Health Care

Table of Contents

The Local VA Hospital System

The Lehigh Valley has two VA community based outpatient clinics, satellites of the Wilkes-Barre VA Medical Center (VAMC).

  • The Allentown VA Outpatient Clinic is located at 3110 Hamilton Boulevard, Allentown, PA 18103. Its telephone number is 610-776-4304 or Toll Free 1-866-249-6472.
  • The Northampton County Outpatient Clinic (aka “Bangor” Clinic) is located at Phoebe Slate Belt Nursing Home & Rehabilitation Center, 701 Slate Belt Boulevard, Bangor, PA 18013-9341. Call 610-599-0127. It is not a full service primary clinic like Allentown’s.
  • The Wilkes-Barre VAMC is located at 1111 East End Blvd., Wilkes-Barre, PA  18711. Call 570-824-3521 or Toll Free: 1-877-928-2621 for medical center needs.

How to Determine if You Qualify and Can Enroll for VA Healthcare

As in the past, you can call a VA clinic or hospital (see the preceding section for the local facilities) and they will send you a VA Form 1010EZ (Application for Health Benefits) package to complete; or you could go down to the facility and pick up the package.  Click here for the new online way of doing it (which also simply explains the entire process) … or you can now apply to enroll in the VA’s healthcare system by picking up the phone and dialing 1-877-222-8387 (VETS) between Monday and Friday from 8 a.m. to 8 p.m. EST.  As of 5 July 2016, telephone applications no longer require a follow-up signature.

If you need additional assistance, call the same number or contact your local clinic or hospital and arrange it.  For an alternative summary on how to apply, click here.

Making a VA Medical Appointment

The procedures below assume you are enrolled in Wilkes-Barre VA Medical Center’s network.  To enroll, contact the nearest clinic or hospital above.

1. Use this procedure when you …

–  Require an appointment within 48 hours
–  Need Medication Refill
–  Other:  Non-Medical Emergency (immediate issue)

Process: 
–  Call 1-877-928-2621, press  4, then your primary care team 4-digit extension.
–  If primary care team extension is unknown, call 1-877-928-2621, press 4, then press 0  and the operator will assist you in connecting you with your primary care team.

2. Use this procedure when you …

–  Receive a reminder letter 30 days before your next visit
–  Receive a 2nd reminder letter 14 days before your next visit
–  Just want to check on your upcoming appointments

Process: 
–  Call 1-877-928-2621, press 2.
–  You will then be personally assisted with scheduling your Open Access Appointment(s).

3. Use this procedure when you …

–  Need to cancel an appointment
–  Want to change your appointment

Process:
–  Call 1-877-928-2621, press 2 and you will then be offered the opportunity to reschedule your appointment or cancel it.

Note:   If you cancel a specialty/consult clinic appointment more than one time, or do not keep a scheduled specialty appointment, it will be necessary for you to contact your health care provider for another consult/referral to that clinic.

4. Use this procedure when you …

–  Have questions after discharge from the hospital as an inpatient

Process:
–  During business hours, contact directly your primary care team using Procedure #1 above.
–  During non-business hours (after 4;30 p.m. and before 8:00 a.m.) and holidays, if you begin to experience new medical symptoms that are not of an emergency by nature and you require guidance on how to manage, use Telephone Triage at 1-877-928-2621,  Press 6.

Sources:
 <http://www.wilkes-barre.va.gov/patients/appointments.asp> Accessed 8 January 2013.
 <http://www.wilkes-barre.va.gov/contact/> Accessed 8 January 2013.

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Explaining The Veterans Choice Card Program

Details on how to use the program can be found here.  However, these VA documents give a quick overview on the program as of as of 1 December 2015:

1) The changes made 1 December 2015
2) The new rules for eligibility
3) An explanation of the term “unusual or excessive burden”

Community Call Center for the Veterans Choice Program

In March 2016, the Veterans Health Administration established  a one-stop  “Community Care Call Center” to resolve billing issues because the use of the Veterans Choice program had led to instances of improper billing which unfairly resulted in adverse credit reports.  It is a resource for both veterans and the medical providers.

According to the VA, the center’s staff is trained and ready to work with the medical providers to expunge adverse credit reporting on veterans resulting from delayed payments to providers.

