Patient Care Law Case Study

Keywords: veterans, Veteran Access, Choice, and Accountability Act of 2014, H.R. 3230, Clay Hunt Suicide Prevention for American Veterans Act of 2014, Clay Hunt SAV Act, Justice as Fairness, vulnerable population, healthcare disparities, healthcare reform, social justice

The Department of Veteran’s Affairs (VA) has been tasked with providing support and benefits to Veterans after they have completed their service. However, many Veterans are reporting difficulty accessing care due to systematic barriers within the VA’s Veterans Health Administration (Oliver, 2007). Complex eligibility requirements, long wait lists and lack of providers are a few of the issues Veterans are faced with when trying to access health and mental health care. Additionally, studies indicate that veterans, predominantly those from the recent wars in Iran and Iraq, have disproportionately high amounts of mental illness (Shim & Rust, 2013). These same veterans are experiencing difficulty accessing mental health care due to issues around a backlog of healthcare eligibility applications and a shortage of mental health providers through the Veterans Health Administration (VHA), which operates the Nation’s largest, integrated health care delivery system (APA, 2014). In 2014, at the request of the Chairman of the U.S. House Committee on Veterans’ Affairs, the VA Office of Inspector General (OIG) evaluated the merit of the allegations of mismanagement at the Veterans Health Administration’s (VHA) and the Health Eligibility Center (HEC).

This study strives to increase the awareness of healthcare disparities among veterans in hopes that veterans can receive the best healthcare possible. This study has the potential to change the structure of veterans’ health care. If their health care is damaged to the extent that some insiders and outsiders believe it to be, then hopefully the veterans’ health care system can be restructured. These disparities can be addressed in community outreach programs to expand common knowledge on the subject.

Over the past 15 years, the Veterans Benefits Administration (VBA) has seen a dramatic increase in the average degree of disability, growth in the number of compensation recipients, a rise in the number of medical issues claimed and an increased level of complexity of claimed issues. To illustrate this point, prior to the September 2011 terrorist attacks, 333,700 Veterans received compensation at the 70-100 percent level; however, these figures rose to over 1.1 million by the end of 2013. Additionally, since 2009, VA’s disability compensation workload rose 132 percent. This is in large part due to an unprecedented demand resulting from over a decade of war, military downsizing, economic issues, increased outreach, the addition of presumptive conditions and an aging Veteran population.

In the past few years there has been increasing discussion about how to provide adequate care for the increasing number of veterasn who are eligible for care through the Veterans’ healthcare administration (VHA). There are concerns is that the VHA is not providing the level of access, efficiency, and quality of care that veterans expect. Lee & Begley, (2016) suggest access to care for the veteran population may be resulting in poor health outcomes. In response to these concerns, the Veterans ' Access to Care through Choice, Accountability, and Transparency Act (VACAA) of 2014, also known as the Veterans Choice Act, was created to improve Veterans’ healthcare. The VACAA proposed to do this by expanding the number of options veterans have for receiving healthcare, by providing access for healthcare at non-VA care centers as well as providing for an increase in staffing at VA facilities (U. S. Department of Veterans Affairs, 2016).

There is a common belief that many combat veterans are suffering; many from invisible wounds that affect them in many ways. The challenge that the VA and other government agencies face is determining which veterans need help, there are several factors that affect this, from the individual’s desire to accept help, to the stigma that most veterans have accepted, which is “if they ask for help, they are weak.” During separation from the military it is a critical time for all soldiers, this time provides an opportunity for the military, the VA and our government to intercede and work with men and women while they are still soldiers. Veteran suicide is an epidemic, the number of veterans taking their life daily has been steadily growing, the statistic published by the VA is that twenty-two veterans end their lives every day (Suicide Data Report, 2012); steps have been taken to curb this number but the efforts have been woefully inadequate.

