Welcome To care for him who shall have borne the battle and his widow and orphan. Abraham Lincoln...

Welcome

To care for him who shall have borne the battle and his widow

and orphan. Abraham Lincoln

Governor’s Task Force5 June, 2008

Jack Heims, MSW, FACHE

VHA – Oregon Medical Services

Portland VAMC Main Campus

Our Organization


The Department of Veterans Affairs is comprised of

• Veterans Benefits Administration – provides compensation and pension, education, life insurance, loan guaranty, & vocational

rehabilitation & employment

• National Cemetery Service – provides burial services to veterans and their spouses

• Veterans Health Administration – provides medical, surgical, mental health & long term care services to veterans

Note: Military hospitals for active duty personnel are part of the Department of Defense, for example - Walter Reed

OUR MISSIONHonor America’s veterans by providing exceptional health care that improves

their health and well-being.

OUR VISIONTo be a patient-centered integrated

health care organization for veterans providing excellent health care, research, and education; an

organization where people choose to work; an active community partner; and a

back-up for National emergencies.

VHA

Roseburg Facility

OUR VALUESTrust, Respect, Excellence, Compassion, Commitment

WHO WE ARE


The Veterans Health Administration

(VHA) is divided into 22 Veterans

Integrated Service Networks (VISN's)

The Oregon Facilities are part of VA Northwest Network

VISN 20, which is comprised of the largest geographical

land mass of any VISN within the Department of Veterans

Affairs


Portland VAMC Main Facility

PORTLAND VA MEDICAL CENTER

149 inpatient & 72 nursing home beds

Referral Center

Full Continuum of Care

Acute Medicine, Surgery, Psychiatry, Neurology, Rehabilitation, Emergency, Primary, Specialty, Transplant, Ophthalmology, Optometry, Cardiology, Endocrinology, Rheumatology, Geriatrics, Hemodialysis, Endoscopy, Chemotherapy, ENT, Orthopedics, Podiatry, General Surgery, Urology, Dental, Psychology, PTSD, Substance Abuse, Opioid Substitution,, Nuclear Medicine, Imaging, Path & Lab, Audiology, etc.

Support VISN 20, Willamette National Cemetery,

and two Vet Centers

VANCOUVER FACILITY


The Vancouver campus includes a 72-bed Nursing Skilled Care Unit/Comprehensive Rehabilitation Unit, Primary

Care Clinic, Mental Health Clinic, Substance Abuse Treatment, Dental, Prosthetics, Community Nursing

Home, Home and Community Based Care, Transitional Lodging Unit, Transplant Lodging Unit, Telephone Care,

Warehouse, Laundry and VISN 20 Administrative Offices.

A Single Room Occupancy Enhanced-Use Lease (EUL)

exists on the campus along with the Clark County Center for Community

Health (EUL)

Roseburg VA Medical Center & Southern Oregon Rehabilitation Center

& Clinics


Roseburg VA Medical Center

•Inpt PTSD, SA

•Not all Specialties

•surgical capabilities

•Primary MH and Primary Care

SORCC (White City)

•Primarily Rehab with 425 Beds

•Primary MH and Primary Care

Additional Medical Care Coverage provided by Community Based Outpatient Clinics


FT Current CBOCs

• Bandon

• Bend (expanded)

• Brookings

• Eugene (expanded)

• Klamath Falls

• Ontario

• Portland East

• Salem

• Warrenton

Planned FT or PT Clinics

• West Portland (12/08)

• Burns

• Grants Pass

• The Dalles (9/08)

• Lincoln County (FY09)

• Ore City Area (FY09)

• Bandon Relocate to North Bend

http://www1.va.gov/directory/guide/facility.asp?ID=5342&dnum=All

FY07 OREGON VITAL STATISTICS

Veterans Served 100,157

Veteran Pop. 305,387

Outpatient Visits 837,410

Budget $427 m

Staff 3653

Hospital Beds

237

NH Beds 127

Dom Beds 472

Total Beds 836

Portland VA Medical CenterVHA – Oregon Medical Services

RESEARCH


• 151 Active Research Investigators• Research and Education Foundation• NW VA Cancer Research Center• National Center For Rehabilitative Auditory Research (NCRAR) • Mental Illness Research Education & Clinical Center (MIRECC)• Parkinson’s Disease Research, Education & Clinical Center (PADRECC)• Alcohol Research Center• MS Center of Excellence• NW Hepatitis C Center of Excellence• Methamphetamine Research Center• Center for the Study of Chronic, Comorbid Mental, and Physical Disorders• Agency for Healthcare Research and Quality (AHRG) Decision & Science Center

