New Mexico VA Health Care System Wounds of War: Healing Trauma in Military Veterans and Their Families Navigating the Veterans Health Administration John P. Buchanan, LISW February 7, 2008

New Mexico VA Health Care System U. S. Department of Veterans Affairs - Overview Veterans Health Administration. Readjustment Counseling Service (Vet Centers). –Albuquerque. –Santa Fe. –Farmington. –Las Cruces. Veterans Benefits Administration. National Cemetery Administration.

New Mexico VA Health Care System Veterans Benefits Administration Four geographical regions, 57 offices. Western Region: –Sixteen offices in 13 states, including NM. Disability Claims. Educational Benefits. Vocational Rehabilitation. Home loan eligibility. Life Insurance. Survivor benefits. More…

New Mexico VA Health Care System National Cemetery Administration 125 cemeteries in 39 states. –New Mexico. Santa Fe Fort Bayard Burial benefits. Headstones. Presidential certificates. Flags. Burial allowance. Grave site in national cemetery.

New Mexico VA Health Care System Veterans Health Administration Services and benefits are provided through a nationwide network of 155 hospitals. 881 outpatient clinics. 135 nursing homes. 46 residential rehabilitation treatment programs. 207 readjustment counseling centers (Vet Centers), 57 veterans benefits regional offices, and 125 national cemeteries.

New Mexico VA Health Care System Veterans Integrated Service Network (VISN) VISN’s provide close and continuing “hands on” supervision and leadership to local VA providers of care. 21 VISN’s nationwide. VISN 18 Headquartered in Phoenix includes Phoenix, Tucson, Prescott, El Paso, NMVAHCS, Amarillo, and Big Spring.

New Mexico VA Health Care System New Mexico VA Health Care System (NMVAHCS) Albuquerque VA Medical Center. Six Community Based Outpatient Clinics (CBOC). Six Contract CBOC’s. Provides PCP coverage for rural state. Social Worker at each site. Psychiatrist and Psychologist split time between Farmington and Durango. Flying Psychiatrist visits other sites. Tele-Mental Health with CNS.

New Mexico VA Health Care System EL PASO DURANGO VA Facilities New Mexico El Paso Durango

New Mexico VA Health Care System Community Based Outpatient Clinics (CBOC) Artesia VA CBOC (505) /3532 Farmington VA CBOC (505) /84 Gallup VA CBOC (505) /7235 Raton VA CBOC (505) /92 Santa Fe VA CBOC (505) Silver City VA CBOC 505) Clovis CBOC (Amarillo) (505) Hobbs CBOC (Big Springs) (505) Las Cruces (El Paso) (505)

New Mexico VA Health Care System VA Contract Community Based Outpatient Clinics (CCBOC) Alamogordo CCBOC (505) /9195 Durango CCBOC (970) Espanola CCBOC (505) Las Vegas CCBOC (505) T or C CCBOC (505)

New Mexico VA Health Care System Albuquerque VA Medical Center Level 1 tertiary referral center authorized to operate 310 beds, including: 158 acute hospital beds. 26 bed Spinal Cord Injury Center. 36 bed Nursing Home Care Unit. Primary care clinics & Specialty care clinics. Fee basis for services not available. Extensive Behavioral Health Programs.

New Mexico VA Health Care System Albuquerque VA Medical Center Affiliations UNM School of Medicine. –115 Full-time residents. Nursing Programs from: –UNM, CNM, Santa Fe Community College. NMHU, NMSU Social Work Programs Psychology Interns nation-wide. 70 Other academic/clinical programs.

New Mexico VA Health Care System Behavioral Health Programs Inpatient Programs: –26 bed inpatient acute care. 100 Residential Rehabilitation Treatment Program beds, including: –26 bed Psychosocial Residential Rehabilitation Treatment Program [PRRTP]. –24 bed Substance Trauma Abuse Residential Rehabilitation [STARR]. –40 bed Domiciliary Residential Rehabilitation (DRRTP). –10 bed Psychosocial Residential Rehabilitation (PRRTP) in Gallup NM.

New Mexico VA Health Care System Behavioral Health Programs Outpatient Programs –Affective Disorders Treatment Program. –Behavioral Medicine. –Crisis Response Team (Beacon Team). –Mental Health Intensive Case Management. –Neuropsychology. –OIF/OEF Program. –Posttraumatic Stress Disorder Clinic. –Women’s Stress Disorder Treatment Team.

New Mexico VA Health Care System Behavioral Health Programs (Con’t) –Psychiatry Primary Care. –Psychosocial Rehabilitation Program. –Substance Use Disorders Treatment Program. –Veterans Outreach Program (Homeless Services). –Telemedicine Program. –Psychological Services to Zia Spinal Cord Injury Center.

