Transcript Slide 1

Wounds of War: Healing Trauma in
Military Veterans and Their
Families
Navigating the Veterans Health
Administration
John P. Buchanan, LISW
February 7, 2008
New Mexico VA Health Care System
U. S. Department of Veterans
Affairs - Overview
• Veterans Health Administration.
• Readjustment Counseling Service (Vet
Centers).
– Albuquerque.
– Santa Fe.
– Farmington.
– Las Cruces.
• Veterans Benefits Administration.
• National Cemetery Administration.
New Mexico VA Health Care System
Veterans Benefits Administration
• Four geographical regions, 57 offices.
• Western Region:
– Sixteen offices in 13 states, including NM.
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Disability Claims.
Educational Benefits.
Vocational Rehabilitation.
Home loan eligibility.
Life Insurance.
Survivor benefits.
More…
New Mexico VA Health Care System
National Cemetery Administration
• 125 cemeteries in 39 states.
– New Mexico.
• Santa Fe
• Fort Bayard
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Burial benefits.
Headstones.
Presidential certificates.
Flags.
Burial allowance.
Grave site in national cemetery.
New Mexico VA Health Care System
Veterans Health Administration
• Services and benefits are provided through a
nationwide network of 155 hospitals.
• 881 outpatient clinics.
• 135 nursing homes.
• 46 residential rehabilitation treatment programs.
• 207 readjustment counseling centers (Vet
Centers),
• 57 veterans benefits regional offices, and 125
national cemeteries.
New Mexico VA Health Care System
Veterans Integrated Service
Network (VISN)
• VISN’s provide close and continuing
“hands on” supervision and leadership to
local VA providers of care.
• 21 VISN’s nationwide.
• VISN 18 Headquartered in Phoenix
includes Phoenix, Tucson, Prescott, El
Paso, NMVAHCS, Amarillo, and Big
Spring.
New Mexico VA Health Care System
New Mexico VA Health Care
System (NMVAHCS)
• Albuquerque VA Medical Center.
• Six Community Based Outpatient Clinics
(CBOC).
• Six Contract CBOC’s.
• Provides PCP coverage for rural state.
• Social Worker at each site.
• Psychiatrist and Psychologist split time between
Farmington and Durango.
• Flying Psychiatrist visits other sites.
• Tele-Mental Health with CNS.
New Mexico VA Health Care System
Durango
El PASO
Paso
EL
New Mexico VA Health Care System
VA Facilities
New Mexico
Community Based Outpatient
Clinics (CBOC)
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Artesia VA CBOC
(505) 746-3531/3532
Farmington VA CBOC (505) 326-4383/84
Gallup VA CBOC
(505) 722-7234/7235
Raton VA CBOC
(505) 445-2391/92
Santa Fe VA CBOC
(505) 986-8645
Silver City VA CBOC
505) 538-2921
Clovis CBOC (Amarillo)
(505) 763-4335
Hobbs CBOC (Big Springs) (505) 391-0354
Las Cruces (El Paso)
(505) 522-1241
New Mexico VA Health Care System
VA Contract Community Based
Outpatient Clinics (CCBOC)
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Alamogordo CCBOC (505) 437-7000/9195
Durango CCBOC
(970) 247-2214
Espanola CCBOC
(505) 753-7395
Las Vegas CCBOC
(505) 425-6788
T or C CCBOC
(505) 894-7662
New Mexico VA Health Care System
Albuquerque VA Medical Center
• Level 1 tertiary referral center authorized to
operate 310 beds, including:
• 158 acute hospital beds.
• 26 bed Spinal Cord Injury Center.
• 36 bed Nursing Home Care Unit.
• Primary care clinics & Specialty care clinics.
• Fee basis for services not available.
• Extensive Behavioral Health Programs.
New Mexico VA Health Care System
Albuquerque VA Medical Center
Affiliations
• UNM School of Medicine.
– 115 Full-time residents.
• Nursing Programs from:
– UNM, CNM, Santa Fe Community College.
• NMHU, NMSU Social Work Programs
• Psychology Interns nation-wide.
• 70 Other academic/clinical programs.
New Mexico VA Health Care System
Behavioral Health Programs
• Inpatient Programs:
– 26 bed inpatient acute care.
• 100 Residential Rehabilitation Treatment
Program beds, including:
– 26 bed Psychosocial Residential Rehabilitation
Treatment Program [PRRTP].
– 24 bed Substance Trauma Abuse Residential
Rehabilitation [STARR].
– 40 bed Domiciliary Residential Rehabilitation
(DRRTP).
– 10 bed Psychosocial Residential Rehabilitation
(PRRTP) in Gallup NM.
New Mexico VA Health Care System
Behavioral Health Programs
• Outpatient Programs
– Affective Disorders Treatment Program.
– Behavioral Medicine.
– Crisis Response Team (Beacon Team).
– Mental Health Intensive Case Management.
– Neuropsychology.
– OIF/OEF Program.
– Posttraumatic Stress Disorder Clinic.
– Women’s Stress Disorder Treatment Team.
New Mexico VA Health Care System
Behavioral Health Programs (Con’t)
– Psychiatry Primary Care.
– Psychosocial Rehabilitation Program.
– Substance Use Disorders Treatment
Program.
