Veterans’ Health MattersVolume 1, 2009Inside this issue:VA National News .......p. 2 & 3VA Facility Highlights .......p. 4 & 5Word Search Puzzle.....p. 6New VA Leader Named.....p. 7Burial and Memorial Benefits.....p. 7A Laughing Matter.......p. 7

New Funding Expands Health Benefits to Priority 8 Veterans

The U.S. Department of Veterans Affairs (VA) has announced that, with the recent passage of Public Law 110-329, it is reopening enrollment in its medical benefits package to approximately 265,000 additional Veterans whose incomes exceed the current VA means test and geographic means test income thresholds by 10 percent or less.

The new law provides additional funding to allow expanded enrollment opportunities for some Priority 8 Veterans. It is anticipated that the change will be implemented by June 30, 2009.

The Veterans’ Health Care Eligibility Reform Act of 1996 (P.L. 104-262) established a priority-based enrollment system and provided a uniform Medical Benefits Package of health care services to all enrollees. The legislation opened enrollment in VA’s health care system to all eligible Veterans and required that each year the Secretary of Veterans Affairs assess Veteran demand and determine if the necessary resources are available to provide timely, quality care to all enrollees.

Enrollment for the lowest priority of the eight groups—Veterans who are not being compensated for a military-related disability and who have incomes above a set threshold—was suspended on January 18, 2003, although Veterans in that priority group who were already enrolled for care were permitted to remain enrolled.VA originally suspended enrollment for Priority 8 Veterans because it was unable to provide all enrolled Veterans with timely access to its health care services due to a tremendous growth in the number of Veterans seeking enrollment at that time. VA is now reopening enrollment for a portion of these Veterans without compromising the Department’s ability to provide high quality health care services to all enrolled Veterans who are eligible. This incremental approach to expanding enrollment allows VA to ensure that access to VA healthcare for a greater number of beneficiaries does not sacrifice timely access or quality for those Veterans already enrolled in VA’s health care system.

Policy Change

The new provision allowsVeterans whose incomes do notexceed VA’s means test thresholdsby more than 10 percent to enrollin VA’s health care system. Assoon as it takes effect, it willbe applied retroactively to allenrollment applications receivedon or after January 1, 2009.

Effect for Veterans

On the effective date of theregulation, a Veteran who appliesfor enrollment, who does not qualify for a higher priority groupand whose income exceeds VA’smeans test thresholds by 10percent or less will be placed ina priority group that allows theVeteran to be enrolled in VA’shealth care system.

Prior to the effective date ofthe rule, a Veteran who appliesfor enrollment, who does notqualify for a higher priority groupand whose income exceeds theVA’s means test thresholds by10 percent or less, will not beenrolled.

However, while VA is not advisingVeterans who may meet the neweligibility criteria to apply priorto effective date of the regulation,VA will inform Veterans andVeterans Service Organizationsof plans for the Health EligibilityCenter (HEC) to re-determinethe enrollment status of thoseVeterans who applied on or afterJanuary 1, 2009 but were rejectedfor enrollment due to income.

This approach reduces burdensto the sites (by not requiringVeterans to apply for enrollmenttwice in the same year), providesfor greater benefit to Veterans,and uses consistent incomeinformation in the applicationprocess. For those Veterans whoapply on or after January 1, 2009and are placed into a rejectedpriority group due to income,VA enrollment correspondencewill indicate that HEC willre-determine enrollment after theeffective date of the new rule.Retired Army Gen. Eric K.Shinseki, the newly appointedSecretary of Veterans Affairs,has pledged his complete supportfor this program, which is a top

priority within VA and will bemonitored on an ongoing basis atsenior levels of the organization toensure successful implementation.

For more information, Veteransare encouraged to contact VA’sHealth Benefits Service Center at1-877-222 VETS (8387), or visitthe VA health eligibility web siteat www.va.gov/healtheligibility.Also, each VA Medical Centerhas an Enrollment Coordinatoravailable to provide Veterans withinformation about their eligibilityunder this new provision.

VA National NewsHelping Veterans with Health Care Costs

For Veterans strugglingfinancially due to job loss ordecreased income, the VA offersprograms that can relieve thecosts of health care or providecare at no cost.

Veterans whose previous incomewas ruled too high for VA healthcare may be able to enter the VAsystem based upon a hardship,if their current year’s income isprojected to fall below federalincome thresholds due to jobloss, separation from serviceor other financial setback.Veterans determined eligibledue to hardship can avoidco-pays applied to higher-incomeVeterans. Qualifying Veteransmay be eligible for enrollment andreceive health care at no cost.

