By Sam Baker, KERA Morning Edition Host
http://stream.publicbroadcasting.net/production/mp3/kera/local-kera-909349.mp3
Dallas, TX –
As part of the KERA Economy Project's series on affordable health care, we look at health care available through the Veterans Administration. 90.1's Sam Baker talked with Brenda Magness, a specialist in enrollment and eligibility. Also, Dr. Clark Gregg. He's chief of staff for the North Texas VA health care system, the 3rd largest VA system in the country. It currently serves about 105-thousand people. But Dr. Gregg says that number could be much larger.
Dr. Clark Gregg: We think that we have a market penetration of eligible, enrollable veterans of about 25 percent so we think that there are a number out there who could still enroll for care in our healthcare system.
Sam Baker: Why do you suppose they aren't?
Dr. Gregg: They either don't know about us or they have alternative means of care in the private sector, maybe not realize that the VA in the last ten years has significantly transformed from your father's VA. Started around 15 years ago, but in the last ten, there have been major steps forward in transforming the VA into a 21st century healthcare system.
Sam: Give me an idea of some of the things that have been done.
Dr. Gregg: We've got state of the art specialty care in both medicine surgery and mental health services, cardiac catheterization; the interventional cardiology program at our hospital ranks at the top of those in the Dallas community. We have major academic affiliations with a number of institutions including University of Texas Southwestern Medical Center, Baylor Dental School, Texas Tech School of Pharmacy, a number of nursing schools and allied health professional schools in the area to help us keep on the cutting edge of what medicine should be.
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Sam: So a vast difference then, from what people would have found 10, 20 years ago.
Dr. Gregg: We're much more oriented toward being patient-centered, making sure that our customer is happy, making sure that the services are delivered.
Sam: So Brenda Magness, then, who can receive veteran's healthcare and how?
Brenda Magness: Those that have served in active duty, military, naval or air service and received an honorable discharge following a minimum of 24 consecutive months of active duty, or your reservist and National Guard members who were called to active duty by federal order and they have completed the full call-up time. There is an enrollment process and it is based on geographical means thresholds and there are some financial criteria for enrollment. There are alternatives if you fall outside those guidelines or those thresholds.
Sam: For instance?
Magness: There are hardships. If you've received a change in your income or a change in your financial situation in your home, you can apply for a hardship.
Sam: There is a period though, once you've been discharged, in which you are automatically enrolled?
Magness: It is for those returning service members, the OIF, the OEF veterans, Operation Enduring Freedom and Operation Iraqi Freedom. Those veterans including the reservists and the National Guards who served active duty in a combat operation, have special eligibility for hospital care, medical services and nursing home care for five years following their discharge from active duty.
Sam: Once you're in the program then what type of services, Dr. Gregg, are you entitled to?
Dr. Gregg: All of the major medical, surgical and mental health subspecialties, with the exception of organ transplantation. We have all of the significant surgical subspecialties, either in-house or by our affiliations with our academic affiliates. We don't do organ transplantation or bone marrow transplantation on-site, but we refer these patients to VA transplantation centers and then we take care of them following the procedure back in our center.
We are expecting about 12 to 15 percent of our veterans to be female over the next 10 to 15 years and so our comprehensive women's health program is a recent development which is getting more and more resourcing and attention so that women would feel comfortable coming and having all of their primary care, including specific gender-related women's health care, in one clinic. Or if they prefer to have an internist in a regular clinic and then a women's health clinic for their gynecologic or breast care, they can have that done whichever way they wish.
In October of this year, we will be opening the new Fort Worth VA out-patient center. It will be on Interstate 20 at Campus Drive. It'll be a 240,000 square-foot center - the largest leased spaced VA clinic in the country. So this is going to be a major step forward in providing out-patient services to veterans, principally those who live in the catchment area from Grand Prairie west all the way out to the far end of the VA North Texas Healthcare System, which is around Brownwood.
There are a number of other big initiatives in rural health and trying to reach out to veterans who live in rural and far rural areas who might have difficulty getting to one of our major centers. The ideal within the VA would be to offer the same range of services to veterans wherever they might live. Obviously that's an ideal for which we can aspire, but it is an ideal. For instance, someone living in a far rural area would have access issues getting to say, the Dallas facility where all the subspecialty care is available. It's there if they're able to get there, but if they're unable to get there and if they live more than 50 miles from the Dallas, Fort Worth, Bonham, or Tyler facilities where some of these services would be, we have also ability to refer these patients to providers in their local community if the service is available at all, to try to make this as close to the veteran as possible.
Sam: One of the themes that we've had in these economy reports this month has been options available for people who now find themselves perhaps, without a job or without health insurance. If someone who is a veteran, but for whatever reason has not enrolled in the program, do they have an option then with veteran's healthcare?
Brenda Magness: Yes. We will be happy to help them through that. We have enrollment specialists that will be happy to help them through that process. We have a website and online application and it is at www.va.gov/healtheligibility. They can access that website and fill out the application online and we will process it. They may contact our eligibility staff by phone and we can mail out an application and help them answer their questions over the phone or they may appear in person at our eligibility department at Bonham, Dallas or Fort Worth, Monday through Friday and we'll have someone available to help them from 8 a.m. to 4 p.m. each day.
Sam: It's never too late to enroll, even if you wait years?
Magness: It is never too late.
Sam: Why is the North Texas system so large? Is there a greater need here than other parts of the state or other parts of the country?
Dr. Gregg: Because a lot of veterans in recent years have been moving from north and northeast to the Sunbelt. So the southern parts of the United States, especially the southwest, have been gaining more and more retiring veterans and retiring people in general, so that the number of possibly eligible veterans in this part of the country is probably going to continue to grow because of those climatic and geographical factors. The size of the different healthcare systems was determined out of Washington based on demographic considerations, probably based on population density. And we are divided up into areas considering issues of what kinds of facilities we had or could develop and what kind of access that our veterans could have to the systems that we put in place.
Dr. Clark Gregg is chief of staff of the North Texas V-A Health Care System. Brenda Magness is a medical administration program specialist.
You can find more about veterans' health care, along with our reports on affaordable medical and dental care at KERA.org/economy
U.S. Department of Veterans Affairs