|
The purpose of the meeting was to conduct a follow-up meeting to the meeting held on April 30, 2008 with the Cambridge Health Alliance on coordination of services to veterans. |
September 10, 2008Committee Report #1
In City Council October 20, 2008 The Veterans Committee held a public meeting on Wednesday, September 10, 2008 at one o’clock and thirty-two minutes P.M. in the Sullivan Chamber. The purpose of the meeting was to conduct a follow-up meeting to the meeting held on April 30, 2008 with the Cambridge Health Alliance on coordination of services to veterans. Present at the meeting were Councillor Craig Kelley, Chair of the Committee, Robert Stevens, Veterans’ Services Director, Ruth Barron, M.D., Director, Adult Outpatient Psychiatry, CHA, Janet M. Dunphy, R.N., Campus Manager Case Management and Social Worker, CHA, Jackie Bisbee, Licensed Social Worker, CHA and Deputy City Clerk Donna P. Lopez. Also present was Nica Bell. Councillor Kelley convened the meeting and explained the purpose. At the previous meeting it was discussed that the Veterans’ Services Director work more closely with the Cambridge Health Alliance (CHA) in an effort to provide veterans who use the CHA a connection with the Veterans’ Service Department. This meeting is a follow-up to the previous meeting. Mr. Stevens stated that since the last meeting Mr. Buckley was going to facilitate a link between the Veterans’ Services and the CHA in an effort to identify veterans to get information to these individuals on veteran services available. This did not happen. Ms. Dunphy stated that patients are asked if they are a veteran. A brochure explaining benefits and services could be distributed to the identified veterans. The Massachusetts Health application asks the veteran question. However, the HIPA regulation does not allow the CHA to give patient information to the Veterans’ Director. Mr. Stevens suggested that patients could sign an authorization form to forward this information to his department. Ms. Dunphy stated that the veteran brochure could be given to CHA patients who are veterans. Mr. Stevens stated that he has updated the veterans’ brochure (ATTACHMENT A). He hoped that the new patient intake form would provide statistics on veterans. Mr. Stevens distributed a fact sheet regarding Veterans’ Benefits under Chapter 115 of the Massachusetts General Laws. (ATTACHMENT B) The veterans’ brochure could be made available to financial advisors at the hospital. The brochure does not include financial information. Individuals who receive free care from the Safety Net or Commonwealth Care recipients may be eligible for benefits through the veterans’ office. An authorization form would not be soliciting health information. If a patient is eligible financially he would like these patients to be referred to his office. The eligibility requirement is a monthly income of $1,700 or less. Health care is paid for by veterans’ services. The fact sheet is generic. Ms. Bisbee stated that at admission financial need is determined and patients are referred to free care. A release is required by the CHA to give patients information on veterans’ services stated Mr. Stevens. He is happy that the veteran question is being asked. The State of Massachusetts also has a generic brochure, but it lacks contact information for cities and towns (ATTACHMENT C). Dr. Barron stated that in the in-patient and out-patient system financial information is not always a question. It is difficult to get statistics for veterans who use the CHA. Mr. Stevens stated that for out-patient information about veterans benefits would be communicated throughout the CHA. The key point is to disseminate information to out-patients. Ms. Bisbee stated that the entry point for all patients is admissions. Ms. Dunphy added that registration does not ask the veteran question. Out-patients do not register. Registration information follows the patient. Councillor Kelley asked there are how many clinics? Dr. Barron stated that there are twenty-five clinics and three hospitals in the CHA. Councillor Kelley summarized the issue. Patient enters the system. Are you a veteran question is asked. Some veterans are not eligible for services. Eligibility could be sorted out quickly. Those eligible would be given a release form. Mr. Stevens commented that any veteran should be given the brochure and referred to the Veterans’ Department. The major piece is out-patients and if the veterans’ question is being asked. Patients send to free care should be encouraged to sign a release form. Mr. Stevens stated that he would like these veterans identified. If the patient is unwilling to give information they do not have to give the information. Mr. Stevens stated that he did not want to place a burden on the intake process. Dr. Barron stated that when the CHA asked the veteran question information was received on veterans from other countries and information on dishonorably discharged veterans. Mr. Stevens informed Dr. Barron that Massachusetts only covers United States veterans. Dishonorably discharged veterans are not entitled to benefits. Dr. Barron stated that the brochure should