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Expand health benefits to cover care for veterans outside the VA system.

By John Downing

Many VA medical centers are not sufficiently responsive to the needs of America’s veterans. Those who have fought should have a choice in where they get services that effectively meet their needs, including private medical care.

The VA health care system needs to become a partner in a community-based services approach if our nation’s veterans are going to receive effective care and support. Many new initiatives that are aligned with best practices are being implemented in the VA health care system. For instance, it is shifting from a focus on disease management to a patient-centered health promotion model. Patient Aligned Care Teams will integrate primary care, behavioral health and social support needs in many places.

Still, there are multiple systemic and retrograde “cultural practices” in many regional offices and VA medical campuses that pose barriers for veterans to access available care systems. Both the Veterans Benefits and Health administrations function within siloed structures and collaborative communication pathways have yet to be developed. Pension and benefits approval continue to be backlogged. Local and regional loyalties often take precedent over loyalty to the VA central administration’s initiatives. Staff hiring at medical facilities is slow and has not kept pace with needs because of aging veterans, recent combat veterans entering the system, new claims of Agent Orange exposure, post-traumatic stress disorder, traumatic brain injuries and sexual traumas.

Soldier On is an example of an integrated, community-based approach to serving veterans. We are one of the largest community-based providers of shelter, housing and supportive services, operating seven Supportive Services for Veteran Families grants throughout five eastern states. Next year, we are slated to increase our breadth of service and assist more than 5,315 veterans. Of the 306 veterans we house in our beds each night in our three Massachusetts locations, 98 percent are dually enrolled in both MassHealth and VA health care.
Soldier On’s service model is shifting from a shelter-bed provider to one that offers safe, sustainable and affordable permanent housing to veterans and flexible outreach services at the location of a former service member’s choice. These include transportation, medical, case management and mental health outreach where they live so that veterans have access to the appropriate level of services and receive support that ensures their well-being and dignity.

Soldier On partners with community-based agencies through its service areas, which provide targeted specialty services such as tenancy preservation, mediation and locating affordable housing. Peer specialists are trained by partnering organizations to assist veterans who have difficulty maintaining health, economic and housing stability. These strategies are effective because they are based on flexible, integrated care models, providing the right level and intensity of service based on a needs assessment and participant-driven housing stabilization plan. This also promotes collaborative, rather than duplicative, local and regional services through partnerships with other community-based agencies, health care, local government and businesses.

We urge our leaders to streamline veterans’ access to health care services through multiple front doors. We owe this level of responsiveness and respect to veterans who met their contract with America. It is our turn to meet this contract.