EDUCATION


• Primary academic affiliate is Oregon Health & Science University

• 138 affiliation agreements with 55 educational institutions

• 133.93 funded house officers in 33 different specialties

OREGON VETERAN POPULATION BY COUNTY


EXAMPLE OF ACCESS & GROWTH


Cumulative Growth

V20 Means

PDX All Vet Trends

PC Overview

V20 PC Trends

PDX PC Uniques

V20 Vesting Trends

PDX Vesting Trends

Comparison Trends

Historical Trends

Priority Overview

P DX P riority 1-6 Trends

PDX Priority Trends

Portland ALL VETERAN Unique Growth(Source: KLF MENU 10-28-07)

-0.9%

1.4%

4.9%

2.6%

6.8%

5.9%

8.2%

9.7%

5.4%

3.7%

2.8%

16.9%

-2.5%

-0.8%

5.3%

6.8%

29,901

32,758

34,976

37,029

40,060

54,152

56,136

57,718

46,841

27,842

27,146

26,900

27,267

28,725

51,367

28,508

31,920

-0.05

0

0.05

0.1

0.15

0.2

1991 19921993 19941995 19961997 199819992000 20012002 20032004 20052006 2007

-

10,000

20,000

30,000

40,000

50,000

60,000

70,000

1991 19921993 19941995 19961997 199819992000 20012002 20032004 20052006 2007

% Growth All Veteran Uniques

OIF/OEF VETERANS


• 48% are Active Duty, 52% are Reserve/National Guard

• 88% are men, 12% are women

• 65% Army; 12% Air Force; 12% Navy; 12% Marine

• 34% were deployed multiple times

• 52%, largest age group, is 20-29 years old

• 69% of those who filed disability claims received

service-connected disability compensation award

• As of March 2008, Oregon Facilities have enrolled approximately 5000 OIF/OEF veterans

OIF/OEF VETERANS


Veterans Tracking Application, March 5, 2008

NATIVE AMERICAN PARTNERSHIPS


• Continued sponsorship of Camp Chaparral, now in its 14th year

• Provision of VA staff to tribal clinics to assist with Post Traumatic Stress Disorder issues, to include training over 200 attendees

• Development of MOUs in Portland and Walla Walla to provide a mechanism for specialty care referrals and prescription support

• Provision of technical assistance in the development of electronic medical records at Warm Springs

Eligibility, Co-Pays, Fee, CHAMPVA


• Eight levels of eligibility (See Handout)

• Co-Pays depending on priority levels, Income, Special Programs and can be waived in certain circumstances (See Handout)

• Generally Fee Cards allow, in certain cases, for veterans to access non-VA services in rural parts of the state. These are on decline due to efforts to bring care closer to where veterans live

• Sometimes we contract (purchase) specialty care in the community when our ability to meet demand outstrips our supply

• CHAMPVA for spouses and Dependents, Few Oregon providers accept it. (See Handout)

OUT OF NETWORK CARE


VA may authorize payment of emergent inpatient care at non-VA facilities only when certain criteria is met. Care must be:

• For emergent treatment of a service connected disability

• For emergent treatment for any condition for a veteran rated permanently and totally disabled by VA regional office

• For female veterans if notified within 72 hours, and

• A few other conditions

OUT OF NETWORK CARE


If neither of these criteria are met, VA may consider inpatient claims for payment if the following is met:

• Veteran is enrolled in VA healthcare and has received treatment at a VA within the past 24 months

• VA is notified within 90 days of the admission

• Veteran has no other insurance

Under these conditions, payment is made only until medically stable.

Each case is reviewed based on eligibility and medical documentation and can be appealed.

If the veteran has other insurance, then VA does not pay

SUMMARY

Meeting the physical and emotional needs of all our Veterans is a complex undertaking

Oregon Facilities have and are continuing to improve access and meet unprecedented growth

OEF/OIF Veterans are increasing, bringing New challenges such as TBI


THANK YOU

For YourService to

Our Veterans


Welcome To care for him who shall have borne the battle and his widow and orphan. Abraham Lincoln...

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