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Minnesota Hospice Provider Guide To Veteran Hospice and Palliative

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Minnesota Hospice Provider Guide To Veteran Hospice and Palliative Powered By Docstoc
					Honoring and Caring
    for Veterans
 at the End of Life




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  Minnesota Hospice Provider
 Guide to Veteran Hospice and
    Palliative Care Services



Hospice Provider Tool Kit
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           Minnesota Hospice Provider Guide to
           Veteran Hospice and Palliative Care
                       Services

End of Life Statistics Pertaining to Veterans
  More than 1800 veterans die each day; this
   represents a quarter of all deaths in America
  Approximately 85% of them do not receive care
   through the VA Health Care System
  Most veterans who are enrolled in the VA health
   care system still die in the community
  Only four percent of veterans die in VA facilities.



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                Minnesota Hospice Provider Guide to
                Veteran Hospice and Palliative Care
                            Services
Issues Related to Veterans
  28,000 veterans/yr die as VA inpatients
     • 24% not Medicare eligible
     • 65% not married
     • Median income less than $10,000/year
  76,000 enrolled veterans/year die outside VA facilities
     • 20% are not Medicare eligible
 Emotional and Spiritual components
     • Can be especially meaningful to veterans, who often face
       issues near the end of life relating to their military/combat
       experiences.
     • Support is even more crucial for veterans who do not have a
       strong network of family and friends.



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            Mission of the Minnesota
           Hospice-Veteran Partnership
                    (MnHVP)


• To establish a network of VA and
  Hospice Providers that work together to
  assure end-of life services for veterans
  in Minnesota and surrounding
  communities


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                Vision of the Minnesota
              Hospice-Veteran Partnership
                       (MnHVP)


• All Minnesota Veterans will have access to
  quality end-of-life hospice and palliative care
  as part of their continuum of care.
• To provide a seamless transition between VA
  and community hospice agencies to ensure
  that veterans’ end of life care needs are met.


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                Objectives of the Minnesota
                Hospice-Veteran Partnership
                         (MnHVP)
• Increase Veteran referrals to Community Hospice
  Programs
• Improve collaboration between the Veteran’s
  Organizations, State Veteran’s Homes, Community
  Hospice and other agencies to improve end of life
  care
• Assess Hospice needs for veterans
• Provide education for VA facilities and Hospice
  agencies regarding end of life benefits
• Present outreach programs for CVSOs



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             Minnesota Hospice Provider Guide to
             Veteran Hospice and Palliative Care
                         Services

  VA Home Hospice Benefit
Services include:
• Routine Home Care
• General Inpatient Care
• Respite Care
• Continuous Care
• Per Diem Payment
• VA Provider may continue as the primary care
  physician: Medications must be prescribed by a
  VA provider
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                What services are provided?

• Services of the Hospice Team consist of your physician, nurses,
  home health aides, social workers, chaplains, and trained
  volunteers
• Respite Services
• Medication and equipment related to the terminal illness
• 24 hour on-call help
• Patient/Family centered care
• Control of pain and symptoms
• Support of the physical, emotional and spiritual needs of
  patients and family
• Grief support and education for families and significant others
  for one year following the death of a loved one



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              Minnesota Hospice Provider Guide to
           Veteran Hospice and Palliative Care Services

Veteran Eligibility: Check with the Veterans
   service officer for your county at:
    http://www.mdva.state.mn.us/macvso/
The Veteran’s eligibility is determined by the Veteran’s
   Administration through an enrollment process. To
   receive benefits, all veterans must be enrolled.
•   Eligibility for most Veteran’s health care benefits is
    based solely on active duty military service in the
    Army, Navy, Air Force, Marines, or Coast Guard (or
    Merchant Marines during WW II), and discharged
    under other than dishonorable conditions.
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               Minnesota Hospice Provider Guide to
            Veteran Hospice and Palliative Care Services


Veteran Eligibility Continued
•   Health Care eligibility is not just for those who
    served in combat.
•   Veteran’s health care is not just for service-
    connected injuries or medical conditions.
•   Veteran’s health care facilities are not just for men
    only. VA offers full-service health care to women
    veterans.