Also eligible for no-cost care orminimal co-pay are most Veteranswho recently returned from acombat zone. Many are entitledto five years of free VA care. Thefive-year “clock” begins with theirmilitary discharge.

Each VA medical center has anenrollment coordinator to provideVeterans information about these

programs. Veterans may alsocontact VA’s Health BenefitsService Center at 1-877-222 VETS(8387) or visit the VA healtheligibility web site at www.va.gov/healtheligibility.

VA Job Search for Injured Vets

Thirty percent of VA employeesare Veterans, with nearly eightpercent having service-connecteddisabilities. Yet, the VA intendsto increase the number of disabledVeterans in its workforce. Allseverely injured Veterans ofIraq and Afghanistan wars willbe contacted by VA’s Veterans EmploymentCoordination Service todetermine their interest in – andqualifications for – VA jobs.

Nine regional coordinators areworking with local facility humanresources offices across thecountry, to reach out to potentialjob candidates and to ensurethat local managers know aboutspecial authorities availableto hire Veterans. For example,qualified disabled Veterans ratedas having a 30 percent or moreservice-connected disability can behired non-competitively.

VA coordinators participatein military career fairs andtransition briefings, and partnerwith Veterans organizations,the Department of Labor’sVeterans Employment andTraining Service, as well asVA’s Vocational Rehabilitationand Employment Service, theMarine Corps’ Wounded WarriorRegiment and the Army’s WarriorTransition Units.

Injury Protection Program Expands

The VA has announced someseverely injured militarypersonnel and Veterans will beeligible for improvements to theServicemembers’ Group Life

Insurance Traumatic InjuryProtection Program, known asTSGLI. Changes are retroactiveto October 7, 2001.

VA recently completed acomprehensive review of theprogram, to consider whether itwas meeting its intended purpose,whether new injuries or lossesshould be added, and whetherimprovements could be made inhow the program is administered.As a result, VA has increased thenumber of injuries covered andliberalized the criteria of otherinjuries. New injuries coveredinclude the partial amputation ofa hand or foot and the degree ofinjuries based on severe burns.

Another important change is thepayment of a $25,000 benefit toservice members hospitalizedfor 15 consecutive days dueto traumatic injury, allowingpayments to begin earlier andfinancial help to be provided morequickly.

The TSGLI program is designedto provide severely injured servicemembers and their families withshort-term financial assistance.Service members who sustainedcertain severe injuries are entitledto payments ranging between$25,000 and $100,000.

TSGLI was designed to offsetthe expenses a service member’sparents or spouse often incurwhen they move to be with theirloved one during long and difficulttreatment and rehabilitationperiods. To date, more than $309million in TSGLI benefits havebeen paid to injured members andtheir families.

Veterans whose claims forTSGLI benefits were previouslydisallowed are being contactedif it appears their loss is noweligible for payment. Servicemembers or Veterans who

sustained severe traumaticinjuries are encouraged to checkthe VA Insurance web siteat www.insurance.va.gov foreligibility criteria and contactinformation.

For additional information aboutVA benefits, contact VA’s toll-freenumber at 1-800-827-1000.

Technology Improves Access to Care

Veterans with chronic conditionscan manage their health andavoid hospitalization by usingspecial technology provided by theVA in their homes, according to arecent study.

The study found a 25 percentreduction in the averagenumber of days hospitalizedand a 19 percent reduction inhospitalizations for patientsusing home telehealth. Forsome patients, the cost of hometelehealth services averaged$1,600 a year – much lower thanin-home clinician care costs.

VA’s home telehealth program,the largest of its kind in theworld, cares for 35,000 patients.VA officials, however, emphasizethat it does not necessarily replacenursing home care or traditionalcare, but can help Veteransunderstand and manage chronicconditions such as diabetes,hypertension and chronic heartfailure. Patients’ partnership withthe medical team can delay theneed for institutional care andmaintain independence for anextended time.

