We Honor Veterans Partner Networking Call Recording 09/13/17

Katherine Kemp – NHPCO Access Manager

  • Welcome and introductions.
  • NHPCO's Interdisciplinary Conference will be held September 18-20, 2017, in San Diego, CA, at the Marriott Marquis and Marina.
  • All are invited to attend the We Honor Veterans Partner Appreciation Event, Tuesday September 19, 5PM-7PM Pacific Time, in San Diego, CA, at the Marriott Marquis and Marina.
  • Hospice Foundation of America (HFA) Improving Care for Veterans Facing Illness and Death is available to our partners at no cost.
  • New Video resources are now available to help partners educate staff on Understanding Veterans' Benefits and Memorial and Salutes.

Lauren Drew – NHPCO Advocacy Manager of the Hospice Action Network

  • NHPCO and We Honor Veterans are asking you to help educate your Members of Congress about the important needs of Veterans and their families at the end of life, and the amazing work that you as a We Honor Veterans Partner do in your community.
  • How can you help with this important task? By inviting your Members of Congress to attend your upcoming We Honor Veterans events, and talking to them about the important hospice and palliative care legislation that will affect your patients. Not only does this help educate Congress about the needs of Veterans and their families, but it also promotes the importance of your program, and the value of hospice and palliative care in the American healthcare community.
  • Now, as healthcare reform is foremost on the minds of Congress, it is important to demonstrate how important access to quality serious illness and end-of-life care is to all Americans. Additionally, building relationships with Members of Congress helps raise the profile of your program, gain attention with local media, and broaden your base of awareness and support within your community. It’s a win-win-win!
  • Congressional schedules fill up fast; please let us know the details of your events ASAP. We will happily reach out to your Members of Congress to invite them to attend. You can even ask your Member of Congress to speak, present a flag, or take another role in your event if you like. We are happy to talk with you about your unique needs and make a plan that works for your program and your patients. Please let us know if you have events planned for October 6-20, or November 17-27, as there are Congressional Recesses and Members are more likely to be available during those weeks.
  • Additionally, the Hospice Action Network has prepared a Letter of Support that your organization can sign and send to your Members of Congress, indicating your support for the Rural Access to Hospice Act and the Patient Choice and Quality Care Act, and requesting their support of these important bills. Please feel free to edit the letter to reflect your unique program, place it on your letterhead, and email it to your Member of Congress. We can give you the correct address if you need it.

Carie Rogers - PsychArmor

  • PsychArmor Institute is a nonprofit that provides free education and support for all Americans to engage effectively with the military community.
  • PsychArmor is the only national institute of its kind, dedicated to bridging the military-civilian divide through free online education. Additionally, they provide a Support Center staffed with mental health experts that are ready to support you.
  • PsychArmor recruits nationally recognized subject matter experts to create and deliver online courses about issues relevant to the military and veteran communities. Our self-paced courses are delivered within six schools geared toward military culture, healthcare providers, employers, educators, volunteers, caregivers and families. We provide critical resources to all Americans who work with, live with, and care about Veterans.
  • A We Honor Veterans landing page has been created for We Honor Veterans partners to easily access resources that may apply to the work our partners are doing with Veterans. To gain access, register for free at https://psycharmor.org/register/ and access courses aimed at the needs of WHV partners by going to the dropdown “My Learning” and clicking on “My Dashboard”. You will have a list of courses you are already registered for and can explore and add more as you like.

Q&A

Q: How long are the courses?

A: All of the courses have different lengths. In the healthcare providers’ school, most courses are 30-60 minutes long, as they offer listeners CEUs. In the military culture or volunteer school the courses are typically 10 minutes.

Q: What does the symbol in the upper left hand corner of the presentations signify?

A:  We use these symbols to categorize the different types of schools represented in our courses. For example: caregivers support school is represented by a heart.

Q: Are these courses designed to be a one-on-one learning tool, or can educators use these courses to educate staff and volunteers?

A: We are happy to work with organizations to use the online learning to incorporate the material into a live course.

Q: Can we use these resources to meet our We Honor Veterans educational requirements?

A: Yes, there are plenty of courses that relate to the work your staff and volunteers are doing with Veterans. Please feel free to use Psycharmor resources to help meet your level requirements.

Q: Is a certification/documentation distributed following the course to prove completion?

A: No, however you are able to earn badges. You are also able to log into your account and see a list of the courses you have completed. If you take a course that gives CEUs you will receive a certificate following the completion of the course.

Ann Rehbein – Quilts of Valor (QOV)

  • Quilts of Valor Foundation began in 2003 with a dream. Founder Catherine Roberts’ son Nat was deployed in Iraq. According to Catherine, the dream was as vivid as real life. She saw a young man sitting on the side of his bed in the middle of the night, hunched over. The permeating feeling was one of utter despair. She could see his war demons clustered around, dragging him down into an emotional gutter. Then, as if viewing a movie, she saw him in the next scene wrapped in a quilt. His whole demeanor changed from one of despair to one of hope and wellbeing. The quilt had made this dramatic change.
  • The first QOV was awarded in November 2003 at Walter Reed Army Medical Center (WRAMC) to a young soldier from Minnesota who had lost his leg in Iraq. From Catherine Robert’s home in Seaford, DE, the Quilts of Valor movement spread across the nation and beyond through the power of word-of-mouth and the Internet.
  • The organization’s original mission statement said its purpose was “to cover all those service members and veterans wounded physically or psychologically with comforting and healing Quilts of Valor.”
  • Quilts are made through donated materials by volunteers. To date, 168,230 quilts have been awarded.
  • There are approximately 300 QOV groups, with a state coordinator in each state and multiple area coordinators throughout the states, as well as individual membership.
  • To request a quilt for a Veteran visit: https://www.qovf.org/. Typically, quilts can take anywhere from 8-6 months to be awarded. Recipients can be moved up the line if someone is very ill or a WWII Veteran.