New Mexico VA Health Care System Access to Care - Eligibility Enrolled OIF/OEF Veterans within five years of their Date of Separation (DOS). –Means test if after 5 years, or –Has established service connected disability. Active duty, any branch of service: –Urgent/Emergent, any time. –MTF referred via formal consult (SF-513). –Routine referred back to MTF.

New Mexico VA Health Care System Access to Care - Enrollment To enroll, Veterans need: –DD-214, Copy 4, Certificate of Release or Discharge from Active duty. –VA Form 10-10EZ, Application for Health Benefits. Take to Enrollment, Bldg 41, Albuquerque VA Medical Center (Recommended). Take to any CBOC and they will Fax to the Enrollment office and provide instructions. (Alternate). Mail documentation to NMVAHCS, 1501 San Pedro Drive SE, Albuquerque Attn Eligibility.

New Mexico VA Health Care System OIF/OEF Intake Clinic Initiated August 1, Integrates Nursing, Medical and Behavioral assessments. Streamlines completion of clinical screens. Reduces the number of false positives for TBI and PTSD. Facilitates referrals/consults to specialty services.

New Mexico VA Health Care System Access to Care – Primary Care To get established with a PCP following enrollment: –Veteran should phone the appointments desk at (505) , Ext –Tell the appointment clerk you are OIF/OEF, this is important. –Select which morning you want to come in. –Eat nothing after midnight the night before except water, black coffee, medications. –Report to GMed A Clinic, first floor of main hospital at –Morning will include Labs, Orientation to MC, Nursing assessment, Primary Care Physician assessment, Behavioral Health assessment. –Process lasts from 0730 to noon.

New Mexico VA Health Care System Behavioral Health Clinical Screens Behavioral Health Clinical Screens Iraq/Afghanistan Post Deployment Screen. Traumatic Brain Injury (TBI) Screen. Posttraumatic Stress Disorder (PTSD) Screen. Military Sexual Trauma (MST) Screen. Suicidality Screen. Depression Screens. Alcohol/Drug Screen. Tobacco Screen. GAF Screen. Note: Positive screens are referred for further assessment.

New Mexico VA Health Care System Veterans Tracking Application (VTA) Tracks seriously injured service members. Provides location and transfer dates. Provides ID of case managers. Provides critical medical documentation: –From theater of operation. –From intermediate stops (Landstuhl Army Medical Center) Germany. –From ConUS MTFs and VAMCs.

New Mexico VA Health Care System VA Polytrauma System of Care Rehabilitation/ re-integration of those with polytraumatic & blast related injuries. 4 Centers: Richmond, Tampa, Minneapolis, Palo Alto + VISN support sites + Polytrauma Support Clinic Teams. Incorporate psychosocial/ mental health issues in care.

New Mexico VA Health Care System Polytrauma Support Clinic Team Members from neurology, SCI, social work, neuropsychology, psychology, occupational therapy, physical therapy and speech and language pathology, primary care. Provides TBI Level II assessments for positive TBI screens. Consults specialists as appropriate.

New Mexico VA Health Care System Polytrauma Support Clinic Team Oversees development of complete assessment and treatment plan. Refers patients to Level II (Tucson) or Level 1 (Palo Alto) Polytrauma sites as needed. Accepts consults for TBI Level II assessments from El Paso, Amarillo and Big Spring.

New Mexico VA Health Care System OIF/OEF Outreach New Employee Orientation. In-service outreach to MC staff. DoD Physical Evaluation Board lists. DoD service member separation lists. DoD Soldier Readiness Programs (SRP). –Predeployment briefings. DoD Reverse SRPs. –Post Deployment briefings.

New Mexico VA Health Care System OIF/OEF Outreach Post Deployment Health Reassessment (PDHRA). Outreach to Family Readiness Groups. Participation in Life Enrichment weekends. Welcome Home events. Focus Groups. Coordination/cooperation/involvement with stakeholders.

New Mexico VA Health Care System OIF/OEF VA Contacts Larry Bussetti, OIF/OEF Program Manger – , Ext or Bernard Duncan, BHCL OIF/OEF Coordinator. – , Ext Scott Anderson, Transition Patient Advocate. – , Ext Nancy Hall, Enrollment Supervisor – , Ext Use if long distance.

New Mexico VA Health Care System National Suicide Prevention Lifeline TALK (8255) Nation-wide. Available 24/7. Call Center refers information to local VA. Local VA Mental Health required to follow- up with the caller.