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             Minnesota Hospice Provider Guide to
          Veteran Hospice and Palliative Care Services


Veteran General Information:
 www.va.gov/health

 Veteran Must enroll for benefits:
 Veteran’s Benefits Phone (National)
 Phone: 1-800-827-1000

 State VA website:
 http://www.mdva.state.mn.us/

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             Minnesota Hospice Provider Guide to
          Veteran Hospice and Palliative Care Services


Benefits for Reservists and National Guard:
    Reservists and National Guard members who were
   called to active duty by a Federal Executive Order
   may qualify for VA health care benefits. Returning
   service members, including Reservists and National
   Guard members who served on active duty in a
   theater of combat operations have special eligibility
   for hospital care, medical services, and nursing
   home care for two years following discharge from
   active duty.

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    Veterans Health Administration
21 Veterans Integrated Service Networks




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   Minnesota Hospice Provider Guide to
Veteran Hospice and Palliative Care Services




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        Eligibility: Veterans who are eligible for VA
         healthcare may qualify for Hospice Care


Who may qualify for Hospice?
• Veterans who have a terminal illness
  with limited life expectancy
• Veterans who choose comfort care
• Veterans who apply and qualify for VA
  healthcare


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         Minnesota Hospice Provider Guide to
      Veteran Hospice and Palliative Care Services

VA Benefit for Hospice Inpatient Services
      (Inpatient Options that require pre-approval)
     • Inpatient care at VA facility
     • VA purchases inpatient hospice services in
       nursing homes that the VA has a contract
       with as well as pays the full room and board
       at these facilities.
     • VA purchases inpatient hospice services
       from community provider at locally
       negotiated rates.
     • Each VA facility has a Palliative Care
       Consult Team.
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      Minnesota Hospice Provider Guide to
   Veteran Hospice and Palliative Care Services




Many VA facilities have special
 beds/suites dedicated for
 provision of hospice and
 palliative care.


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                What is the Cost?

• Costs are covered by private insurance,
  Medicare, Medicaid, or by the Veteran’s
  Administration.
• Veterans who choose Medicare Hospice
  retain eligibility for VA Care and
  benefits


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            Minnesota Hospice Provider Guide to
        Veteran Hospice and Palliative Care Services


How Does the Veteran Obtain Hospice and
Palliative Care?
Providers would refer the patient/caregiver to local VA
enrollment service.
Referral Process for Hospice and Palliative Care
  • For home care the primary care provider, service
    officer, or Home Health or Hospice Agency,
    consultant identifies the veteran in need of this
    care and makes a referral
  • Once the need for referral has been established,
    the VA Community Health Nurse Coordinator
    must be contacted. The coordinator sets up all
    outside services.
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          Minnesota Hospice Provider Guide to
      Veteran Hospice and Palliative Care Services


Hospice Agencies should contact ChampVA or
  Tricare to determine coverage for individual
                    veteran.
    ChampVA
     • Civilian Health and Medical Program of the
       Department of Veterans Affairs is a federal health
       benefits program administered by the Department of
       Veterans Affairs
     • VA shares the cost of covered health care services
       and supplies with eligible beneficiaries
     • Contacting CHAMPVA: Phone: 1-800-733-8387;
      http://www.va.gov/hac/forbeneficiaries/champva/champva.asp


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        Minnesota Hospice Provider Guide to
    Veteran Hospice and Palliative Care Services


TRICARE
 • Program of the Department of Defense
 • Regionally managed
 • Active duty and retired members of the
   uniformed services
 • Contacting Tricare: Phone: 1-888-874-9378
   or website:
    http://www.tricare.mil/mybenefit/home/overview/Eligibility

     www.cem.va.gov


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        Minnesota Hospice Provider Guide to
    Veteran Hospice and Palliative Care Services

Veteran Burial Benefits:
Mission: To honor veterans with final resting places in
  national shrines and with lasting tributes that
  commemorate their service to our nation
  Purpose
    •   Provide burial space for veterans and their eligible family
        members
    •   Maintain national cemeteries as national shrines, sacred to
        the honor and memory of those interred or memorialized
        there
    •   Mark veterans’ graves with a Government-furnished
        headstone or marker and to provide Presidential Memorial
        Certificates in recognition of their service to a grateful
        nation
    •   Administer grants for establishing or expanding state
        veterans cemeteries.
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                 Minnesota Hospice Provider Guide to
             Veteran Hospice and Palliative Care Services


