Veterans’ Health Today
Need Care? We’ll Get You There!
As most Southern Californians know, getting from one place to another can take time and planning. For many Veterans, transportation is a significant obstacle to getting the health care that they need. Beneficiary travel benefits are one way that VA has dedicated resources to improving access to health care for our Veterans. Through these benefits, VA can reimburse eligible Veterans for mileage driven in a car. VA can also provide special mode transportation via a wheelchair, gurney van or ambulance for eligible Veterans who meet the medical requirements for such travel. However, those benefits come with eligibility criteria that not all Veterans meet. Enter the Veterans Transportation Service (VTS). VTS is a special program designed to enhance a VA facility’s ability to provide transportation to more Veterans through VA owned and staffed vehicles and improved partnerships and collaborations for community sponsored and subsidized options.
Charles Kirkman, Manager at VA San Diego Healthcare System, says this fairly new service fills a critical gap.
“Not all Veterans are eligible for Special Mode Transportation or reimbursement through the Beneficiary Travel program, that’s where VTS comes in to close the gap. The only qualifying criterion for VTS is to be a Veteran. Just like other travel programs, VTS allows for caregiver escorts and registered service animals. VA San Diego’s VTS also has some capability to transport Veterans with special needs such as wheelchairs, canes, and walkers.”
Kirkman says each participating facility sets its own guidelines. At the VA San Diego Healthcare System, for example, you must book at least 24 hours prior to your appointment, and you cannot book more than seven days before an appointment. Also, VTS drivers give you a two-hour window for pick-up to allow for traffic, weather, or other delays.
“We most often make residential home pickups or airport runs when Veterans fly in for care,” adds Kirkman. “But again, each VTS program sets its own guidelines.”
Kirkman, a Veteran with 25 years of service, says the program has gained a lot of momentum.
“VA San Diego is always exploring opportunities to expand and maximize services. If we cannot provide transportation for some reason, we give Veterans a list of low-cost community resources—we do what we can to meet their transportation needs. We simply want to ensure all Veterans have reliable access to health care or mental health services.”
At VA Greater Los Angeles Healthcare System (GLA) the VTS program is just getting off the ground. Jermaine DuPree, a 30 year Marine Corp retiree, was selected to launch and head what will shortly become a centralized travel office. GLA will be increasing the number of staff drivers available to transport Veterans to and from their appointments and adding vehicles and schedulers to improve the access to transportation.
At VA Loma Linda Healthcare System, the VTS program is expanding. With the upcoming opening of their Ambulatory Care Center in late 2016, VTS will be a critical component for health care access. In December, Loma Linda will start its first VTS 30-passenger bus shuttle between the Murrieta CBOC and Loma Linda. This long-range shuttle will travel from Murrieta, the Perris Transit Center or the Moreno Valley Mall to VA Loma Linda in the morning and return in the afternoon Monday through Friday.
To read more about VST, go to http://www.va.gov/HEALTHBENEFITS/vtp/veterans_transportation_service.asp.
To learn more about Beneficiary Travel reimbursement, go to http://www.va.gov/HEALTHBENEFITS/vtp/Beneficiary_Travel.asp.
To make travel arrangements for upcoming appointments, contact:
VA Greater Los Angeles Healthcare System
310-478-3711 ext. 41486
VA Long Beach Healthcare System
562-826-8000 ext. 4899
VA Loma Linda Healthcare System
909-825-7084 ext. 2063
909-825-7084 ext. 2063
VA San Diego Healthcare System
858-552-8585 ext. 7572
VETERANS CHOICE PROGRAM: WHO IS ELIGIBLE?
Eligibility requirements as of December 1, 2015
A Veteran must be enrolled in VA healthcare and meet one of the surrounding criteria.
Wait-Time (30 Days)
The Veteran is informed by his/her local VA medical facility that they are not able to schedule an appointment for care either:
· Within 30 days of the date the Veteran’s physician determines the Veteran needs to be seen, or
· Within 30 days of the date the Veteran wishes to be seen
No full-service VA facility
The Veteran lives in a state or territory without a full-service VA medical facility and lives more than 20 miles from such a facility. This applies to Veterans who live in Alaska, Hawaii, New Hampshire, Guam, America Samoa, Commonwealth of the Northern Mariana Islands, or the U.S. Virgin Islands.