The number to call is 1-877-881-7618, between the hours of 9 a.m. and 5 p.m. EST.

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Suicide Prevention/Emotional Crisis Assistance

If you are or a veteran you know is experiencing an emotional crisis and need to talk with a trained professional, the primary way to get prompt VA service is to use the National Suicide Prevention toll-free hotline number, 1-800-273-TALK (8255) and press 1 after the introduction to obtain a VA counselor (If you do not press 1, you will speak to a non-VA contact). The service is available 24 hours a day, seven days a week. This service will later connect you with a local point of contact for follow-up. It really has worked in our area.

Lehigh Valley Suicide Prevention Telephone Numbers:

  • Lehigh County Crisis Intervention Hotline: 610-782-3127
  • Northampton County Crisis Intervention Hotline: 610-252-9060
  • 911

The Suicide Prevention Coordinator:  Since 2007, each VA Medical Center has at least one Suicide Prevention Coordinator.  Wilkes-Barre VA Medical Center has two and provides a 24/7 service.  These Coordinators are “… serve to
facilitate implementation of suicide prevention strategies at the local level. Activities will include support for the identification of veterans at high risk; coordinating enhanced care when needed; education of providers, veterans, families, and members of the community on risk factors and warning signs for suicide; and [assisting with] treatment options.”  As such they are a mainstay operation and can serve as a “warmline” and ultimately, those calling the veterans crisis line above will be referred to them.  To contact them, call Adalberto Morales, tel: 1-877- 928-2621 Ext. 7033 or Denise Carey, tel: 1-877- 928-2621 Ext. 0430.

VA Veterans Center Local Outreach Station: VA Veterans Centers operate on an outpatient basis and are a mental health alternative conducted in a non-medical setting.The Scranton Veterans Center operates an outreach center at Nazareth twice a month. To arrange for counseling, contact Mike DeLuzio, tel:1-866-776-1516. For more information about this service visit www.vetcenter.va.gov/ .

Vets4Warriors Helpline: Modeled on the New Jersey Vet2Vet program and also provided by the University of Medicine and Dentistry of New Jersey – University Behavioral HealthCare, this free helpline offers peer counseling and support by trained veterans, telephone assessments, referrals, and assistance to National Guard and Reserve service members and their family members. Although funded by DoD, it does not discuss your calls with the military, the VA, or anyone else and, if you choose, you may remain anonymous. Call 1-855-VET-TALK (838-8255).

Give an Hour: A nonprofit organization which provides a wide range of free mental health services to U.S. military personnel, veterans, and loved ones (uses a broad definition) affected by the current conflicts in Iraq, Afghanistan and elsewhere, including members of the National Guard and Reserves who have not yet deployed. Providers are mental health professionals, licensed and in good standing. The process begins with using the Visitor portion of their website. There is no phone number to call. Based upon input, the nearest providers’ contact information is given. Has a developed network in the Lehigh Valley.

The Soldiers Project:  Another nonprofit which is a group of licensed mental health professionals trained in military culture, PTSD, TBI and a host of other trainings that provide them insight. Working from their offices, they   offer free, unlimited psychological treatment to military service members (active duty, National Guard, Reserves) and veterans who have served or who expect to serve in the current conflicts in Afghanistan, Iraq, and elsewhere – and to their families and other loved ones. Claim they “will respond within 24 hours if not sooner.”  Unlike, Give an Hour, help can be initiated using a telephone number.  The local chapter number is 215-242-7736 and the toll-free national number is 1-877-576-5343.

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VA’s Five Year Combat Veteran Program

Here’s the information you need to know about the VA’s Five-Year Combat Veteran Program if you cannot find it elsewhere. The program applies to you if you were deployed to a combat theater of operations and are within five years of discharge. Even if not considered combat veteran, you should apply under the regular program as early as possible. The earlier you enroll, the easier for you to establish a condition related to service.

VA OEF/OIF/OND Program Manager

For our area, the Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OEF) Healthcare Program Manager is Sandra Dompkosky (replaced Colleen Kaskel ca. October 2012), tel: 1-877-928-2621 ext 4297 (formerly 7803), email: Sandra.Dompkosky@va.gov, at the Wilkes-Barre VA Medical Center.  Although originally intended to assist the seriously injured, the program will help other returning veterans seeking assistance regarding healthcare or related to getting it.

