Katherine Kemp: NHPCO Access Manager
- Welcome and introductions
- All We Honor Veterans partners received an annual educational needs assessment. We ask that you take a few minutes to fill this out. Your answers will provide us with ways to improve upon the program.
Amanda Bow – NHPCO Director of Communications
- In 2017, a We Honor Veterans quarterly digital newsletter will be in publication! The first edition will be released March 2017. The content will be focused on Veterans and partner stories. Please share stories of your Veterans, pinning ceremonies, Veteran Volunteers, etc. HERE or via email: Veterans@nhpco.org.
Arlene Stepputat & Hazel Blankenship – VetNet
- Arlene is the Manager of Volunteer Services at Visiting Nurses and Hospice Care in Santa Barbara, California. Hazel and her husband are the creators of the Pierre Claeyssens Veterans Foundation. This foundation was started 12 years ago, and raises one million dollars a year! All funds are spent directly towards Veterans.
- VetNet was created after Arlene attended a training program on homeless Veterans in her community. It was there that she recognized the assortment of organizations that had come together to gain a better understanding on Veterans needs and the power they could have if they all worked together. A board member of Visiting Nurses and Hospice Care then introduced Arlene to Hazel and VetNet was created.
- VetNet was created as a way to get groups that work with Veterans, networking with one another. The group was also able to come together and serve as a “safety net” for the Veterans in the community, facing distress. The group educates one another on how they each can benefit the Veterans in need in the community.
- Through VetNet, the group was able to assist two homeless Veteran families, during the holiday season. Veterans and their family members were provided with financial support, social support, housing, rehabilitation, etc. VetNet has had City Council Members present at meetings; they have been recognized by their local Congress Woman, and grown into a powerful program in the community.
- For more information on VetNet visit: http://www.vnhcsb.org/8690-2/
Q&A
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Q: What advice can you provide other organizations who may be interested in starting a program in their community?
A: Identify what your program will and will not do. For example, we are not a socializing group for Veterans; we are a group of not-for-profits and service organizations that are actively involved with Veterans. Also, it is nice in your first few meetings to have something to provide to your members. In our case we provided information on We Honor Veterans, why the program is important, and the statistics on Veterans dying.
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Q: I feel that I am limited to only tend to the Veterans in hospice care to use the funds that we have available. How did you provide funds to those not in hospice care?
A: We put out an email to everyone involved in VetNet about the situations that the Veterans were in and asking how the members of our group could help. Some organizations donated and some individuals donated to raise the funds to support the Veterans in need.
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Q: We are looking to recruit Veterans to volunteer at our facility. What is your advice on the best way to go about this?
A: We ask on our volunteer application “Are you a Veteran?” You may be surprised who amongst your volunteers already is a Veteran. American Legions, VFWs, the communities where Veterans get together are a great place to recruit. Your Veterans Volunteers can hold the pinning ceremonies, as long as a certified hospice employee is present. Often times finding out where Veterans go and asking the question is all that needs to be done.
Cynthia Robotham – Cape Cod Military Veteran and Family Collaborative
- Cynthia is the Volunteer Coordinator of Beacon Hospice, an Amedysis company. Beacon Hospice was the first hospice, in Cape Cod, to receive a Level Four with the We Honor Veterans program. Part of their success has been through reaching out to other organizations.
- Beacon Hospice reached out to local programs such as Adopt a Soldier, The Grace Center, and other Veteran-focused organizations, and invited them to their facility. After meeting, all of the organizations put their efforts together to create a website to improve access to services for Veterans: http://www.capecodveteransdirectory.com/
- The Cape Cod Military Veteran and Family Collaborative takes part in adopting Veteran families during the holidays. Veteran families will provide a wish list, and staff voluntarily gathers and supplies the items on the list. The group creates and distributes patriotic neck pillows to Veterans, as well as sends toiletries to active military. Another project that is currently underway is the development of five apartments for homeless Veterans, thanks to a donation of land.
- Recently a steering committee has been created to bring together all of the organizations that deal with Veterans, and develop a needs assessment.
For more information on the Cape Cod Military Veteran and Family Collaborative, please reach out to Veterans@nhpco.org and we will be sure to get you in touch with them.
Q&A
- Q: Do you have any advice for partners trying to join collaborations within their community?
A: The ability to contact someone within agencies with similar objectives as yours. Having the cohesiveness within your partnership to form ways to educate and reach out in the community.
Scott Shreve from the Department of Veterans Affairs: Updates from VA
- The No Veterans Die Alone Resource Manual has received positive feedback from VA staff, for the in depth resources available within the manual. Please be sure to take advantage of the resource.