(Note that the Veteran is not eligible under this criterion if he/she lives in New Hampshire and within 20 miles of the White River Junction VAMC.)
The closest VA medical facility where the Veteran can see a full-time primary care physician is more than 40 miles driving distance from his/her home.
The Veteran has to travel by air, boat, or ferry to the nearest VA medical facility.
Unusual or Excessive Burden
The Veteran faces an unusual or excessive burden in traveling to a VA medical facility based on geographic challenges, environmental factors, a medical condition, the nature or frequency of the care needed, and whether an attendant is needed.
Most Veterans must call 866-606-8198 to verify eligibility and set up an appointment. Veterans who qualify under the wait-time requirement will be contacted by VA partners directly to set up an appointment.
Visit www.va.gov/opa/choiceact for more information or to chat live with a VA representative.
Take your shot at fighting the flu. Get Vaccinated!
Stop by your local VA medical center to get your annual flu shot, and help the flu end with you.
Learn more at http://www.publichealth.va.gov/flu/vaccination/
VA Retail Immunization Care Coordination Program
VA and Walgreens are national partners, providing no-cost flu shots to enrolled Veterans of the VA health care system. From August 1, 2015 to March 31, 2016, enrolled Veteran patients nationwide have the option of getting their flu shot at any of Walgreens’ 8,000 locations in addition to their local VA health care facilities.
Military Sexual Trauma: You Are Not Alone
When Veterans are asked to complete confidential surveys, up to 70 percent of women and 30 percent of men say they suffered from sexual assault or sexual harassment during their military career. Sadly, many Veterans never tell anyone about their experience— and instead suffer with feelings of fear, shame, and guilt.
If this sounds familiar, you are not alone. Dr. Carolyn Allard, Military Sexual Trauma Coordinator for the VA San Diego Healthcare System, hopes you will stop suffering in silence.
“I encourage Veterans to seek our free, confidential services for mental and physical health conditions related to military sexual trauma,” she says. “There is a high chance you can get your life back.”
Military Sexual Trauma (MST) means that while serving our country, you experienced
· physical sexual assault, or
· threatening, unsolicited verbal or physical contact of a sexual nature.
“Any sexual activity that was unwanted or happened against your will is military sexual trauma,” Dr. Allard explains. “That includes someone touching your genitals or breasts when you didn’t want it or any sexual act obtained through pressure or force. Sexual harassment—when someone repeatedly makes derogatory, threatening remarks—is also military sexual trauma.”
Sexual assault and sexual harassment affect victims in many of the same ways, according to Dr. Allard.
“It is the same kind of trauma, and we think it’s vastly underreported. We want to break down the stigma that MST is not important or that it is something we can’t talk about. The overall physical and mental health of all Veterans is very important to us, and we want them to know we have free MST-related services available. There is hope!”
Service connection or disability compensation is not required to receive free treatment for MST, and your length of service does not matter. The benefit may be available even if you are not eligible for other VA care, and you do not need to have reported the incidents when they happened or have documentation that they occurred. There is no time limit on eligibility for MST-related care, meaning you can seek treatment regardless of when you served.
Every VA facility has a designated MST Coordinator—an advocate who can help you access VA services and programs, state and federal benefits, and community resources—and all Vet Centers also have specially trained sexual trauma counselors.
MST services may include individual or group counseling, marital and family counseling, and other assistance.
“We offer group treatment because it works, and it allows us to start helping more Veterans more quickly. These are not support groups—they are therapy groups that have helped many people. We also offer some Veterans the option to use community providers through the Choice Program.”
Dr. Allard says there is good news and bad news about MST.
“The bad news is that if you experienced MST, you are at high risk for posttraumatic stress disorder [PTSD] or other conditions that make it hard for you to function. MST has been related to PTSD to a greater extent than any other kind of trauma, including combat. That’s a pretty high-risk trauma.” Consequently, you may be dealing with mental or physical health issues often associated with PTSD, even if your encounter happened many years ago.
