Clinics Help Usher In Wider Care for Vets

Medical care for millions of veterans is expanding under a sweeping change that guarantees treatment for virtually anyone who served in the military.

Eligibility changes mean nearly all veterans across the state will be able to get outpatient care, prescription medicines and a full range of medical benefits from the federal Veterans Health Administration. Previously, such benefits were guaranteed only to veterans with low incomes or those with service-connected disabilities.

The expansion of benefits, which went fully into effect Oct. 1, comes as the Department of Veterans Affairs reorganizes veterans medical facilities in California and nationwide to emphasize outpatient treatment and preventive medicine.

Nationwide, the VA has opened 263 community-based clinics in the past year, and 150 more are planned, officials say.

The move means a shift away from dependence on a handful of sprawling VA hospitals--such as those in Long Beach, West Los Angeles, Loma Linda and San Diego--that aging veterans may find difficult to reach and use.

The reorganization includes the opening of satellite clinics in Orange, Los Angeles and other counties across the state staffed with doctors to bring primary care into the community, said veterans officials.

“We have redirected many of our services so that 95% of our enrollees have a primary-care provider,” said Dr. Terry Wepsic, chief of staff of the Long Beach VA Medical Center. “We want you to know who to call with a question and to get care. It is the kind of care you or I would want to have as sophisticated consumers.”

New facilities opened in the past year include clinics in Anaheim, Culver City, Gardena, the Antelope Valley, Port Hueneme and Lompoc.

A clinic will open in Santa Ana on Dec. 1, and others will be staffed within the next several months in Hollywood, Palm Desert, San Luis Obispo, Vista and Chula Vista, said VA spokesman Dave Bayard. Others are being considered for south Orange County and Torrance or Carson.

The new program is popular, though the VA has no figures available for how many have enrolled since Oct. 1. Dozens of veterans were signing up one afternoon this week at the Long Beach VA Medical Center and a few at its satellite clinic in Anaheim.

Pasquale Murano, who served six years in the Air Force ending in 1961, typifies the kind of veteran targeted by the sweeping reform, which simplifies eligibility requirements for health care at VA hospitals and clinics.

Murano, 61, a retiree from Rockwell who lives in Buena Park, was signing up to add to the benefits he has from the aerospace company. Previously, he would not have been guaranteed care by the VA.

“It is a good thing to have,” he said, a few minutes before getting the colorful new national veteran health identification card and seeing a doctor. “You never know when you might need it.”

The new program has led to some confusion, officials say. Rumors were widespread in the veteran community that anyone who did not sign up by Oct. 1 would lose all eligibility, for example. The misinformation was spread on the Internet and by word of mouth, said veterans and officials.

In fact, there is no deadline and veterans may enroll in the new program at any time, receiving services the same day in some cases, Bayard said.

There are about 89,300 enrollees in Los Angeles and Orange counties--about 11% of the 796,000 eligible veterans. Nationwide, there are 3.4 million veterans using the system out of 26 million eligible.

Enrollees receive a magnetized enrollment card that identifies them and makes it easier for them to get treatment and for medical personnel to tap into their health history. Use of the card is optional.

Before the reforms, which were approved by Congress in 1997 and began taking effect earlier this year, veterans got care based on service-connected disability, need, status as a prisoner of war, or a string of other criteria.

Previously, eligibility “was very complicated. The point was to simplify this,” Bayard said.

Under the new program, all veterans who have served two years and received a discharge that was not dishonorable are guaranteed treatment at VA hospitals and clinics. The benefits range from immunizations to surgery to hospice care to mental health and substance abuse programs.

Veterans with household incomes exceeding $26,000 and who have no service-connected disabilities generally will pay $2 to $46.

Bayard said that in some instances qualifications varied from region to region and clinic to clinic depending on the demand for services. “If you went for services in Minneapolis in wintertime you could get whatever you wanted,” he said. “But if you went to a clinic in Florida, you couldn’t even get blood-pressure medicine.”

The new VA program is particularly useful for working veterans whose jobs do not carry health benefits and for retirees. In many cases, VA benefits are better than those provided retirees under Medicare, said Linda Karlson, a registered nurse and manager of the new Anaheim clinic.

Medicare, for instance, does not pay for drugs. But veterans pay $2 for a 30-day supply of medicine prescribed by a VA physician, she said.

The clinic program, which ends the long drive for many to distant hospitals, is drawing veterans who never before sought care from the VA, officials say. Since opening on Sept. 18, the Anaheim clinic has seen nearly 400 patients, with about 70% of them new to the program, said Karlson.

The new VA emphasis on preventive care is meant to reduce hospitalization by linking patients with primary-care physicians, said Dr. David Webb, deputy chief of staff for ambulatory care at the Long Beach VA facility.

Nationwide, the VA since 1994 has reduced the number of hospital beds by 52% and reduced inpatient admissions by 32%, while increasing ambulatory visits by 35%, according to a spokesman.

“We are opening clinics where people live so they can take care of themselves through preventive care and wellness programs,” Webb said. “The climate in Washington has changed.”

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Care Network

In an effort to emphasize outpatient treatment and preventive medical care, he Veterans Health Administration is opening clinics around Southern California. The locations:

SAN LUIS OBISPO COUNTY: San Luis Obispo*

SANTA BARBARA COUNTY: Lompoc**

VENTURA COUNTY: Port Hueneme**

ORANGE COUNTY: Anaheim**, Santa Ana*

LOS ANGELES COUNTY: Lancaster**, Hollywood*, Culver City*, Gardena**

SAN BERNARDINO COUNTY: Victorville**

RIVERSIDE COUNTY: Palm Desert*, Sun City**

SAN DIEGO COUNTY: Vista*, Chula Vista*

IMPERIAL COUNTY: El Centro**

**Open

*Open by March 199

Doctor now available for limited services on part-time basis at the Hollywood location.

Source: DEPARTMENT OF VETERANS AFFAIRS