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News
Smoke Signals
The facts on the VA's new enrollment plan
Answers to clear up misconceptions about changes
Smoke Signals recently printed a misinformed article that has been finding
its way into many hands. Joel Preston Smith, Public Affairs Officer at the
Portland VA Medical Center, submitted the following in hopes to clear up
any questions raised:
PORTLAND, OR The Department of Veterans Affairs launched a new
enrollment program this January to improve patient access to its services and
streamline the way the agency does business. Under the new system, veter
ans who have not received care since October 1996 must enroll in the VA
health plan to get care. Those who have received care since that time will be
automatically enrolled.
"Enrollment will make the VA system much more consistent from facility to
facility and from state to state," says Steve Zimmerman, Chief Financial Of
ficer for the Portland VA Medical Center. Zimmerman notes that under the
old system (which is being phased out in favor of the enrollment package),
each facility decided what "categories" of patients it would treat based on its
budget. Under the new system, every VA health care facility will open its
doors to the same categories of patients.
The enrollment plan is a product of the Veterans Health Care Eligibility
Reform Act of 1996; the primary purpose of the law was to simplify the rules
for providing health care to veterans and improve the cost-effectiveness of
care at the VA. One of the best parts of the law is that it repealed a require
ment that said that the VA could only give care for "disabilities." The law
now clearly allows the VA to provide essential preventive and primary care,
meaning that the VA can now take a much more active roll in helping patients
be healthy and productive members of their community. Veterans will not
have to wait, in order to get health services, until they are ill or injured.
The following facts address the new plan and what it means to patients and
providers alike.
Who has to enroll to get care? Nearly everyone. Veterans who have not
received care at a VA facility since October 1, 1996 must be enrolled after
October 1. Veterans can enroll at any time; however, we encourage veterans
to enroll as soon as possible.
The VA will automatically enroll any veteran who has received health care
in a VA facility since October 1, 1996. Those vets won't have to do any
paperwork; the VA will do it for them. If a veteran who is not enrolled comes
into a VA medical center for care, the staff will help the veteran complete an
enrollment application.
These veterans may not have to enroll (check with your local VA to see if
you meet the criteria):
Veterans with a service-connected disability of 50 percent or more;
Veterans who were discharged or released from active duty for a com
pensable disability that happened or was aggravated during their service
may be treated (without first being enrolled) within the first 12 months of
their discharge.
Veterans who are seeking care only for their service-connected disabil
ity. (We would still encourage anyone in the last two groups to enroll as
soon as possible).
If a veteran doesn't enroll by October 1, 1998 can he or she still get
care? Absolutely. The VA calls the process "rolling enrollment," meaning
that the process will continue indefinitely. Veterans can apply for enrollment
at any time.
How do patients enroll? First, a patient has to apply. Contact the nearest
VA health care facility and they will help you. For the Portland VA Medical
Center, call the eligibility hotline at (503) 273-5289. If you live outside the
503 area code, call the toll-free enrollment hot-line at 1-800-949-1004.
Once a patient is enrolled, can he or she get care at any VA facility?
Yes. There are approximately 1,100 service sites nationally in the VA health
care system. Veterans have the option of choosing a preferred VA facility for
their primary-care; veterans who heed specialized care may be able to choose
another facility (after their primary-care provider makes a list of recommen
dations). What benefits will veterans get under the new plan? Those who are
enrolled will be eligible for inpatient and outpatient services, including pre
ventive and primary care. Other services include: diagnosis and treatment;
rehabilitation; mental health and substance abuse treatment; home health, re
spite and hospice care; and drugs and pharmaceuticals in conjunction with
VA treatment.
What about veterans with health insurance? Can they still enroll for
care at the VA? Yes. The VA will bill a veteran's insurance carrier for any
care that is not rated as being service-connected. Veterans who are enrolled
will not be billed.
Is every veteran who applies going to be enrolled? We don't know yet.
Applicants will be placed in one of seven "enrollment priority groups." The
criteria for each group has been specified by Congress; the structure is simi
lar to the VA's current Category A, Category C system. The seven priori
tized groups range from group one (roughly, patients who have a 50 percent
or greater service-connected disability) to group seven: patients again, in
general terms who have no service connection and can usually afford non
VA health care.
Three main things will determine how many (and what types of) veterans
will be enrolled: the number of patients placed in each priority group, the
total number of veterans who apply, and the funds that Congress allots for
their care. If the VA has congressional funding, for example, for treating
only applicants in categories one through six, veterans in category seven would
not be eligible for enrollment (they could still get emergency care at the VA,
though).
Naturally, the VA hopes that when the line is drawn, it's drawn as a circle,
and it includes everyone who applies. Veterans will be notified by mail begin
ning in late spring of 1999 whether or not their application for enrollment has
been accepted.
Kwelth Tahlkie Culture and Hei
Kwelth Tahlkie Culture and Heritage Board is recruiting persons interested
in serving on its Board of Trustees. The term of office is for three years.
Two positions currently are vacant and are open to both tribal and non-tribal
members.
The Culture Board meets no more than eight times yearly to give direction
to the Board by making policy decisions. A Board Trustee helps oversee the
activities of a Culture Center staff and develop support from others, both
within and outside the Tribe.
The mission of Kwelth Tahlkie Culture and Heritage Board is to recognize,
affirm, and celebrate the historical and contemporary cultural achievements
of the Grand Ronde people; to preserve and perpetuate that culture and col
laborate with other groups and individuals with similar aims; to collect, pre
serve and interpret articles of cultural patrimony as well as documents, lan
guage and oral history; to use such resources as educational opportunities for
students and scholars alike.
tage Board seeking applicants
Interested applicants are encouraged to write a letter of application the Cul
ture Board office. Any letter should contain the answers to the following
questions:
a) Are you a member of any Indian tribe or married into the Grand Ronde
Tribe? If you are a tribal member, please include your roll number.
b) What do you think you have to offer to the Culture and Heritage Board?
c) Why do you want to serve on the Culture Board?
Please send the letter of application to Culture Board, 9615 Grand Ronde
Road, Grand Ronde, OR 97347; or call 879-2085 or toll free 1-800-422-0232,
ext. 2085.
All applications need to be received by Monday, June 1 to be considered.
A committee of the Culture Board will interview selected applicants in June
and make its recommendation to the Culture Board, which will advise Tribal
Council on these appointments.