CANANDAIGUA — Out with the old, in with the new.
The U.S. Department of Veterans Affairs is dusting off that cliché as it ushers in new health care options under the MISSION Act — short for Maintaining Internal Systems and Strengthening Integrated Outside Networks — Act. It went into effect June 6.
The MISSION Act replaces the Veterans Choice program, which ended by law on June 5, and establishes a new Veterans Community Care program.
“Basically, the Veterans Choice Act was by the previous administration and the MISSION Act is by the current administration,” said Brian Westlake, group practice manager at the Canandaigua VA Medical Center, which serves about 20,000 veterans in the area.
Under the Veterans Community Care program, veterans can work with their VA health care provider or other VA staff to see if they are eligible for community care. Eligibility for community care does not require a veteran to receive that care in their community — veterans can still choose to have the VA provide their care.
Veterans are eligible to receive care in their community if they meet any of six following eligibility requirements:
1. A veteran needs a service 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 U.S. territories of Guam, American Samoa, the Northern Mariana Islands and the U.S. Virgin Islands.
3. A veteran qualifies under the “grandfather” provision related to distance eligibility for the Veterans Choice program.
4. VA cannot furnish care in a manner that complies with designated access standards. The specific access standards are:
• Average drive time to a specific VA medical facility — 30-minute average drive for primary care, mental health and non-institutional extended care services, and 60-minute average drive for specialty care; average times are calculated by VA using geo-mapping software.
• Appointment wait time at a specific VA facility — 20 days or more for primary care, mental health care and non-institutional extended care services, unless the veteran agrees to a later date in consultation with his or her VA provider; 28 days or more — from the date of request — for specialty care, unless the veteran agrees to a later date.
5. The veteran and referring clinician agree it is in the best medical interest of the veteran to receive community care based on defined factors.
6. VA has determined that a VA medical service line is not providing care in a manner that complies with VA’s standards for quality.
“We are honored to reaffirm our commitment to American’s veterans,” said Bruce Tucker, director of the VA Finger Lakes Healthcare System (Canandaigua and Bath medical centers). “Our staff is steadfast in providing health care that meets the needs of our veterans at the right time and place.”
While the VA Finger Lakes system focuses on primary care, mental health and geriatric care of veterans, Westlake said the MISSION Act partners with communities for more comprehensive care. That will include telehealth options with medical specialists.
“The hope is between what the VA has and what the community has, the veteran can get care as close to home as possible,” Westlake said.
Through the MISSION Act, VA is working with a third party administrator — TriWest Health Care Alliance — to build a network of area urgent care centers to work with VA. While veterans will be able to access urgent-care benefits in their community, Westlake said veterans should still continue to see their primary care doctors.
“Urgent care is nice, but there is a difference between comprehensive medicine and rescue medicine. Studies have shown that people who see primary care providers on a regular basis have better health outcomes than those who solely rely on urgent care,” he said. “Our main product line is primary care, and we want to encourage veterans to use this.”
Veterans can learn more about the Veterans Community Care program when they see their VA doctor.
“You will be told ‘Here are your VA options and here are your community options.’ You make a choice between the two,” Westlake said.