– Veterans Outreach Program (Homeless
Services).
– Telemedicine Program.
– Psychological Services to Zia Spinal Cord
Injury Center.
New Mexico VA Health Care System
Access to Care - Eligibility
• Enrolled OIF/OEF Veterans within five
years of their Date of Separation (DOS).
– Means test if after 5 years, or
– Has established service connected disability.
• Active duty, any branch of service:
– Urgent/Emergent, any time.
– MTF referred via formal consult (SF-513).
– Routine referred back to MTF.
New Mexico VA Health Care System
Access to Care - Enrollment
• To enroll, Veterans need:
– DD-214, Copy 4, Certificate of Release or Discharge
from Active duty.
– VA Form 10-10EZ, Application for Health Benefits.
• Take to Enrollment, Bldg 41, Albuquerque VA
Medical Center (Recommended).
• Take to any CBOC and they will Fax to the
Enrollment office and provide instructions.
(Alternate).
• Mail documentation to NMVAHCS, 1501 San
Pedro Drive SE, Albuquerque 87108 Attn
Eligibility.
New Mexico VA Health Care System
OIF/OEF Intake Clinic
• Initiated August 1, 2007.
• Integrates Nursing, Medical and
Behavioral assessments.
• Streamlines completion of clinical screens.
• Reduces the number of false positives for
TBI and PTSD.
• Facilitates referrals/consults to specialty
services.
New Mexico VA Health Care System
Access to Care – Primary Care
• To get established with a PCP following enrollment:
– Veteran should phone the appointments desk at (505) 265-1711,
Ext 2743.
– Tell the appointment clerk you are OIF/OEF, this is important.
– Select which morning you want to come in.
– Eat nothing after midnight the night before except water, black
coffee, medications.
– Report to GMed A Clinic, first floor of main hospital at 0730.
– Morning will include Labs, Orientation to MC, Nursing
assessment, Primary Care Physician assessment, Behavioral
Health assessment.
– Process lasts from 0730 to noon.
New Mexico VA Health Care System
Behavioral Health Clinical Screens
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Iraq/Afghanistan Post Deployment Screen.
Traumatic Brain Injury (TBI) Screen.
Posttraumatic Stress Disorder (PTSD) Screen.
Military Sexual Trauma (MST) Screen.
Suicidality Screen.
Depression Screens.
Alcohol/Drug Screen.
Tobacco Screen.
GAF Screen.
Note: Positive screens are referred for further
assessment.
New Mexico VA Health Care System
Veterans Tracking Application
(VTA)
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Tracks seriously injured service members.
Provides location and transfer dates.
Provides ID of case managers.
Provides critical medical documentation:
– From theater of operation.
– From intermediate stops (Landstuhl Army
Medical Center) Germany.
– From ConUS MTFs and VAMCs.
New Mexico VA Health Care System
VA Polytrauma System of Care
• Rehabilitation/ re-integration of those with
polytraumatic & blast related injuries.
• 4 Centers: Richmond, Tampa,
Minneapolis, Palo Alto + VISN support
sites + Polytrauma Support Clinic Teams.
• Incorporate psychosocial/ mental health
issues in care.
New Mexico VA Health Care System
Polytrauma Support Clinic Team
• Members from neurology, SCI, social
work, neuropsychology, psychology,
occupational therapy, physical therapy and
speech and language pathology, primary
care.
• Provides TBI Level II assessments for
positive TBI screens.
• Consults specialists as appropriate.
New Mexico VA Health Care System
Polytrauma Support Clinic Team
• Oversees development of complete
assessment and treatment plan.
• Refers patients to Level II (Tucson) or
Level 1 (Palo Alto) Polytrauma sites as
needed.
• Accepts consults for TBI Level II
assessments from El Paso, Amarillo and
Big Spring.
New Mexico VA Health Care System
OIF/OEF Outreach
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New Employee Orientation.
In-service outreach to MC staff.
DoD Physical Evaluation Board lists.
DoD service member separation lists.
DoD Soldier Readiness Programs (SRP).
– Predeployment briefings.
• DoD Reverse SRPs.
– Post Deployment briefings.
New Mexico VA Health Care System
OIF/OEF Outreach
• Post Deployment Health Reassessment
(PDHRA).
• Outreach to Family Readiness Groups.
• Participation in Life Enrichment weekends.
• Welcome Home events.
• Focus Groups.
• Coordination/cooperation/involvement with
stakeholders.
New Mexico VA Health Care System
OIF/OEF VA Contacts
• Larry Bussetti, OIF/OEF Program Manger
– 505-265-1711, Ext. 5951 or 3302.
• Bernard Duncan, BHCL OIF/OEF Coordinator.
– 505-265-1711, Ext. 4723.
• Scott Anderson, Transition Patient Advocate.
– 505-265-1711, Ext 2799.
• Nancy Hall, Enrollment Supervisor
– 505-265-1711, Ext 4522.
• Use 1-800-465-8262 if long distance.
New Mexico VA Health Care System
National Suicide Prevention Lifeline
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1-800-273-TALK (8255) Nation-wide.
Available 24/7.
Call Center refers information to local VA.
Local VA Mental Health required to followup with the caller.
New Mexico VA Health Care System