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VA Patient Advocate

If you feel your concerns are not being addressed by your treatment team, you may contact a VA Patient Advocate.  A Patient Advocate is an employee who is specifically designated at each VHA facility to manage the feedback received from veterans, family members and friends.  The Patient Advocate works directly with management and employees to facilitate resolutions.

The Patient Advocate for the Allentown Clinic is Michelle Koch, Administrative Officer, tel: 610-776-4304.

The Patient Advocate at the Wilkes-Barre VA Medical Center is Joyce Nardozzi and she can be reached at tel: 570-824-3521 ext. 7604.

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VA Family Caregiver Program

On 9 May 2011, the VA finally rolled out its “Family Caregiver Program” required by the Caregivers and Veterans Omnibus Health Services Act 2010. It provides for enhanced services to a family caregiver of a veteran who sustained a serious injury in the line of duty on or after September 11, 2001. The Act does not help veterans of other periods.

Aspects of the program are:

  • In-home and community-based care is to be provided. This includes skilled home health care, homemaker home health aide services, community adult day health care and Home Based Primary Care.
  • Respite care services are to be provided. These are designed to relieve the family caregiver, which can include can include in-home care, a short stay in one of VA’s community living centers (the new VA name for nursing homes on VA Medical Center grounds) or adult day health care.
  • Caregiver education and training programs are to be provided. The training includes pre-discharge care instruction and specialized caregiver training for severe traumas such as traumatic brain injury (TBI), spinal cord injury or disorders, and blindness.
  • A special caregiver website has been created at www.caregiver.va.gov . It provides information, to include on VA and community resources.
  • Trained, Caregiver Support Coordinators are located at every VA Medical Center. You can use the general VHA number 1-877-222-8273 or the website to locate one … or use the support line (next bullet).  The designated Coordinator for the Wilkes-Barre VA Medical Network, which supports us, is Ms. Janet Schmidt, who can be reached at  570-824-3521, ext.7527.
  • A National Caregiver Support Line has been created at 1-855-260-3274. Its purposes are counseling and information about resources and services.
  • Caregiver support groups are to be offered – either in a face-to-face setting or on the telephone (one day, web chatlines?)
  • Other caregiver support services are available. Examples are family counseling, spiritual and pastoral care, family leisure and recreational activities and temporary lodging in Fisher Houses.
  • Other existing services will continue – like durable medical equipment and prosthetic and sensory aides to improve function, financial assistance with home modification to improve access and mobility, and transportation assistance for some veterans to and from medical appointments.
  • And finally and at last, the “Primary Family Caregiver” will receive a monthly stipend in addition to other reimbursements (like transportation). The stipend will be received for each prior month’s participation and the amount will be determined by “the veteran’s level of dependency based upon the degree to which the eligible veteran is unable to perform one or more activities of daily living (ADLs) or the degree to which the eligible veteran is in need of supervision or protection based on symptoms or residuals of neurological or other impairment or injury …”

The regulation and application is available on the above website and. The veteran must first be enrolled in the VA healthcare system and a separate application for this program is required. Assistance in filling out the form will be provided.

Sources:
<http://www.caregiver.va.gov/> Accessed 9 May 2011.
<http://www.blogs.va.gov/VAntage/?p=2790> Accessed 9 May 2011.

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VA Home Based Primary Care Program

As of September 2014, the Allentown VA Clinic, in addition to the Wilkes-Barre VA Medical Center Outpatient Clinic, offers Home Based Primary Care (HBPC).

The mission of HBPC is to provide comprehensive, interdisciplinary primary care in the homes of veterans with complex medical conditions when routine, clinic-based care would not be effective or practicable. Consequently, the program focuses on the frail and chronically ill who require interdisciplinary care and ensures the necessary continuity and coordination of the care occurs at home as much as possible. The integration of diverse services such as skilled nursing visits and home health services addressing complex medical, psychosocial, and rehabilitative needs are frequently involved.