New Women Veterans Committee Members

The VA has announced theappointment of four new membersto the Advisory Committee onWomen Veterans, an expertpanel that advises VA on issues

and programs affecting womenVeterans. The new committeemembers are:

• Davy Coke, Poway, Calif., aretired Navy petty officer whoserved in Vietnam. He currentlyis a trainer and mentor fornew service members in theaerospace field.• Yanira Gomez, Germantown,Md., a former Army medicalspecialist who served in Iraq.She is currently nationaloutreach officer for the Veteransof Foreign Wars.• Gloria Maser, Alexandria,Va., a colonel in the ArmyReserves, and a former deputychief of staff for health affairswith the Multi-NationalSecurity Transition Commandin Iraq. She currently worksfor a strategy and technologyorganization.• Barbara Ward, Sacramento,Calif., a former Air Force staffnurse, currently serving asdeputy secretary for womenand minority Veterans affairsin the California Department ofVeterans Affairs.

The approximately 1.8 millionwomen Veterans constitute nearlyeight percent of the Veteranpopulation and about five percentof Veterans using VA health care.VA estimates that by 2020 womenVeterans will comprise 10 percentof the Veteran population.

VA has women Veterans programmanagers at VA medical centersand women Veterans coordinatorsat VA regional offices to assistwomen Veterans with health andbenefits issues.

VA Urges Vets to Sign-up for Direct Deposits

Every month, 730,000 Veteransor survivors look for theircompensation, pension checks oreducational assistance payments

in their mailboxes. In a fewcases, theft and mail delayscause problems, which can beprevented by direct deposits. TheVA is urging Veterans and familymembers now receiving paperchecks to join nearly 3.1 millionothers whose VA payments aredeposited electronically.

Veterans and family memberscan sign up for direct deposit bycalling VA toll-free at (800) 333-1795, enrolling online at www.GoDirect.org, or by contactinga VA regional benefits officeor their financial institution.Information about direct depositswill be included in VA’s monthlycompensation and pensionenvelopes throughout 2009.

Direct deposits relieve worryabout mail delivery being delayedby severe weather or naturaldisasters. The deposits alsoeliminate trips to banks or creditunions to deposit checks, whileproviding immediate access tomoney at the same time eachmonth.

New Services for Rural Veterans

As part of a two-year program toimprove the access and qualityof health care for Veterans ingeographically isolated areas,the VA is providing $21.7 millionto its regional health caresystems. The funds will be usedto increase the number of mobileclinics, establish new outpatientclinics, expand fee-based care,explore collaborations withfederal and community partners,accelerate the use of telemedicinedeployment, and fund innovativepilot programs.

The new funds will be distributedaccording to the proportion ofVeterans living in rural areaswithin each VA regional healthcare system, called VISNs, for

“Veterans Integrated ServiceNetworks.” VISN 21, the VASierra Pacific Network, witha population of rural Veteransbetween three and six percent,will receive $1 million.

VA Facility Highlights

Sierra NevadaReno VA Medical Center Honors Family for HelpOn January 9, the RenoVA Medical Centerpaid tribute to theStassinopoulos familyin appreciation for theirdonation of $100,000 inmemory of their uncle,Ioannis “John” A.Lougaris. The family flewfrom Athens, Greece tojoin Lougaris’ daughter,Betty Lougaris of LasVegas, to honor the lateMr. Lougaris, for whomthe facility was renamed in1981 as the Ioannis A. LougarisVA Medical Center.

Mr. Lougaris was born in 1887and immigrated to America in1907 from a small Greek islandin the Ionian Sea, Zakynthos. Hebecame a U. S. Citizen in 1915.In 1917, he enlisted in the U.S.Army and fought in World War I.After the war, he settled in Renoand began practicing law in 1927.Mr. Lougaris joined a neworganization shortly after itwas formed: the AmericanLegion. As a NationalExecutive Committeeman forthe organization, he went toWashington D. C. to campaignfor the building of a VA Hospitalin Reno. He kept up his fight tocontinue adding new additionsand new equipment until hisdeath in 1988, at the age of 100.

The generosity of the

Stassinopoulos family hashelped the Reno VAMC provideadditional equipment and servicesfor our Veterans, and we’regrateful for their support.

Pacific IslandsNew Outpatient Clinic Coming to Guam

On January 7, VA PacificIslands Health CareSystem (VAPIHCS)hosted a groundbreakingceremony for areplacement VeteransAffairs Community BasedOutpatient Clinic on thegrounds of the U.S. NavalHospital, Guam. The $4.5million, 6,000-squarefootconstruction projectincludes a free-standingVA clinic with its ownparking area and improvedentry through a dedicated accessroad connected to the adjacentpublic highway.

