In the News

The Hays Daily News
Recent changes in the Veterans Choice program have improved health care options for military veterans in rural areas is the message Sen. Jerry Moran heard during a Friday visit at the Hays Veterans Affairs clinic.

The Hays VA facility is a community-based outpatient clinic of the Robert J. Dole VA Medical Center in Wichita. Other clinics are located in Dodge City, Hutchinson, Liberal, Parsons and Salina.

The Hays clinic, located in the Hadley Center, 207 E. Seventh, provides primary care services, behavioral health services including counseling, and laboratory and prescription services.

The Veterans’ Access to Care through Choice, Accountability and Transparency Act of 2014 was passed in response to a report by CNN that at least 40 veterans died while waiting for care at VA facilities in Phoenix. An internal investigation revealed the problem to be more widespread and resulted in the VA secretary and top health official leaving their offices.

The Veterans Choice program stipulated veterans who lived 40 miles from the nearest VA facility or who could not get an appointment within 30 days could seek treatment from a local, non-VA facility.

The $10-billion plan originally was set to expire in August, but last month President Donald Trump signed a bill extending the program until January or until the remainder of the funding runs out. Moran said U.S. Secretary of Veterans Affairs David Shulkin is working on a replacement for the Veterans Choice program.

In addition, the VA also has relaxed the requirement on the “40-mile rule” and expanded other regulations, giving staff at local clinics more discretion in referring veterans to local health care.

VA staff also has more discretion in declaring an undue and excessive burden for care, said Tracy Ramsey, acting chief of care at the Dole Medical Center.

Araceli Revote, chief of staff at the Dole Medical Center, said, for example, if a veteran’s medical team in Hays decides to order an MRI, it can be done at the hospital nearest the veteran rather than at the Dole Medical Center in Wichita.

“That’s how we define the expansion of (undue and excessive burden),” she said. “If they feel it’s a burden for the patient to travel, they just go ahead and order it. They know what’s best for the patients,” she said.

“Congress put those words in statute to give the VA authority to take care of circumstances that didn’t fit anyplace else, and then the VA developed regulations to narrow the scope,” Moran said.

“Ours is probably the most liberal with the definition,” Ramsey said.

The clinic staff told Moran 2,700 veterans are seen at the clinic each month, and they receive orders for new patients every day.

Dr. Harley Calvin said more education is needed to reach more veterans, however.

“Now we just need to be able to show and teach the veterans, the more elderly ones, so they’re not driving from St. Francis and Atwood down here at 90 years old. We need to make it easier for them to use their local providers but still receive the VA services,” he said.

Moran toured the clinic and showed particular interest in its telemedicine capabilities. Services such as behavioral health counseling, audiology, and fittings for prosthetics and walkers can be conducted with staff in Wichita through the Hays clinic.

A few select veterans are equipped to receive counseling at home, and portable equipment can allow the staff to provide home care visits with nutritionists and social workers, Revote said.

There still are some problems with the Choice program, Moran said, especially in working with the local physicians.

“We need to get the VA to the next point where all necessary services associated with the referral are also provided. There ought not to be an approval process for everything the physician orders once he or she gets their patients,” he said.

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