The good news? “We have come a long way in 20 years, and we have great treatment for PTSD. We understand it and can treat it, especially as it relates to military sexual trauma. We have very high success rates, and our treatment is free to MST survivors.”
If you aren’t sure whether you have PTSD related to your MST, or if you have questions, Dr. Allard suggests you visit the National Center for PTSD at www.ptsd.va.gov.
“You can learn the risk factors and symptoms, read about treatment options, and watch videos of Veterans who’ve gone through it and hear them share their experiences. It is a great website. Even if you have had years of treatment but still have issues, there may be another treatment that will fit you better.”
Additionally, VA conducts many PTSD studies, including within the Desert Pacific Healthcare Network, to learn about prevention and treatment. Veterans can access help through those studies, which ultimately contribute to science and help fellow Veterans.
“My work with Veterans who have experienced MST is rewarding,” Dr. Allard concludes, “but I would feel successful if I was out of a job—meaning military sexual trauma didn’t happen in the first place.”
To get help for MST, speak with your VA primary care provider or contact the MST Coordinator or Women Veterans Program Manager at your local VAMC. You may also contact your local Vet Center. Dr. Allard is available at (619) 400-5189. Also, a Safe Helpline offers confidential, one-on-one help by phone 24 hours a day at 1-877-995-5247.
To learn more about MST, visit www.sandiego.va.gov/services/Military_Sexual_Trauma.asp or www.mentalhealth.va.gov/msthome.asp.
Like other types of trauma, MST can affect your mental and physical health for years. Some problems associated with MST include:
· Feeling afraid, anxious, angry, irritable, depressed, numb, or alone
· Excessive feelings of guilt or shame
· Difficulty with interpersonal relationships
· Trouble sleeping, nightmares
· Problems with alcohol or drugs
· Suicidal thoughts or attempts
· Physical health problems, such as diabetes, chronic pain, gastrointestinal and gynecologic problems, or immune system disorders
A Call Away
For Veterans in need of help or advice, VA provides help at their fingertips, with a variety of resources just a call away — 24 hours a day, 7 days a week.
· Nurses are available for health care advice at 1-877-252-4866
· The Veterans Crisis Line aids Veterans in crisis (as well as their families and friends) at 1-800-273-8255, by texting 838255, or online at www.veteranscrisisline.net
· The National Call Center for Homeless Veterans hotline provides homeless or at-risk Veterans access to trained counselors at 1-877-4AID VET (877-424-3838) or online at www.va.gov/homeless/nationalcallcenter.asp
Quit Tobacco. WE Can Help!
Quitting tobacco is hard, but more than three million Americans successfully kick the habit each year. We can help you be a quitter, too!
“VA medical centers across the country have tobacco cessation support for Veterans,” says Dr. Tim Chen, Director of the Tobacco Cessation Clinical Resource Center for the VA San Diego Healthcare System. “Whether you use cigars, cigarettes, or smokeless tobacco—we can help.”
Dr. Chen explains that VA uses a two-part treatment plan because there are two parts to addiction.
“There is a physical addiction to nicotine, but there is also a behavioral aspect. So we use medication and counseling to give you the best chance to succeed,” he says. “Medication makes those first few weeks of quitting more comfortable, and counseling helps you identify and deal with triggers.”
Medications such as Nicotine replacement therapies, Bupropion (Zyban™) or Varenicline (Chantix™) help reduce the body’s need for nicotine, and they are especially helpful early in the process. Nicotine replacement therapies include a nicotine patch, nicotine gum, or a nicotine lozenge, according to Dr. Chen. Nicotine patch and Bupropion can be used in combination with nicotine gum or nicotine lozenge.
“Nicotine replacement therapies provide your body reduced levels of nicotine without the harmful ingredients of tobacco,” he explains. While the products VA uses are FDA approved, it is important to talk to your primary care provider before using one—whether a prescription medication or an over-the-counter nicotine replacement therapy.
Counseling teaches Veterans what events can trigger tobacco use—such as stress or boredom—and how to handle those triggers.
“Helping you learn to cope with urges and cravings is an important part of tobacco cessation,” Dr. Chen adds, “as is developing new behaviors.” Some people say, for example, that smoking is a habit: they answer the phone and light up; they finish a meal and light up. Counselors can help Veterans devise new, healthy habits.