The ceremony was well attendedand extensively covered by theGuam media. Speakers includedGuam Governor Felix Camacho;Lieutenant Governor Dr. MichaelCruz; Rear Admiral WilliamFrench, USN, Commander NavalForces Marianas; Captain DavidMiller, USN, Commanding Officerof the Naval Hospital Guam;Captain Paul Fuligni, USN,Commanding Officer, NavalFacilities Engineering CommandMarianas; and VA PIHCSDirector Dr. James Hastings askeynote speaker.

The new clinic is designed to servean estimated 9,000 Veterans whoreside in Guam, and is expectedto be completed in approximately12 months. Efforts are also wellunderway to establish a VAoutreach clinic on the neighboringisland of Saipan to offer quality

health care to the growingnumber of Veterans who residethere.

San FranciscoNestlé Military Team Volunteers

A group of 53 Nestléemployees recently spenta day volunteering at theSan Francisco VA MedicalCenter, in their effort togive something back toVeterans. Through thecoordinated effort of theDepartment of VeteransAffairs’ Veterans CanteenService and the SanFrancisco VA Medical Center,Nestlé Military Team donated notonly their skills and talent, butalso $5,000.

The Nestlé staff broke up intofour teams, each tackling adifferent project. Two teamscompleted landscaping projectsin front of several clinic areas. Atthe Community Living Center,which serves as home to nearly100 Veterans, another teamplaced decorative rock and set uppots with soil and plants.

“Clean and Shine” was thetheme for the team whichfocused its efforts on cleaningand shining the wheelchairs ofthe residents in the CommunityLiving Center. Team membersscrubbed wheelchairs until theysparkled, much to the delight andappreciation of Veteran residents.Jeff Lozito, Director of NestléMilitary Channel stated, “Thisis the first group volunteeringproject Nestlé Military Teamhas performed. This was sucha worthwhile experience, andwe plan to continue having theNestlé Military Team volunteer atother VA Medical Centers.”

Palo AltoHomeless Program Receives National Recognition

Veterans make up nearlyone-third ofthe nation’shomelesspopulation.California hasmore homelessVeterans thanany state inthe Unionand the VA at Palo Altois taking those numbersseriously. The VAPAHCSrecently was awarded the

VA Secretary’s top Award forOutstanding Achievement inService to Homeless Veterans.Last year, nearly2,500 homelessVeterans receivedhousing orcare througha VAPAHCSinitiative calledTHRIVE (TheHealth and Resource Initiativefor Veterans Everywhere). Thisis the initiative that caught theattention of the Secretary inWashington, D.C.

“Our work at VA on behalf of ournation’s homeless Veterans isenhanced by so many outstandingorganizations, national andcommunity leaders and countlessvolunteers, who reach out withheartfelt compassion to theirbrothers and sisters on thestreet and in shelters,” said Dr.Keith Harris, chief of VAPAHCSHomelessPrograms. “But the fightto reclaim our nation’s heroesis far from over. Homelessnessis a complex issue and VAcontinues to work diligentlywith community partners to

develop strategies to end chronichomelessness in America.”

Central CaliforniaClinic Renovations in 2009

The EmergencyDepartment has beentemporarily relocated to thesecond floor of VACCHCS,while a major renovationtransforms the groundfloor into state-of-the-artemergency services. Therenovation project, costing$4.1 million, will double thetotal patient gurney bays,while improving the entirearea and adding new equipment.The new ER will reopen inJanuary 2010.

Other clinic renovations includethe Eye Clinic, with the additionof three new eye exam roomsand a larger waiting room. Thisproject is forecast for completionin June. The Primary Care ClinicRenovation project will add 10 newexam rooms, more restrooms andenlarges the consolidated waitingroom, while the clinics remainopen in a very busy area.

Construction is currently in Phase5 of 7, with completion expected byJuly. The Pharmacy Renovationproject includes a completelyrebuilt I.V. preparation roomand an outpatient medicationmail-out center to help ensurethe latest standards in safe andsterile medication preparations,and improving delivery times forprescription mail-out. Completionis expected in April.

In the first new building since1988, a stand-alone 12,000-squarefootOutpatient Mental HealthBuilding will be built, beginningin April. The Mental HealthOutpatient Programs, currently

in various locations in the mainhospital, will be consolidated inone outstanding new location,with a dedication ceremonyscheduled for January 2010.

Northern CaliforniaVolunteerism Among VA Providers

Healthcare providers atVANCHCS exemplify theVA spirit of selflessnessand generosity by donatingtheir skills for the benefitof underserved people.David Chapman, MD,and Tim Kress, RN,regularly participatein Flying Doctors, andrecently provided carefor needy individuals inthe Coachella Valley, inSouthern California. Inaddition to providing childcar seats and other social services,the team delivered health servicesto 1,377 people, mostly in themigrant labor community.

