veterans with disabilities rated at 50 percent
or more.
For the severely disabled, the priority includes care for
non-service-connected medical problems.

The number of veterans using VA's health care system has risen
dramatically
in recent years, increasing from 2.9 million in 1995 to nearly 5
million in
2003. Although VA operates more than 1,300 sites of care, including
162
hospitals and more than 800 outpatient clinics, the increase in
veterans
seeking care outstrips VA's capacity to treat them.

"VA provides the finest health care in the country, but if a veteran
cannot
see a doctor in a timely manner, then we have failed that veteran,"
Principi
said.

"I will work to honor our commitment to veterans," he said. "But
when it
comes to non-emergency health care, we must give the priority to
veterans
with service-connected disabilities."

## DIRECTIVE ##

Department of Veterans Affairs
VHA DIRECTIVE 2003-062
Veterans Health Administration
Washington, DC 20420
October 23, 2003

PRIORITY SCHEDULING FOR OUTPATIENT MEDICAL SERVICES AND
INPATIENT HOSPITAL CARE FOR SERVICE CONNECTED VETERANS

1. PURPOSE: This Veterans Health Administration (VHA) Directive
outlines policies and
actions required in support of Department of Veterans Affairs (VA)'s
commitment to providing
priority care for non-emergent outpatient medical services and
inpatient hospital care for any
veteran with service connected (SC) disabilities. NOTE: As always,
medical care for emergent
or urgent cases takes precedence over a priority of service
connection.

2. BACKGROUND: Public Law 104-262, the Veterans Health Care
Eligibility Reform Act
of 1996, mandated VA to establish and implement a national
enrollment system to manage the
delivery of health care services to veterans. The enactment of this
legislation generated a
significant increase in the number of VA enrollees and patient
users. The result has been a
steady increase in the number of veterans on wait lists or scheduled
in excess of 6 months for
non-emergent outpatient appointments. VHA Directive 2002-059
outlines VA's policy on
providing priority access for care to veterans who are 50 percent or
greater SC. Additionally,
VA has identified the need to provide priority access for care to
veterans who require care for a
SC disability regardless of the percentage of SC rating.

3. POLICY: It is VHA policy to provide priority access to outpatient
medical care and elective
inpatient hospital care for any veteran who requires care for a SC
disability. In addition to
ensuring that this priority for access to care is provided to
veterans requiring care for a SC
disability, every effort must be made to provide clinically
appropriate care to every enrolled
veteran. NOTE: Service connection in and of itself, does not justify
cancellation of a current
appointment for another veteran as a mechanism for accommodating
priority scheduling for the
SC veteran.

4. ACTION: Network and medical center Directors must ensure health
care facilities
implement the following procedures to manage appointment scheduling
for new enrollees and
established patients who require care for a SC disability. NOTE:
While staff at the health care
facilities may place these veterans on wait lists, their
appointments must be scheduled within the
timeframes as outlined in subparagraph 4a.

a. All new enrollees and/or new patients who are rated less than 50
percent SC requiring care
for a SC disability, and who request VA care, must be scheduled for
a primary care evaluation
within 30 days of desired date. If the outpatient appointment cannot
be scheduled within this
timeframe, arrangements must be made to have the patient seen at
another VA health care
facility or to obtain the services on fee basis or under a sharing
agreement or contract at VA
expense within the 30-day timeline.

THIS VHA DIRECTIVE EXPIRES OCTOBER 31, 2007

b. Appointments for established patients (i.e., a patient who has
received care anywhere in
the VA system within the past 2 years) who are less than 50 percent
SC requiring the
appointment for a SC disability, must be scheduled within 30 days of
the clinically appropriate
appointment date based on the clinical need of the veteran as
determined by the veteran's VA
treating clinician. If an appointment cannot be scheduled within the
specified timeframe,
arrangements must be made to have the patient seen at another VA
health care facility or to
obtain the needed services on a fee basis or under a sharing
agreement or contract at VA
expense.

c. If non-VA care at VA expense is authorized, close coordination
must be maintained with
the veteran and the local authorized care provider to ensure
coordination of the veteran's care.
Alternative arrangements for appointments are intended to provide
interim medical care for
veterans who require care for a SC disability. These veterans need
to be scheduled at the
preferred VA health care facility or at another VA health care
facility as soon as possible.

d. Any veteran less than 50 percent SC needing admission for an
elective procedure related
to a SC disability must receive priority admission scheduling over
other elective admissions.
NOTE: In no case should priority scheduling of any SC veteran impact
the medical care of any
other previously scheduled veteran.

e. Veterans rated less than 50 percent SC who are on a wait list at
the time of
implementation of this Directive, must be provided priority access
as outlined in subparagraphs
4(a) and 4(b).

5. REFERENCES
a. Public Law 104-262.
b. Federal Register (FR) Notice published September 17, 2002, at 67
FR 58528.
c. VHA Directive 2002-059, dated October 2, 2002.

6. FOLLOW-UP RESPONSIBILITY: The Chief Business Officer (16) is
responsible for the
contents of this Directive. Questions may be referred to this office
at (202) 254-0324.

7. RESCISSIONS: None. This VHA Directive expires October 31, 2007.
S/ Jacquelyn Vassanelli for
Robert H. Roswell, M.D.
Under Secretary for Health

DISTRIBUTION:
CO:

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