New Mexico VA Health Care System Wounds of War: Healing Trauma in Military Veterans and Their Families Navigating the Veterans Health Administration John

New Mexico VA Health Care SystemNew Mexico VA Health Care System

Wounds of War: Healing Trauma in Wounds of War: Healing Trauma in Military Veterans and Their Military Veterans and Their

FamiliesFamilies

Navigating the Veterans Health Navigating the Veterans Health AdministrationAdministration

John P. Buchanan, LISWJohn P. Buchanan, LISWFebruary 7, 2008February 7, 2008


U. S. Department of Veterans U. S. Department of Veterans Affairs - OverviewAffairs - Overview

• Veterans Health Administration.• Readjustment Counseling Service (Vet

Centers).– Albuquerque.– Santa Fe.– Farmington.– Las Cruces.

• Veterans Benefits Administration.• National Cemetery Administration.


Veterans Benefits AdministrationVeterans Benefits Administration

• Four geographical regions, 57 offices.• Western Region:

– Sixteen offices in 13 states, including NM.• Disability Claims.• Educational Benefits.• Vocational Rehabilitation.• Home loan eligibility.• Life Insurance.• Survivor benefits. • More…


National Cemetery AdministrationNational Cemetery Administration

• 125 cemeteries in 39 states.– New Mexico.

• Santa Fe• Fort Bayard

• Burial benefits.• Headstones.• Presidential certificates.• Flags.• Burial allowance.• Grave site in national cemetery.


Veterans Health AdministrationVeterans 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.


Veterans Integrated Service Veterans Integrated Service Network (VISN)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 New Mexico VA Health Care System (NMVAHCS)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.


EL PASO VA FacilitiesNew Mexico

El Paso

Durango


Community Based Outpatient Community Based Outpatient Clinics (CBOC)Clinics (CBOC)

• 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


VA Contract Community Based VA Contract Community Based Outpatient Clinics (CCBOC)Outpatient Clinics (CCBOC)

• 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


Albuquerque VA Medical CenterAlbuquerque 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.


Albuquerque VA Medical CenterAlbuquerque VA Medical CenterAffiliationsAffiliations

• 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.


Behavioral Health ProgramsBehavioral 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.


Behavioral Health ProgramsBehavioral 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.


Behavioral Health Programs (Con’t)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.


Access to Care - EligibilityAccess 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.


Access to Care - EnrollmentAccess 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.


OIF/OEF Intake ClinicOIF/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.


Access to Care – Primary CareAccess 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.


Behavioral Health Clinical ScreensBehavioral Health Clinical Screens

• 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.


Veterans Tracking Application Veterans Tracking Application (VTA)(VTA)

• 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.


VA Polytrauma System of CareVA 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.


Polytrauma Support Clinic TeamPolytrauma 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.


Polytrauma Support Clinic TeamPolytrauma 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.


OIF/OEF OutreachOIF/OEF Outreach

• 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.


OIF/OEF OutreachOIF/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.


OIF/OEF VA ContactsOIF/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.


National Suicide Prevention LifelineNational Suicide Prevention Lifeline

• 1-800-273-TALK (8255) Nation-wide.

• Available 24/7.

• Call Center refers information to local VA.

• Local VA Mental Health required to follow-up with the caller.

Documents

New Mexico VA Health Care System Wounds of War: Healing Trauma in Military Veterans and Their Families Navigating the Veterans Health Administration John