Veterans

Confusion surrounds VA’s community care offerings after talk of program pause

Veterans Affairs officials are scrambling to explain what is happening with their community care offerings — President Donald Trump’s self-proclaimed signature achievement for veterans — after Capitol Hill staffers were told this week the program is facing a 90-day “strategic pause” because of the coronavirus outbreak.

On Wednesday, Veterans Affairs officials denied that major changes are coming to the outside care programs, which allow veterans to seek private-sector medical appointments paid for by VA funds.

But they also acknowledged that some new applicants who should be automatically enrolled in the program may be denied in the name of safety, a move which some advocates have suggested may be outside the department’s authority.

The community care program has been a major point of controversy in recent years for the department, which critics deriding it as a slow abdication of core of VA responsibilities to the private sector. VA estimates more than 1.5 million veterans will use the program for some medical appointments this year.

The confusion around the program stems from a message sent to congressional offices this week from Veterans Health Administration officials announcing they are considering “a temporary strategic pause in the MISSION Act access standards for 90 days, or until the soonest possible time that routine care may safely resume” because of the ongoing coronavirus pandemic.

“Completing non-urgent and routine health care appointments to meet access standards puts veterans at risk of contracting COVID-19 and also uses valuable healthcare resources that need to be conserved to respond to COVID-19,” the note from senior VA health officials said. “This is true for both VA and community healthcare providers.”

The news brought immediate concern from advocates who have pushed for years to broaden the community care program, arguing that VA does not have the capacity to see every veteran on a timely basis.

Senate Veterans’ Affairs Committee Chairman Jerry Moran said he has “serious concerns” about the idea of a temporary pause.

“When the VA cannot provide care to veterans, the VA is required under MISSION Act to send them to the community,” he said in a statement.

“As the VA’s role in the COVID-19 response grows … veterans should be able to continue accessing community care, which will keep them closer to home, prevent unnecessary exposure at larger VA Medical Centers and free up VA resources to fight COVID-19.”

But following the uproar, department officials insisted that the program is not being halted. VA press secretary Christina Mandreucci said the department “is not stopping or pausing the law, but ensuring the best medical interests of veterans are met.”

VA community care referrals for emergent or urgent clinical needs will proceed unchanged, and veterans with outside care appointments currently scheduled “should continue with this care as clinically appropriate and if available.”

However, Mandreucci said new cases “will be reviewed on a case-by-case basis for immediate clinical need and with regard to the safety of the veteran.” That plan will be in case even if veterans automatically qualify for outside care, because of significant wait times or travel distances with available VA facilities.

Nate Anderson, executive director of Concerned Veterans for America — a vocal proponent of the community care expansion — said those new restrictions go against Trump’s promises to broaden care options.

“VA should be working to remove barriers between veterans and their health care, not creating new barriers,” he said. “A blanket approach like the VA has proposed does not account for the unique circumstances facing many communities and their respective medical systems.”

In a separate message to veterans service organizations Wednesday, VA leadership said the original congressional guidance “was sent with good intent and out of an abundance of clinical caution, but the guidance lacked all the requisite concurrences prior to being transmitted to the field,” seemingly walking back the 90-day pause.

Both Moran and House Veterans’ Affairs Committee ranking member Phil Roe, R-Tenn., promised further investigation into the VA plan. Mandreucci said the new measures will be reassessed next month to determine whether changes need to be made.

“VA’s actions are in line with current Center for Disease Control recommendations and are necessary to help protect veterans from unnecessary COVID-19 exposure,” she said. “Many community health care systems are taking the same approach, and we anticipate less capacity in the community for routine care in an effort to limit foot traffic in their facilities and help stop the spread of COVID-19.”

Nationwide, more than 54,000 individuals have tested positive for coronavirus. VA officials said they have seen 365 cases among their patients, and four deaths.

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