Welcome

1. VHA – Oregon Medical Services Welcome To care for him who shall have borne the battle and his widow and orphan. Abraham Lincoln Governor’s Task Force 5 June, 2008 Jack Heims, MSW, FACHE Portland VAMC Main Campus

2. VHA – Oregon Medical Services Our Organization • The Department of Veterans Affairs is comprised of • Veterans Benefits Administration – provides compensation and • pension, education, life insurance, loan guaranty, & vocational • rehabilitation & employment • National Cemetery Service – provides burial services to veterans • and their spouses • Veterans Health Administration – provides medical, surgical, • mental health & long term care services to veterans • Note: Military hospitals for active duty personnel are part of • the Department of Defense, for example - Walter Reed

3. VHA OUR MISSION Honor America’s veterans by providing exceptional health care that improves their health and well-being. OUR VISION To be a patient-centered integrated health care organization for veterans providing excellent health care, research, and education; an organization where people choose to work; an active community partner; and a back-up for National emergencies. Roseburg Facility OUR VALUES Trust, Respect, Excellence, Compassion, Commitment

4. VHA – Oregon Medical Services WHO WE ARE The Veterans Health Administration (VHA) is divided into 22 Veterans Integrated Service Networks (VISN's) The Oregon Facilities are part of VA Northwest Network VISN 20, which is comprised of the largest geographical land mass of any VISN within the Department of Veterans Affairs

5. VHA – Oregon Medical Services PORTLAND VA MEDICAL CENTER 149 inpatient & 72 nursing home beds Referral Center Full Continuum of Care Acute Medicine, Surgery, Psychiatry, Neurology, Rehabilitation, Emergency, Primary, Specialty, Transplant, Ophthalmology, Optometry, Cardiology, Endocrinology, Rheumatology, Geriatrics, Hemodialysis, Endoscopy, Chemotherapy, ENT, Orthopedics, Podiatry, General Surgery, Urology, Dental, Psychology, PTSD, Substance Abuse, Opioid Substitution,, Nuclear Medicine, Imaging, Path & Lab, Audiology, etc. Portland VAMC Main Facility Support VISN 20, Willamette National Cemetery, and two Vet Centers

6. VHA – Oregon Medical Services VANCOUVER FACILITY The Vancouver campus includes a 72-bed Nursing Skilled Care Unit/Comprehensive Rehabilitation Unit, Primary Care Clinic, Mental Health Clinic, Substance Abuse Treatment, Dental, Prosthetics, Community Nursing Home, Home and Community Based Care, Transitional Lodging Unit, Transplant Lodging Unit, Telephone Care, Warehouse, Laundry and VISN 20 Administrative Offices. A Single Room Occupancy Enhanced-Use Lease (EUL) exists on the campusalong with the Clark County Center for Community Health (EUL)

7. VHA – Oregon Medical Services Roseburg VA Medical Center & Southern Oregon Rehabilitation Center & Clinics • Roseburg VA Medical Center • Inpt PTSD, SA • Not all Specialties • surgical capabilities • Primary MH and Primary Care • SORCC (White City) • Primarily Rehab with 425 Beds • Primary MH and Primary Care

8. VHA – Oregon Medical Services Additional Medical Care Coverage provided by Community Based Outpatient Clinics • FT Current CBOCs • Bandon • Bend (expanded) •     Brookings •     Eugene (expanded) •    Klamath Falls •     Ontario •     Portland East  •   Salem •     Warrenton • Planned FT or PT Clinics • West Portland (12/08) • Burns • Grants Pass • The Dalles (9/08) • Lincoln County (FY09) • Ore City Area (FY09) • Bandon Relocate to North Bend

9. VHA – Oregon Medical Services Portland VA Medical Center FY07 OREGON VITAL STATISTICS

10. VHA – Oregon Medical Services RESEARCH • 151 Active Research Investigators • Research and Education Foundation • NW VA Cancer Research Center • National Center For Rehabilitative Auditory • Research (NCRAR) • Mental Illness Research Education & Clinical • Center (MIRECC) • Parkinson’s Disease Research, Education & Clinical • Center (PADRECC) • Alcohol Research Center • MS Center of Excellence • NW Hepatitis C Center of Excellence • Methamphetamine Research Center • Center for the Study of Chronic, Comorbid Mental, • and Physical Disorders • Agency for Healthcare Research and Quality (AHRG) • Decision & Science Center

11. VHA – Oregon Medical Services EDUCATION • Primary academic affiliate is Oregon • Health & Science University • 138 affiliation agreements with • 55 educational institutions • 133.93 funded house officers in 33 different specialties

12. VHA – Oregon Medical Services OREGON VETERAN POPULATION BY COUNTY

13. VHA – Oregon Medical Services EXAMPLE OF ACCESS & GROWTH

14. VHA – Oregon Medical Services OIF/OEF VETERANS • • 48% are Active Duty, 52% are Reserve/National Guard • • 88% are men, 12% are women • • 65% Army; 12% Air Force; 12% Navy; 12% Marine • • 34% were deployed multiple times • • 52%, largest age group, is 20-29 years old • • 69% of those who filed disability claims received • service-connected disability compensation award • As of March 2008, Oregon Facilities have enrolled approximately 5000 OIF/OEF veterans

15. VHA – Oregon Medical Services OIF/OEF VETERANS Veterans Tracking Application, March 5, 2008

16. VHA – Oregon Medical Services NATIVE AMERICAN PARTNERSHIPS • Continued sponsorship of Camp Chaparral, now in its 14th year • • Provision of VA staff to tribal clinics to assist with Post Traumatic Stress Disorder issues, to include training over 200 attendees • • Development of MOUs in Portland and Walla Walla to provide a mechanism for specialty care referrals and prescription support • • Provision of technical assistance in the development of electronic medical records at Warm Springs

17. VHA – Oregon Medical Services Eligibility, Co-Pays, Fee, CHAMPVA • Eight levels of eligibility (See Handout) • Co-Pays depending on priority levels, Income, Special Programs and can be waived in certain circumstances (See Handout) • Generally Fee Cards allow, in certain cases, for veterans to access non-VA services in rural parts of the state. These are on decline due to efforts to bring care closer to where veterans live • Sometimes we contract (purchase) specialty care in the community when our ability to meet demand outstrips our supply • CHAMPVA for spouses and Dependents, Few Oregon providers accept it. (See Handout)

18. VHA – Oregon Medical Services OUT OF NETWORK CARE • VA may authorize payment of emergent inpatient care at non-VA facilities only when certain criteria is met. Care must be: • For emergent treatment of a service connected disability • For emergent treatment for any condition for a veteran rated permanently and totally disabled by VA regional office • For female veterans if notified within 72 hours, and • A few other conditions

19. VHA – Oregon Medical Services OUT OF NETWORK CARE • If neither of these criteria are met, VA may consider inpatient claims for payment if the following is met: • Veteran is enrolled in VA healthcare and has received treatment at a VA within the past 24 months • VA is notified within 90 days of the admission • Veteran has no other insurance • Under these conditions, payment is made only until medically stable. • Each case is reviewed based on eligibility and medical documentation and can be appealed. • If the veteran has other insurance, then VA does not pay

20. VHA – Oregon Medical Services SUMMARY Meeting the physical and emotional needs of all our Veterans is a complex undertaking Oregon Facilities have and are continuing to improve access and meet unprecedented growth OEF/OIF Veterans are increasing, bringing New challenges such as TBI

21. VHA – Oregon Medical Services THANK YOU For Your Service to Our Veterans