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The Veterans Choice Act has been passed by Congress. This is an attempt to improve access to care for Veterans. Council has permitted the VA to use the Choice money towards home hospice care. Several, if not all, VA facilities will be converting over to use Choice money, which comes out of a separate accounting pot.
- How does this impact the community hospice provider? You will be asked to establish a provider agreement with a local VA medical center, if you do not already have one. Provider agreements are not contracts, they are far less intensive legally.
- There is no longer a requirement for Veterans to have a primary physician’s appointment prior to receiving payment for hospice care.
- In the past, we have struggled to share our educational resources outside of the VA. We are currently in the process of populating a platform with all of the resource materials on it. In addition, the VA will be able to provide free CEUs to the community. The EPEC for Veterans modules will be available to the public at the beginning of 2017, at which time WHV will send out an announcement to partners. They will be available on the TRAIN website: www.vha.train.org
Q &A
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Q: We are currently having a very difficult time getting the Dallas VA to respond to hospice appropriate Veterans. What are the best channels to go through to make a provider agreement happen?
A: The VA has not yet implemented this policy; we are currently in the process of writing the education technical sheets. The VA facility currently may not know how to fill out a provide agreement to work with a hospice system. As far as engaging with the VA to meet Veteran’s needs, each Veteran must be enrolled for VA benefits, however through the correct hospice contacts there are ways to get the paperwork expedited within a day or two. Also, be sure you are working with the correct clinical contact. If you would contact veterans@nhpco.org I can provide you with who I believe the best contact in Dallas is.
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Q: We are having challenges with getting paid for our services and this has been happening for the past 6 months. We are aware of who to contact and are responsive to bringing them everything that they need from us, however they are not responsive in return.
A: Billing in the VA is done by a separate program with the centralized business office. Please share with us at veterans@nhpco.org with whom you are in contact with. I believe that I can raise awareness of this at a leadership level in their facility.
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Q: As of November 28, 2016 CMS has put new requirements on nursing homes on anti-psychotics. We had a patient with numerous documentations about his PTSD and he was in a facility and they would not give him medication. He ended up going home with his wife to be cared for. The new law limits anti-psychotics and I was wondering if you knew of any new protocols to make exceptions for Veterans with PTSD.
A: I am not aware of any exceptions. VA falls under the same anti-psychotic protocol that Medicare does. Anti-psychotics are not the first line form of therapy for PTSD, however they are still used. There is a very shallow evidence pool of treating PTSD at the end of life and its interaction with delirium. I believe anti-psychotics have some value there. Additionally, JAMA recently published an article that I believe will change the treatment of delirium at the end of life. Bottom line, there is no good answer to that. CMS is a very powerful and steadfast with their public reporting on anti-psychotics.
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Q: Recently, news has been published regarding misappropriate care of a deceased Veteran in a VA hospital facility. How can you best tell us how we might address this through our network of accountability?
A: This is the first I have heard of a situation such as this in my 22 years in the VA. Secretary Bob McDonald and others are aware and doing everything possible to be sure that this rare event will never happen again. I believe this is an isolated event and I do not have any easy answers for this terrible situation.
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Q: We recently received news that all of our facilities have been registered as Veteran Choice Program providers and that we need to contact our local VA to verify that we are in their system. Who should we contact to verify this?
A: A whole other layer will be coming, which requires a provider agreement with the VA. Due to how new this is, your VA may not understand what it is you are referring to yet. If you can hold off until the VA has time to better educate VA staff on this implementation, I believe in the New Year we will be ready for implementing the process.
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Q: We are currently working with a retirement community that offers assistance to Veterans on income sensitive level, so they are unable to pay for homecare. By the time that they process aide and attendance they have passed away before they qualify for the benefit. In order to stay in independent care, the building has asked us to figure out the homecare benefits. The VA that we work with has told us to have the Veteran contact their case worker but by the point that they are on hospice they are on able to do so. Do you know of homecare benefits that they can tap into?
A: The VA does provide homemaker/ home health aide. There are significant incentives to using the homemaker/home health aide. The issue of duplication of services arises when hospices are asking VA to provide Homemaker/ home health aide. As far as the VA providing the services prior to hospice care, that is handled under geriatric services program. Please send an email to veterans@nhpco.org so that we can get you in touch with the correct geriatric contact within the VA.
Wrap Up and Next Meeting
- The next meeting will be in March, 2017. Have a wonderful Holiday season and we are looking forward to hearing from everyone again!