be distributed to the CHA. Mr. Steven stated that if the veteran question is answered in the affirmative he would like the patient to be given a brochure. Next he would like free care patients who are veterans identified because they are entitled to these services. Dr. Barron suggested to Mr. Stevens that he contact the insurance agencies and making an agreement with them to mail a brochure. Mr. Stevens stated that this is a state program, but is administered locally. It is a good idea to work with Mass. Health who is free care provider. Mr. Stevens stated that the largest group he would like to identify is the veterans. A subset of this group is free care patients. There are other benefits that these individuals may be entitled to such as tax abatements. Surviving spouses of veterans and dependent children or parents of veterans are entitled to benefits. He requested that the financial handout be given to financial personnel at the hospital. Dr. Barron asked where should veterans go to apply for benefits. Mr. Stevens stated that veterans apply in the city or town in which they live. Mr. Stevens complimented the CHA in identifying veterans. He will make the brochure available to the CHA. He asked that the veteran question be asked of out-patients. Councillor Kelley stated that at the conclusion of the last meeting Mr. Stevens was to meet with the financial advisors at the CHA. Could Mr. Stevens meet with the financial advisors at the CHA, he asked? Ms. Dunphy stated that she will ask administration. Mr. Stevens stated that he would like to meet with the financial advisors and the registration personnel at the CHA. Dr. Barron stated that the CHA CEO writes an e-mail newsletter. She would like the veteran information made available to the CHA hospital staff. Specifically that veteran applies for benefits in the city or town where they live and to contact their local Veterans’ Services Department. If a patient is not a resident of Cambridge they need to go to their local Veterans’ office. Focus should be on initial registration of patient. Councillor Kelley stated that the big issue from the last meeting was that the Veterans’ Director was to meet with CHA financial advisors. Due to personnel changes the meeting never took place. Mr. Stevens stated that he envisioned a formal communication between the CHA and the Veterans’ Services Department, but he see the problem. He urged CHA personnel to encourage patients in in-take, admissions and those having free care to apply for veterans’ services. Ms. Bisbee stated that she would pass this information onto the social work department. Councillor Kelley stated that if CHA could identify personnel where it would be beneficial for them to have this information for patients. Ms. Bisbee stated that patients have the right to decline service. Mr. Stevens stated that elder service agencies are identifying eligible veterans. Dr. Barron stated that the CHA could hold and publicize a town meeting and Mr. Stevens could explain the veterans’ services available. Mr. Stevens stated that he has attended many meetings at the senior center and shelters where he has explained the services available. Councillor Kelley stated that he and Mr. Stevens need to meet with Mt. Auburn and Mass. General Staff on this matter. Mr. Stevens stated that he needed to coordinate this effort at the state level. Ms. Bisbee stated that there are only three public systems in the state. They are CHA, Boston Medical and U Mass Medical. A state-wide approach could be done later stated Mr. Stevens. Mr. Stevens stated that he would follow-up with Ms. Dunphy and Ms. Bisbee and that they will follow-up with the hospital administration about meeting with the financial advisors and registration staff. Dr. Barron provided a summary of her meeting with Dr. Tapper. Forty percent of patients at VA are combat veterans; unknown about the remained 60%. She spoke of readiness to return to combat. Mr. Stevens stated that every service person who seeks assistance for disability is reviewed to determine whether they are ready to return to combat. There is resistance to be “documented” by service person. Post Traumatic Stress Disorder (PTSD) models have been developed by the VA. A service person with PTSD may not seek treatment. He was concerned with the state VA and the CHA treating the same disorders. There is an initiative by the District Attorney to be sensitive when a veteran is identified and involved in a crime. He asked if the CHA uses the same medical treatment. Dr. Barron stated her concern. Treatment is theoretical until administered. She spoke of spouse, child and parent abuse and suicide. Mr. Stevens stated that 1600 potential suicides were intervened successfully. Dr. Barron stated that there is a grand round to learn from professionals on PTSD and other related disorders. In conclusion Ms. Dunphy stated that she would be in contact with Mr. Stevens. Councillor Kelley stated that a meeting will be held on this matter in six months. Councillor Kelley thanked those present for their attendance. The meeting adjourned at two o’clock and fifty-eight minutes p. m. For the Committee,
|