1. Elected Official Update Elizabeth Joyce Freeman, Director December 16, 2014

2. Update Agenda Veterans Choice Act (Special Briefing) Wait Times Upcoming Events

3. Background Veterans Choice Act is a major element of Public Law 113-146, passed Aug. 7, 2014 Funded at $10 billion nationally Temporary (up to 3- year) program to bridge gap while VA expands capacity, access Veterans choice increases access to care in the community, not a requirement

4. Background 9 million enrolled Veterans to receive a Choice Card Program to be run by a contracted third party administrator - Triwest Implementation began Nov. 5 Scheduling staff play an integral role in this implementation

5. Veteran must be enrolled in VA Health Care on or before August 1, 2014 or be a combat Veteran within 5 years of post-deployment AND Veteran who lives more than 40 miles away from a VA Point of Care (VAMC, CBOC) or faces unusual burden to travel due to geographical challenges 40 mile calculated using a straight line distance  Eligibility – 40+ Miles

6. Veteran must be enrolled in VA Health Care on or before August 1, 2014 or be a combat Veteran within 5 years of post-deployment AND VA Facility is unable to schedule an appointment within 30 days of the Veteran’s preferred date or the date determined to be clinically appropriate by the provider for a particular service Eligibility - 30 + days

7. Choice Card By January 2015 all eligible veterans will be provided with a Choice Card

8. Determine Veteran eligibility for Choice Program Managing call center to answer Veteran question 1-866-606-8198 Coordinate appointments for care Mailing of cards Coordinate care with VA staff Contact VA facility to cancel scheduled appointment when Veteran elects to use this program Role of the Third Party Administrator - Triwest

9. Bene travel available for these appointments Co-payments still apply Veterans are required to provide private insurance information for this program Prescriptions written by Choice provider needs to be paid from money authorized through PL 113-146 (same for Prosthetics) Pharmacy and Prosthetics benefit: utilizing current in-house process (same as other non-VA medical care prescriptions) Veterans Choice Program

10. Other Health Insurance (OHI) Veteran Choice Program Veteran must provide any OHI coverage information to use program; however Veteran is not required to have other health insurance. Non-VA provider will bill the Veteran’s OHI for treatment of non-service connected conditions. Veteran may be responsible for cost shares and deductibles owed by the Veteran’s health insurance policy.

11. Date deemed clinically appropriate by a VA health care provider If a time range is indicated (2-3 months) than the latest clinically appropriate date will be used to determine eligibility (desired date field) Most often used for established patients Clinically indicated date supersedes the patient’s preferred date when determining eligibility for this program Clinically Appropriate Date

12. If no clinically indicated date is available, then use patient preferred date For new patients will be determined in the following manner “What is the first date that you would like to be seen?” For Established patients the scheduler indicates when the provider would like to see them back and then asks the patient “When they would like to be seen?” – This is the preferred/desired date Veterans Preferred Date/Desired Date

13. When scheduling staff an appointment 30 days beyond the clinically appropriate date or preferred date than they will populate the Veterans Choice List (VCL) to indicate eligibility for this appointment Scheduling staff are responsible for notifying Veteran that they are eligible for this program If the Veteran indicates that he is not interested in the program, we still need to make a VCL entry Implementation is currently underway Eligible for 30+ Days

14. Total to Receive Card = 1380  EWL: 463 Veterans  VCL: 917 Veterans 30+ Days Choice Card Recipients

15. Veteran Questions 1-866-606-8198 VA intranet web site for Veterans http://vaww.va.gov/choice/ VA internet web site for staff http://www.va.gov/opa/choiceact/ http://www.va.gov/opa/choiceact/ Facility leadership and “Choice Champions” Important Resources

16. VA is posting regular data updates showing progress on its efforts to accelerate access to quality health care for Veterans who have been waiting for appointments. These access data updates will be posted at the middle and end of each month at the following website: http://www.va.gov/health/access-audit.asp Current Wait Time Data

17. Upcoming Events Second Quarter Veterans Town Hall: Calaveras County

18. Questions/Discussion Next Scheduled Update: March 2014