1. OEF/OIF/OND Health & Benefits Overview VA

2. Department of Veterans Affairs (VA)

3. OEF/OIF/OND Program Program Manager Nurse & Social Worker Case Managers Transition Patient Advocate Other Case Managers (VIST, SCI, Women Veterans, Polytrauma) Program Support (Clerical) Programs located at all VA Medical Centers

4. VISN 11 VA Medical Centers in the “Mitten”

5. VISN 12 VA Medical Centers in the “U.P.” Iron Mountain (Oscar G Johnson VAMC) Hancock: Hancock Clinic Ironwood: Ironwood Clinic Manistique: Manistique Outreach Clinic Marquette: Marquette Clinic Menominee: Menominee Clinic Sault Ste. Marie: Sault Ste. Marie Clinic

6. Demographics: Michigan Total Veterans: 660,773 Total male Veterans: 610,652 Total female Veterans: 50,121 http://www.va.gov/vetdata/VeteranPopulation.asp http://www.va.gov/vetdata/VeteranPopulation.asp Sep 2013

7. Characteristics of OEF/OIF/OND Population Younger (18-29)– joined military for reasons of:  Patriotism – post 9-11  National need  Family history  Education and career training  Need for comradeship and guidance 65-70% have had multiple deployments creating major disruptions to their families and careers Many come home to experience relationship problems, re- employment problems, financial distress and other domestic issues. Smaller segment of older (29-50) individuals with similar but different needs – many have more resources so financial problems and/or employment issues are not as prevalent – relationship issues exist as does a powerful desire to maintain military career status

8. OEF/OIF/OND 1,791,420 Veterans have become eligible for VA health care since 2002 -- Of the total: 59% are former Active Duty and 41% are National Guard or Reservists 92% of Veterans seen at VA have been outpatients and ~7% have been hospitalized at least once in a VA health care facility VA Healthcare Utilization – Cumulative from 1 st quarter 2002, to 2 nd QTR FY2014

9. National Data on Diagnoses among OEF/OIF/OND Veterans Diseases of Musculoskeletal System 60.0% Mental Disorders 56.1% Signs/symptoms of Ill Defined 55.8% Nervous system/Sensory 48.7% Digestive system 37.1% Endocrine/Nutritional systems 36.3% Injury/Poisonings 31.3%

10. National Data on Diagnoses cont. Top 7 on previous slide Remainder of the most common medical problems range from Respiratory system (28.3%) to infectious/parasitic and neoplasms that are in lower or single percentages (4.6 to 1.6%) What we see locally mirrors the national statistics -- Muscle/joint problems – MH problems – Hard to define or multi symptom presentations VA Health Care Utilization among OEF/OIF/OND Veterans, Cumulative from 1 st Qtr. FY 2002 to 2nd Qtr., FY2014.

11. Health Issues “Nothing is pure” with this group – very seldom see one stand alone medical problem - Comorbid conditions are the norm -- Musculoskeletal Problems + psychosocial or mental health problems of anxiety, depression and PTSD are very common –(approximately 85% of service members present with this combination)  Musculoskeletal problems of back, hips, neck, shoulders are believed to be caused by the weight of battle gear + other equipment > Mental health symptoms are thought to impact service members for a variety of reasons: multiple deployments, no or little down time (constant vigilance), no front line (who is the enemy), different tactics (IED’s & secondary devices) –Service Members must develop keen skills to survive and many of these adaptations do not subside when returning home

12. Basic Healthcare Eligibility 24 continuous months (unless discharged for hardship, injury) Discharged under conditions other than dishonorable 24 continuous months (unless discharged for hardship, injury) Discharged under conditions other than dishonorable

13. Enrollment Requirements What We Need From You DD-214 copy VA Form 10-10EZ What We Need From You DD-214 copy VA Form 10-10EZ

14. Veterans of Operations Enduring Freedom, Iraqi Freedom, & New Dawn VA provides enhanced enrollment opportunity and five years of cost-free health care to veterans who served in a theater of combat operations, for any injury or illness associated with this service

15. Veterans of Operations Enduring Freedom, Iraqi Freedom, & New Dawn The five year window of care starts over with each additional deployment to a theater of combat operations

16. Non-Service Related Issues Veterans who experience Non- Service related illness/injuries Post Deployment may be charged a co- pay at VA for treatment of these conditions i.e. flu, colds, auto accident

17. Women Veteran Programs Women Veterans may receive  full continuum of medical benefits package  women’s family planning and birth control, gender- specific health care, e.g. hormone replacement therapy, breast and GYN care, maternity, limited infertility  Special considerations Each VAMC has a Women Veterans Program Manager

18. Medical Benefits Combat Deployment Screening Primary Care Services Prescription Services Mental Health Optometry Audiology Speech Pathology Neurology Dermatology & Wound Care Physical Medicine & Rehab (KT, PT, OT, Spinal Cord Injury)

19. Airborne Hazards “Airborne Hazards and Open Burn Pit Registry” Veterans of Southwest Asia theater of operations after Aug 2, 1990 (ODS) OEF/OIF/OND or in Djibouti, Africa after Sep 11, 2001 Register: https://veteran.mobilehealth.va.gov/AHBurnPitRegistry/ To learn more http://www.publichealth.va.gov OR call 1-877-222-8387http://www.publichealth.va.gov

20. Contact Information 616-285-5795 FAX 616-285-5898 www.vetcenter.va.gov Serving Combat Veterans

21. VET CENTER SERVICES  Vet Center Staff include Combat Veterans (Veterans serving Veterans)  Individual Counseling  Group Counseling  Military Sexual Trauma Counseling  Marital/Family Counseling  Bereavement Counseling  Drug and Alcohol Referral  Liaison with VA & Community Resources  Benefits Assistance Referral  Community Education and Career Referral

22. Compensation Education Vocational Rehabilitation & Employment Life Insurance Home Loan Guaranty VBA Benefits & Services

23. Burial for Veteran and Spouse Headstone, Flag, and perpetual care Nationwide Gravesite Locator 800-535-1117 or www.cem.va.gov National Cemeteries

24. Local VA Contacts VA Medical Center (VHA): 1-800-214-1247 Battle Creek VAMC Toll Free 269-966-5600 x35308 OEF/OIF/OND Program 269-966-5600 x36451 TPA (Mick) Vet Center: 616-285-5795 Grand Rapids Vet Center VA Regional Office (VBA): 1-800-827-1000 Detroit Regional Office www.va.gov