Q&A

Q: How do we connect with our a hubs?

A: You can search the “who’s in my area” section of our website.

Q: Do all recipients have to be nominated to receive a quilt?

A: We do prefer that all recipients have an online document filled out and submitted through our website. You can also call your state hub if you would like to speak directly to somebody about receiving a quilt.

Q: Can recipients receive their quilts at home or in the hospice inpatient unit?

A: Quilts are given at a ceremony. It can be at their home, at a hospice inpatient unit, or in a public location where others are receiving a quilt.

Q: If someone would like to donate a quilt to QOV, how would they go about accomplishing that?

A: Our website explains the preferred material, size requirements, and standards of excellence required for the quilts being donated.

Q: If the patient passes before the quilt is received are we able to present the quilt to the Veterans family.

A: No, quilts are only presented to living Veterans. If the Veteran passes before the Veteran is able to receive the quilt the quilt will go to the next Veteran on the recipient list.

Scott Shreve – Department of Veterans Affairs

  • Care of Veterans from the Vietnam Era is a growing issue, not only from the demographic perspective but also from a knowledge and expertise perspective. If you have resources that you believe would be helpful for others please share them with us at veterans@nhpco.org
  • An additional $2.1 billion of funding to expand VA care was passed by the Department of Veteran Affairs, in August. Unfortunately, we are not permitted to use those funds to purchase hospice care. The way the Choice Act is written it is for other care. Other VA funds are still being used to purchase hospice funds for enrolled Veterans, when needed.
  • An article was published in Health Affairs, by researcher Susan Miller,  highlighting that the use of hospice by enrolled Veterans surpassed the private sector’s use of hospice. 
  • If a Veteran is receiving hospice care in their home under the Medicare Hospice benefit and decease directed care (palliative, radiation, immunologic, etc.) from their VA Medical Center, it may be beneficial to have the VA pay for the hospice care to allow the delivery of concurrent care. 

Q&A

Q: What kind of resources regarding Vietnam Veterans are you looking for?

A: We are looking to educate all caregivers on how to best care for terminally ill Vietnam Veterans. Any training programs, online links, etc. is of value to us as we look to provide assistance to hospice programs.

Q: Our understanding is that the VA has a mark distinction between combat Veterans and era Veterans and their benefits, death, burial, etc.

A: All enrolled, honorably discharged, Veterans have hospice as part of their benefit package. There are high income non-service connected Veterans that, under current law, cannot get enrolled in the VA system. If a Veteran starts to decline from terminal illness, the loss of two or more activities of daily living, they can be enrolled under the Catastrophically Disabled category. All Veterans that die in a VA facility have a VA benefit. However, depending on your service related status there are various degrees of support from the VA.

Q: Does Tricare for Life hinder anything dealing with VA vs Medicare hospice benefits?

A: Many active or retired military personnel do have Tricare benefits. As a VA doctor, working with VA benefits, I do not know how the Tricare system works. I recommend calling the Department of Defense with additional Tricare questions.

Q: Can you speak towards getting Veterans and their survivors signed up for the appropriate benefits, as well as the appropriate service related statement on death certificates, on a limited time frame?

A: There is a readily available list online called Presumptive Diagnoses. For example: if the Veteran’s foot touched ground on Vietnam soil, and later in life the Veteran developed Lung Cancer, that Veteran does not have to go through compensation and pension exams it is automatically presumed to be service connected. Prior to death, the Veteran can file a claim for pension disability. If the Veteran dies before filing the claim the survivor can file a claim after death. Whoever is doing the pronouncement, you must have the death certificate show that condition contributed to the death. Keep a list of the presumptive diagnoses readily available for your admissions teams.    

Q: What is the legislative status of the general receiving what now considered to be palliative care at the same time as receiving hospice are?

A: For Veterans the issues have been the disease directed treatment directed at the terminal illness. I do not believe any of the immunologic available, although potentially life prolonging, are being used for curative measures.

Lauren Drew: There are several bills attempting to address concurrent care however it is highly controversial and does come with a cost to the Medicare hospice benefit. The Medicare Care Choices Model (MCCM) - after its first trial there were issues with how strict the regulations were to become eligible for MCCM. We have worked with Medicare to loosen up some of the regulations to allow more patients into the program. We are hoping the pilot will come back with good data so that we can potentially take it to congress with an argument.

Q: Is the VA purchased hospice care identical to the Medicaid hospice care?

A: We may want to put this on another call agenda. When VA is paying for the care, sometimes the VA physician wants to be the physician of record, which is supported by the VA. However, some issues have come up that some VA physicians have weekends off and the hospice needs a contact person and are sent to either the emergency department or the hospitalist on call. Anytime the VA and a community hospice are working together, we believe open communication about expectations is extremely important, ie: who to call during off hours, what is the process for moving a Veteran form home to an inpatient unit, etc.

Partner networking

Q: Where can I find the notes from last quarter’s Partner Networking Call?

A: All calls are record and notes are posted on our website, along with a list of frequently asked questions for Scott Shreve