Current funding for veteran healthcare care is low and insufficient because of the large number of veterans, who are being discharged from the military as the country transitions to a democratic President. According to Dr. Rachel Nardin in her article about veteran healthcare, “Soldiers get excellent acute care when injured on active duty, but as revelations of poor conditions for soldiers receiving ongoing outpatient care at the Walter Reed Army Medical Center highlighted, service members often have trouble getting the care they need once active duty ends” (Nardin 1)

These rural veterans face numerous barriers in quest for access to health care, including: long travel distances to VA hospitals, limited provider choice, lack of specialty services, and inadequate provider supply. Rural veterans and non-veterans will benefit from this bill if they are allowed to receive treatment from delivery systems that allow nurse practitioners to practice with full authority

During the botched 2010 roll out of the affordable care act, multiple veteran’s agencies marched on Washington with fears of how the Tax/Mandate would affect indigent veterans who could not afford the penalty and could not afford secondary insurance. In their hubris, these agents pushed an agenda that has greatly hurt the veteran population.

For many years, the VA has offered health care to the men and women who have surrendered a large part of their lives to protect our nation. The VA has made great stride in providing specialized services to veterans such as Traumatic Brain Injury (TBI), Military Sexual Trauma (MST), and Mental Health treatment. In fact, the VA is leading the field on Post-Traumatic Stress Disorder (PTSD) research, but now that many of our men and women are returning home from war, the commitment that the VA made to provide accessible health services and a smooth transition from military life back to civilian life to these heroes and their dependents are not being granted in a timely manner. Studies show that suicide among veterans is the number one leading cause of death in the United States and

President Obama’s endorsed the “Veterans Access, Choice and Accountability Act of 2014” (Public Law 113-146) on August 7, 2014. The Veterans Access and Accountability Act often referred to as the “Choice Act”, set forth public law aiding the enhancement of veteran’s benefits (American Association of State Colleges Universities Policy Matter Brief, 2015). However, the goals of the “Choice Act” are to ensure that Veterans receive time “high quality” health care services (U.S. Department of Veterans Affairs,

Veterans are everywhere throughout the United States, but just because they are everywhere, doesn’t meant they are getting the proper care. According to the Iraq and Afghanistan veterans of America, “One in three veterans return home and suffer from some sort of mental health issue.” Their mental health issues vary from post traumatic stress disorder to anxiety and depression. The switch from fighting everyday to being home is tough for the veterans and they need to receive the proper treatment so they can possibly live a life as normal as possible. The state Department of Mental Health and Addiction Services, started a $810,000 program to support these veterans with their issues returning home. The transition is hard, not

Veterans Affairs is infamous for corruption and public scandals, yet have high rankings of overall patient satisfaction from outside reports. The Congressional Research Service estimates that there are about 21 million veterans in the United States and only 9 million veterans are enrolled in the VA. Only 5 million veterans actually received care during 2014’s fiscal year. “In a given year, not every VA-enrolled veteran receives VA health care services. Some veterans may opt not to seek care during the year, while others may receive care outside the VA system, paying for care using private health insurance, Medicare, Medicaid, the military health system”

As a result, it is important to identify these data and strategies to improve post-hospitalization follow-up for Veterans who are admitted to Non-VA facilities. There are two phases of this scholarly project. The first phase will focus on conducting a retrospective chart review from July 2016 to September 2016 for all Veterans who is admitted into Non-VA facilities. During the second phase of the scholarly project, one will evaluate the current practice and perform a comparative analysis of Chronic Care and Transitional Care Models with the evidence from literature search.

Another issue regarding the VA system is the limitations that is places on the abilities of the private sector to provide aid to Veterans. The private sector of the United States has no access to the files of former members of our military; as a result of this, a Veteran would potentially have to drive hours to get to a VA facility for something as simple as a flu shot. Veterans should be able to enjoy the benefits that they are entitled to without having to go a great distance. This very solution presents yet another conflict: the majority of returning military members are uninformed regarding what it is that they are medically entitled to. There is often far too little communication between VA facilities and Veterans concerning how they