Another Northern California grouprecently completed a 20-day trip toNorthern India. Led by HarkeshSandhu, MD, the team, incollaboration with local providersand volunteers from Canada,delivered care to both rural andurban homeless citizens in a seriesof eight clinics.

The team included Dr. Sandhu;Arthur Swislocki, MD; MervynNicholas, PA; Joy Meier,Pharmacist; Wafa Samara,Pharmacy; Dolores Menesini,RN; Ann Manheimer, teacher;and Carol Bowden, Pharmacy.Approximately 4,500 people wereserved, receiving both medical andophthalmologic care, as well asfree medicines and counseling onmedication use.

Scott Carter, MD, a primary care

physician at the Martinez OPC,and his family, have made severaltrips to Central America, withseveral agencies, such as GlobalHealth Outreach, and AlternativeMissions, providing health care tounderserved rural people, and alsoassisting in building projects.

New VA Leader NamedRetired ArmyGen. EricK. Shinsekihas been appointedthe nation’s seventhSecretary of VeteransAffairs, assumingthe leadership of theDepartment of VeteransAffairs following hisconfirmation by theSenate.

“The overriding challenge I amaddressing from my first day inoffice is to make the Departmentof Veterans Affairs a 21st centuryorganization focused on thenation’s Veterans as its clients,”Shinseki said.

Shinseki plans to develop a2010 budget within his first90 days that realizes thevision of President BarackObama to transform VA intoan organization that is peoplecentric,results-driven andforward-looking.

Key issues on his agenda includesmooth activation of an enhancedGI Bill education benefit thateligible Veterans can beginusing next fall, streamliningthe disability claims system,leveraging information technologyto accelerate and modernizeservices, and opening VA’s healthcare system to Veteranspreviously unableto enroll in it, whilefacilitating accessfor returning Iraqand AfghanistanVeterans.

Shinseki, a formerArmy Chief of Staff,takes the reins of a284,000-employeeorganizationdelivering health care and

financial benefits to millions ofVeterans and survivors under a$98 billion budget authorized thisyear through networks of regionalbenefits offices and health carefacilities from coast to coast.

Born in 1942 on the islandof Kauai, Hawaii, Shinsekigraduated from the U.S. MilitaryAcademy at West Point, N.Y.,in 1965. He served two combattours and was wounded inaction in Vietnam. He servedwith distinction in Europe, thePacific and stateside, eventuallybecoming the Army’s seniorleader from June 1999 to June2003. Retired from militaryservice in August 2003, Shinseki’smilitary decorations include threeBronze Stars and two PurpleHearts.

Shinseki succeeds Dr. James B.Peake as Secretary of VeteransAffairs.

Burial and Memorial Benefits

A statement often heard bypersonnel in our DecedentAffairs Office is “Ourfather just passed away and wewere told VA would take careof everything.” Although somebenefits may be offered and used,burial arrangements are madeby the family, with the help of afuneral home of their choice.

For those eligible, benefits include:• burial in a VA or StateVeterans’ cemetery at no cost;• a burial flag which can be usedin a memorial service, keptas a memento or donated to anational cemetery;• an inscribed headstone ormarker for their grave at anycemetery;• a Presidential MemorialCertificate recognizing the

Veteran’s honorable militaryservice can be requested byfamily and friends.

Some Veterans’ familiesmay be eligible for monetaryreimbursement for burialexpenses. Details concerningreimbursement of burial expensesand other VA benefits may befound in VA Pamphlet 80-0-01,“Federal Benefits for Veteransand Dependents,” which canbe obtained from most VAoffices. Online information canbe obtained from the nationalcemeteries web sitewww.cem.va.gov.

Military honors are not providedby the Department of VeteransAffairs. Families may requesta funeral with military honorsfrom local Department ofDefense military bases or units.Additionally, Veterans serviceorganizations or volunteer groupsmay help provide honors.

A Laughing Matter:• The guy who invented the first wheel was an idiot.The guy who invented the other three, he was thegenius. (Sid Caesar)

• Fortunately the wheel was invented before the car,otherwise the scraping noise would have been terrible.(Laurence J. Peter)

• My therapist told me the way to achieve true innerpeace is to finish what I start. So far I’ve finishedtwo bags of M&Ms and a chocolate cake. I feel betteralready. (Dave Barry)