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Albany VA hospital prepares rollout of new community care model

The Albany Stratton VA Medical Center.

VA

By JOHN CROPLEY | The Daily Gazette, Schenectady, N.Y. | Published: May 30, 2019

ALBANY, N.Y. (Tribune News Service) — Veterans will see roughly $50 million worth of upgrades on-site at the Albany Stratton VA Medical Center in the next year and see changes in how they obtain off-site community care starting next week.

Stratton has been working all month to prepare itself and its patients for changes to its community care model that take effect June 6.

The U.S. Department of Veterans Affairs launched an initiative it called Choice after it was rocked several years ago by a wave of reports on veterans suffering through lengthy waits for medical appointments. With Choice, vets can obtain authorization for VA-paid care at non-VA facilities when a formula of wait time and/or travel time shows that the patient would wait too long to be seen at a VA hospital.

While Stratton was rated one of the better VA hospitals among 157 nationwide, with only 1.39 percent of appointments taking more than 30 days to schedule, it still instituted Choice as part of the systemwide initiative.  

Now, the VA is replacing Choice with Mission, for Maintaining Internal Systems and Strengthening Integrated Outside Network, which is a similar arrangement but designed to better serve patients and be easier for the VA to administer. 

The VA Mission Act of 2018 was approved by Congress with wide bipartisan support and signed into law by President Trump. It drew some criticism as a move toward potentially privatizing the VA health care system but has attracted mostly positive reviews by veteran and military organizations that say it will be an improvement if it is implemented as it was envisioned.

Throughout May, the Stratton VA Medical Center has been using a variety of means to educate its patients, their advocates and various agencies about the arrival of Mission, and has been training staff to be ready for the changeover. That will continue when Stratton (@VAAlbany) hosts a Facebook Live event to discuss the switch from 1 to 1:30 p.m. on June 5.

“We understand any transformation of this size and on such a rapid timeline is not without risk,” Stratton VA Medical Center Director Darlene DeLancey said in a news release. “We are aiming for excellence in this effort, and we will continue to tweak and improve the process.”

Stratton VA spokesman Peter Potter said Wednesday that Mission will be better for patients than Choice, but not necessarily any easier to understand.

There’s still a formula of travel time, wait time, doctor availability and other conditions that determine whether a veteran must come to Stratton for treatment or is eligible to be treated closer to home by a VA-approved doctor. It's just an easier set of qualifications to meet.

The best way for veterans to learn what choices they have is to ask their primary care physician what those options are, Potter said.

The VA anticipates that most doctors who participate in Choice also will seek to be part of Mission, he added. 

Stratton patients will see certain practical changes as a result of the transition, Potter said. 

For example, patients who have needed heart surgery have been transported (at VA expense) to VA facilities in Manhattan or Buffalo for their procedure. Now, they’ll have the option of being treated by a non-VA doctor closer to home.

More-common procedures can be outsourced as well, Potter said, based on the calculation of transport costs and wait time. Stratton has approved an off-site colonoscopy as close as Glens Falls.

Stratton has the largest service area of any VA hospital in New York, from Plattsburgh to Kingston and from Vermont to Utica, Potter said.

It sees about 50,000 patients a year at its 117-bed Albany hospital and 11 satellite facilities, which include outpatient centers in Clifton Park, Schenectady and Troy. And it estimates there are 40 to 50 percent more veterans in Stratton’s service area who are eligible for VA health care but do not seek it.

The facility is the midst of a series of physical updates at a cost likely to exceed $50 million. These include: 

Sterile processing department, Phase II, $6.2 million, anticipated completion fall 2019;

Community Living Center renovations (two units), $11 million, anticipated completion December 2019 and January 2020;

Upgrade of elevators, anticipated cost roughly $5 million, anticipated completion February 2020;

Addition of 175 to 185 spaces to parking garage, work anticipated to begin autumn 2019, anticipated cost roughly $10 million;

Dialysis unit expansion, going out for bids shortly, anticipated cost $5 million to $10 million;

Six-bed expansion of Emergency Department, now in pre-design stage, anticipated cost $10 million to $15 million.

Potter noted that while an individual VA hospital such as Stratton may not be the biggest in its market — nearby Albany Medical Center is several times larger — it is part of the largest healthcare system in the nation, the Veterans Health Administration.

It has been an early adopter of technology and practices that the health care industry has pursued, such as electronic medical records, telemedicine and community health — or preventative health, as the VA calls it. 

Stratton has hired an acupuncturist and is looking to hire a chiropractor for patients who want to avoid drug-based pain treatments. 

It was the first hospital in the state to use the Telestroke system, Potter said, and on its first use, a neurologist working on a tablet computer in Arizona was able to treat a 93-year-old veteran in Albany. After being transferred to Albany Med as a precaution, the patient was able to walk out under his own power and go home that night.

So there is a wide range of care on-site at Stratton, and with the coming of Mission, there will be greater options for off-site care, Potter said.

“We’ve got a good network of providers,” he said.

©2019 The Daily Gazette, Schenectady, N.Y.
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