Posted: January 25th, 2023

Free Emergency Mental Healthcare for Veterans

Posted in: General

DENVER — This week, the U.S. Dept. of Veterans Affairs (VA) announced veterans can get free emergency mental health care during an acute suicidal crisis. It would cover things like the transportation costs and even long-term care, including 30 days of inpatient care and 90 days of outpatient care. In a release the VA wrote:  “Starting Jan. 17, Veterans in acute suicidal crisis will be able to go to any VA or non-VA health care facility for emergency health care at no cost – including inpatient or crisis residential care for up to 30 days and outpatient care for up to 90 days. Veterans do not need to be enrolled in the VA system to use this benefit. This expansion of care will help prevent Veteran suicide by guaranteeing no cost, world-class care to Veterans in times of crisis. It will also increase access to acute suicide care for up to 9 million Veterans who are not currently enrolled in VA.”

The change is sending a very clear message to Dr. Eric French. “I think the most important thing to say at this point is to really make sure that these veterans understand, you know, listen, there is no need to shoulder this stuff anymore,” French said. “There are options, there are more options than ever. And, you know, this is not how it has to end. This is a point on the map that you’re navigating through not your final destination, so don’t shoulder it more than you have to come get some help.” French is a veteran and now a Greenwood Village-based specialist in mental health care for military and first responders. He is hoping to see an influx of people after the VA’s announcement. “We just felt it was very important that they had better options in the community,” he said. “And that there’s more people who actually know how to work with them. It’s a unique demographic, and I think many people can’t quite handle the level of trauma that we listen to on a regular basis. And you have to know how to navigate those waters delicately and appropriately.”

In an email, the VA wrote: “Veterans can get the emergency suicide care they need, when they need it, no matter where they are, without worrying about a bill. As of Jan. 17, 2023, VA will provide, pay for or reimburse emergency care for certain Veterans at imminent risk of self-harm, including ambulance and other transportation costs. Go to your nearest VA or community care facility to get emergency care. Regardless of VA enrollment status, you may also be eligible for up to 30 days of inpatient or crisis residential care, and up to 90 days of outpatient care, including social work. The Comprehensive Prevention, Access to Care and Treatment (COMPACT) Act of 2020 covers the cost of care during an acute suicide crisis if you were discharged after more than 24 months of active-duty service under conditions other than dishonorable, or you served more than 100 days under a combat exclusion or in support of a contingency operation either directly or by operating an unmanned aerial vehicle from another location, and were discharged under conditions other than dishonorable. COMPACT Act also extended eligibility for emergency suicide care to Veterans who were the victim of a physical assault of a sexual nature, a battery of a sexual nature, or sexual harassment during their service. VA established an expedited review process to ensure costs get handled appropriately.”

“And we’re hoping that at minimum, this information can help veterans realize that not only you know, is their emergency care important, but that there’s something waiting for them on the other side,” said Ben Kremer, a licensed clinical social workers with the VA Eastern Colorado Health Care System. The other side could include as much as 90 days of outpatient care that would be free but there wait times. Kremer shared: Accesstocare.va.gov is a resource for Veterans and their caregivers to find the latest access and satisfaction information, including wait times. For non-emergency care, the current wait time for individual mental health services at Rocky Mountain Regional VA Medical Center is 43 days for new patients, nine days for established. At PFC Floyd K. Lindstrom VA Clinic, our largest facility outside Denver metro, it’s 31 days for new patients and 16 days for established. Keep in mind, this data is consistently updated.

Veterans are considered new patients if they have not been seen by a provider or a clinical service at the same medical center for the same, or a related, health care need in the past three years. For new patient appointments, average wait time is calculated from the earliest time a request for care is consistently recorded in the scheduling system to the date the appointment is completed–or the date it is scheduled to occur if not yet completed. In many cases, Veterans who need a new type of care will have a referral entered by their provider into the medical record during a visit, and this starts the care coordination process. For appointments with a referral, this referral date is the starting point used for measuring average wait times and the end point is the date care is received or the date it is scheduled to occur if not yet completed. If he or she had an appointment in a clinical service at the same medical center for the same or similar health care need in the past three years (either in person or via phone/video), he or she is considered an established patient. For established patient appointments, average wait times are measured from the date agreed upon between a Veteran and provider for future care and ends on the date care is received, or the date that care is scheduled to occur if it has not yet occurred.”

Kremer said the VA is hiring more providers and expanding services to keep up with the anticipated influx of patients. He also said there is a system set up for patients who are in-between inpatient and outpatient care.  “A temporary follow up even if they aren’t established with care because the VA does recognize that we cannot just release people and expect things to be better,” said Kremer.  “Most often with depression and trauma, anxiety, insomnia, those tend to be the most common issues in that in that patient demographic,” said French. “And the, you know, the biggest concern being if we leave those things alone, and we don’t address them, the highest comorbid diagnosis with trauma is substance use disorder, because they’re just trying to check out of their heads.”

Waitlists aren’t a unique issue to the VA. We’ve heard of these issues across the board in a variety of health care systems and facilities.  As for inpatient care, Kremer said they are able to utilize the entire VA system to find a patient a bed, which means there shouldn’t be a wait list.  However, it could mean that a patient is transferred outside of their community or even out of state or brought to Colorado for care.  Kremer said their goal is to keep veterans as close to home as possible.  In a statement the VA wrote:

“In September, VA released the 2022 National Veteran Suicide Prevention Annual Report, which showed that Veteran suicides decreased in 2020 for the second year in a row, and that fewer Veterans died by suicide in 2020 than in any year since 2006.”

That’s why French said it’s so important veterans can now get care both in the VA system and outside, so they can find the care as quickly as possible with more options.  “I worry about that that population,” he said. “I was that population. And so yeah, it’s just nice to see that this is that’s such a clear message like, ‘Hey, we need to do right by you guys.'” The VA is anticipated there will be issues with some bills. They said if people call them or reach out with bill issues, they are expedited so veterans don’t have to spend as much time on sorting out bills.

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