“Even a few minutes of counseling or a few sessions can help,” Dr. Chen continues. “But the more counseling you receive or the longer the sessions, the better your chance of quitting for good.”
If you are not quite ready to quit—or you have tried before without success—Dr. Chen still encourages you to talk with your health care provider or a tobacco cessation counselor.
“Simply identifying the reasons that make you think about quitting might motivate you to actually attempt it,” he says. Some people quit for health reasons; others want to save money. Most Veterans say family is their main reason for quitting tobacco. Whatever your reason, you don’t have to go it alone, and it’s never too late.”
Dr. Chen emphasized that giving up tobacco really is the best thing you can do for your health.
“Your sense of smell comes back, your blood pressure drops, your lung function and blood circulation improve, your risk of heart attack and stroke go down, your risk of cancer declines, and you heal better after surgery.”
YOU have the power to give up tobacco. Let us help!For more information, including mobile apps that provide you with tips and strategies, go to www.publichealth.va.gov/smoking or text the word VET to 47848.
Also, the Smoking Quitline is available Monday–Friday from 8:00 am to 10:00 pm Eastern at 1-855-QUIT-VET (1-855-784-8838).
70 percent of Veterans who ever smoked have successfully quit.
News We Like to Hear ...
A Veteran who smoked for 63 years called 1-855-QUIT-VET to thank the service on his one-year anniversary of being tobacco free after using the Quitline!
Medication Allergies: What You Should Know
An allergic reaction, such as sneezing, is your body’s way of responding to a substance like pollen or pet dander. Some people, however, are allergic to certain medications, which can be life-threatening and require immediate medical attention.
Fortunately, there are things you can do to lower your risk of such an event. Maggie Mendes, a pharmacist who develops patient safety initiatives for VA Desert Pacific Healthcare Network, explains.
“If you are allergic to any medications, be sure to tell your health care provider and pharmacist so they don’t prescribe that medication or something similar,” she says. “Also, tell them if an immediate family member, such as a parent or sibling, has such an allergy, as that may increase your risk of being allergic.”
Medications more likely to cause an allergic reaction include antibiotics, anti-seizure drugs, anesthesia, dye used in scans or imaging procedures, and vaccinations—some people are even allergic to aspirin!
VA providers keep an updated medication profile in your electronic medical record to keep track of your drug allergies, as well as to prevent duplications of (or potential negative interactions with) other medications.
“Some drugs contain the same or similar ingredients,” Mendes says. “For example, you can purchase ibuprofen without a prescription, but certain prescription medications also contain ibuprofen—and too much can have serious side effects. That’s why it is important to tell providers and pharmacists everything you take, including over-the-counter drugs or herbal remedies.”
Keeping this list current also gives VA providers a “big picture” of your medications. Then, if you have a certain symptom—such as drowsiness or confusion—they can look at the list of medications and perhaps try to determine which one is causing it.
Mendes adds that when you get a new prescription, you should tell the provider and/or pharmacist about any reactions you have had to previous medications. You should also ask the following questions.
· What is this drug for, and how long will I take it?
· Will it interact negatively with other medications I take—prescription, over-the counter, or herbal?
· Should I avoid certain foods while taking it?
· What are the side effects?
· What are the symptoms of an allergic reaction or overdose?
The most severe type of medication allergy can result in anaphylaxis, which can be fatal. Symptoms may include shortness of breath, hives or itching, pain or tightness in the chest, and trouble swallowing. Other symptoms can include dizziness, low pulse, lightheadedness, feeling warm or flushed, nausea, vomiting, diarrhea, and ultimately loss of consciousness. Some patients also experience an anxiety attack due to the sense of doom that can accompany the symptoms.
If these symptoms are present and you suspect any type of allergic reaction, seek immediate medical treatment or call 911.
· VA facilities can print your medication list for you. Be sure to correct any errors on the list.
· When traveling, always pack enough medication for a few extra days in case your plans change.
· Ask your health care provider or pharmacist before consuming alcohol (even in small amounts) with your medication.
· Consider wearing a medical bracelet to notify caregivers of a severe allergy.
Thank you for your service. Now let us serve you.
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