Burial Benefits Continued
       For questions about burial details for,
        • VA cemetery
        • Private cemetery
        • Burial benefits for families of veterans, contact the
                office of Veteran’s Benefits at: Phone: 1-800-827-
          1000 or www.cem.va.gov.
   Who can be buried in a VA cemetery?
        • Veterans
        • Any members of the Armed Forces of the USA who die
          on active duty

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          Minnesota Hospice Provider Guide to
      Veteran Hospice and Palliative Care Services


Veteran Eligibility Criteria For Death Benefits
   • Before 1980
        Honorably discharged
        24 months of active duty
   • After 1980
        Honorably discharged
          24 months of active duty
          Not guilty of capital offense


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           Minnesota Hospice Provider Guide to
       Veteran Hospice and Palliative Care Services


Burial Benefits in a private cemetery:
Contact Veterans Benefits
   • Government headstone or marker
   • Burial flag
   • Presidential Memorial Certificate
   • Some veterans may also be eligible for Burial
    Allowances
   • No benefits available to spouses and dependents




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            Minnesota Hospice Provider Guide to
        Veteran Hospice and Palliative Care Services


Veteran Burial Benefits in a National
 Cemetery
   • Gravesite in any of the 124 national cemeteries with
     available space
   • Opening and closing of the grave
   • Perpetual Care
   • Government headstone or marker
   • Burial flag
   • Presidential Memorial Certificate
       – http://www.va.gov/vaforms/va/pdf/VA40-0247.pdf.
   • Some veterans may also be eligible for Burial
     Allowances
   • Burial benefits available for spouses and dependents.
     Refer to Decedent Affairs                               27
           Minnesota Hospice Provider Guide to
        Veteran Hospice and Palliative Care Services


Burial Allowances: Contact Veteran’s Benefits
  • Partial reimbursements of an eligible veteran’s burial and
    funeral costs
  • Burial Allowances based on eligibility
      – 1. Up to $300 toward burial and funeral expenses
      – 2. Up to $300 plot-internment allowance
      – 3. If the veteran died because of a service-related
        disability, the burial allowance increases to up to $2,000
  • Eligibility criteria can be found http://www.cem.va.gov




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                                      Resources

Department of Veterans Affairs        www.va.gov
Find a VA Facility
Veterans Health Administration        www.va.gov/health
VA Health Care Eligibility            www.va.gov/healtheligibility
Veterans Benefits Administration      www.vba.va.gov
VA Cemetery Administration            www.cem.va.gov
Hospice Minnesota                     www.hospicemn.org
VHA Forms and Publications            www.va.gov/vhapublications
Veteran Data                          www.va.gov/vetdata
National Center for PTSD              www.ncptsd.va.gov/ncmain/index.jsp
VA Hospice and Palliative Care        www.va.gov/GeriatricsSHG/page.cfm?pg=65

Veterans Healing Arts Program for     www.hiv.va.gov
HIV/AIDS.
Healing Art Program for Hepatitis C   www.hepatitis.va.gov             29
Program
                 Minnesota Hospice Provider Guide to
              Veteran Hospice and Palliative Care Services


Additional Hyperlink/Resource Page
    http://www.tricare.mil/mybenefit/home/overview/Eligibility
    http://www.va.gov/healtheligibility/coveredservices/StandarBenefits.asp
   Contacting CHAMPVA: Phone: 1-800-733-8387;
    http://www.va.gov/hac/forbeneficiaries/champva/champva.asp
   Contacting Tricare: Phone: 1-888-874-9378 or website:
    http://www.tricare.mil/mybenefit/home/overview/Eligibility
    www.cem.va.gov
    http://www.mvh.state.mn.us/board.html
   Contacting NHPCO: Phone: 1-800-658-8898;
    http://www.nhpco.org
   Contacting Hospice MN: Phone: (651) 659-0423 or toll free:
   (800) 214-9597;
    http://www.hospicemn.org

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                         Contacts
• Minneapolis VA Medical Center: 612-467-2043
• Saint Cloud VA Medical Center: 320-255-6414
• Fargo VA Medical Center:
• State Veteran’s Homes:
• Department of Veterans Affairs: (800) 827-1000 www.va.gov
• Hospice Minnesota: (800) 214-9597 or 651-659-0423
  www.hospicemn.org
• National Hospice and Palliative Care Organization
  (800) 646-6460; www.nhpco.org




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