Ask the Question: When the Answer is "Yes"

Transcript of video:

So you’ve asked the question
And taken a Military Service Health History
Now what?

Sometimes, after a good military health history is taken, 
or at any point in treatment or care, 
you might find that what the veteran needs exceeds what your facility or providers are able to treat, 
or you might know that another service, 
specific to military and service members, 
might be better suited for their needs 
or may even be less expensive or free.  

The unique needs, exposures and experiences of those who have served in the military sometimes require a willingness to collaborate and link with other means for appropriate care and services. 
The Toolkit includes many different resources and tools to help determine when referrals are necessary and how to talk to the patient about his or her options. 
One topic to be sensitive to is a referral to the VA. 
Most veterans, even if they are eligible, chose not to get their care at the VA. 
There may be several reasons for this- 
but the most common is the perception that the VA should be reserved for veterans who really need it. 
Meaning those who might not have health insurance to access private medical care. 
Some believe that the VA’s care is substandard or only meant for catastrophic injuries or illness. 
The reality is that the VA’s care is comprehensive and, for many specialties, state of the art. 
But another reality is that capacity is a chronic issue 
and wait times for appointments and needed care are infamously long.  
Another important factor when considering referral to the VA is that while the Toolkit treats anyone who ever served for any length of time as a veteran, 
the VA health care system does not, 
and eligibility must be met if the patient is not already enrolled. 
The Toolkit provides detailed information that can help providers and patients determine if they might be eligible for VA services.  

When suggesting a referral to the VA for care, you may face some resistance. 
It will be important to be respectful of the patient’s feelings but also take time to clarify the benefits of the referral and educate on some of the processes. 
You might find that the veteran feels rejected or dismissed.
Some of the stigma fears associated with military service and seeking health care are that private providers and facilities don’t want to deal with them or their needs. 
This also includes concerns that their military health insurance such as TriCare doesn’t reimburse as well as privately funded insurance 
and therefore facilities do not want to treat them. 
It is important to reassure and explain how the referral is in their best interest, 
how it may be specific to a certain health concern or problem they might have that is better suited for the VA, 
and that you and your facility are more than willing to continue to serve them for other health care needs. 
The Toolkit includes a worksheet with tips and information on how to talk to patients about referral to the VA.  
Identifying a military liaison in your facility who makes it a priority to be educated on these issues and who can guide patients through the process can save valuable provider time 
and is an indicator to veterans, service members, and their families that your facility or organization takes their care seriously 
and appreciates their service.  

Here are some examples of when to consider a referral to the VA:

Some veterans are not required to make copays at the VA- some veterans even qualify for free healthcare. 
If you have a patient who is struggling financially to engage in the care that they need, 
or has a high deductible and an expensive procedure is needed, 
explore the VA as an option for their needs. 
Many VA-enrolled veterans can get very low cost or free prescriptions, even for illness and ailments being treated in your facility. 

Some important services are free to all VA-enrolled veterans:
 such as… 
smoking cessation or weight loss programs,
special screenings and exams related to common exposures and health risks associated with service,
Counseling for military sexual trauma, 
readjustment counseling, 
certain cancer care treatments,  
and hospice care, to name a few. 

Do not assume that veterans know what they are eligible for. They often don’t. 

Here’s a quick tip that might help encourage a reluctant veteran to enroll in VA care.  
Many veterans do not know that by enrolling in their local VA, 
even if they never use it for any of their health care, 
they will actually help all veterans in their region. 
Individual VAs are federally funded and sourced based on the number of veterans enrolled. 
The more veterans enrolled, the more federal money for services that particular VA receives. 
Encouraging all veterans who are eligible to enroll in their local VA, 
even helping them do it,
 will improve quality and access to care for all of the veterans who rely on that VA for their health care. 
There is no downside to enrolling in VA care. 
They may never choose to use it, but they will help all of the other veterans who do. 
This Toolkit provides handouts that your providers and facilities can give to patients. 
The handouts contain information on how to determine eligibility, 
how to enroll in their local VA, 
how to file a VA disability claim 
and even how to contest or request an upgrade in discharge status. 
Use the handouts as is or adapt them to fit your facilities needs. 
In addition to the VA, individual states and communities often have services, 
charitable organizations and funds meant to support those who have served and their families. 
These services can be financial, health related, employment related, housing supports and the like.
This Toolkit includes many different resources for those living in NH.
 And these kinds of services, when not federally funded or supported, often have a broader definition of a veteran 
and thus allow for supports and services to be extended to those who otherwise may not be eligible for VA benefits and supports. 

Linking veterans to other services, 
staying aware of the collaborative services that are available- including programs at the VA, 
can be a time-consuming task. 
It cannot be emphasized enough how valuable a military liaison in your facility can be.