The program does not require your applying and meeting the standards for a home-bound or aid and attendance supplemental monthly increase to a disability pension or service-connected compensation. Instead, the HBPC program targets three types of patients:

1) Those with chronic complex medical conditions, particularly those at high risk for hospitalization of nursing home placement otherwise;

2) Those who require palliative care for an advanced disease that is life-limiting and/or resistant to disease-modifying treatment;

3) Those whose home care needs are expected to be of a short duration or for a focused problem – and whose going to a clinic is not possible until after recovery.

Presently the Allentown Clinic has one HBPC team which includes a primary care physician, a registered nurse, a licensed physiotherapist and a social worker.  Other disciplines, such as nutrition and psychology, are included as needed.

When assisting the veteran’s transition from a healthcare facility to home, the team also provides both patient and caregiver education; provides guidance in rehabilitation and use of adaptive equipment; recommends adaptations to the home as needed for a safe and therapeutic environment; and arranges for and coordinates additional supportive services, such as telehealth, in-home hospice, home health aide services and respite care. Therefore, in addition to providing veteran-centered medical and behavioral health care, HBPC is beneficial in assisting and supporting the primary caregiver.

If you are need of such services, you must be enrolled or automatically entitled to VA healthcare. Contact the Allentown clinic for additional information. Typically, the service is arranged through your primary care provider.

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Your VA Copays

The copayment system of the VA is not well understood and can be complicated.  However, most errors in billing occur as a result of a clinician failing to code the service correctly when service-connection is involved (no copayment in such event) or the hospital staff erroneously overrule him or her.  To understand the system better, refer to the copay chart. It is updated annually. For a more detailed explanation that might ironically be easier to understand than a “simple chart”, click here.  To reaffirm what priority group you belong to (important to how copays are determined), click here.

All this assumes you have no other form of insurance.  However, private insurance or TRICARE, which can be billed, may indeed cover the entire copay cost.  And Priority Group 5 (being financially distressed or indigent) provides yet another twist on whether or not a copay applies..  Click here for more on determining the ultimate cost of care.

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Locate a TRICARE Service Provider

HealthNet Federal Services is under contract to provide TRICARE services in our area.  To locate a local doctor or other TRICARE service provider under the plan you are currently using and for other information, click here. The nearest TRICARE Service Center  staffed with representatives who can help with your health care needs and answer questions about the TRICARE program is located at McGuire Air Force Base Clinic.  The TRICARE number for inquiries is 1-877-874-2273 (1-877-TRICARE).

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Prosthetic and Sensory Aid Services from the VA

Veterans enrolled in the VA healthcare system have services available to them of which they are often unaware.  Prosthetics, eyeglasses, and hearing aids are among them and service-connection is not necessarily a prior condition for eligibility.  The VA makes little mention of them to the average veteran under their care.  Nor does does it make it easy to find out what the game rules are (as of June 2014).  The website page http://www.va.gov/healtheligibility/coveredservices/SpecialBenefits is no longer available with the latest revision of the website.

This is what their 2012 Healthcare Benefits Overview  says on the subject of vision and hearing services:

VA medical services include diagnostic audiology and diagnostic and preventive eye care services.  VA will provide hearing aids and eyeglasses to Veteran’s who receive increased pension based on the need for regular aid and attendance or being permanently housebound, receive compensation for a service-connected disability, are a former POW, were awarded a Purple Heart, currently enrolled in a Vocational Rehabilitation program, are about to be admitted to a VA Blind Rehabilitation Program, you have a eye or hearing impairment that resulted from the existence of another condition for which you are currently receiving VA care, or which resulted from treatment of the medical condition, or your vision or hearing are so severely impaired that aids are necessary to permit active participation in your own medical treatment. Otherwise, hearing aids and eyeglasses are provided only in special circumstances, and not for normally occurring hearing or vision loss. For additional information, contact the prosthetic representative of your local VA health care facility.

By these criteria, the availability of these services applies to a broad number of veterans enrolled.  But no mention of prosthetic devices is made.  Therefore we seem to have to rely on other resources.   One of the better sources for a readable, detailed explanation and guidance on all prosthetic benefits is provided by the Military Handbooks at this link:  click here.  However, it lacks eligibility details on what is traditionally associated with the VA’s prosthetic services.  For that, go to the VetsFirst website (a product of the United Spinal Association) on prosthetics as a start point:  click here.

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Last Updated: 29 July 2016 (Addition of new enrollment process)

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