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VA program gives West Texas veterans a home-based health care option
San Angelo Standard-Times - 1/29/2018
Jan. 29--For veteran Jerry Smith, making trips to the West Texas VA Health Care System in Big Spring or even the local San Angelo clinic is not an easy task.
The Purple Heart recipient relies on the VA's Home Based Primary Care program that brings the hospital's health care services to him.
"I love it," Smith said. "It's the best thing they've come out with because if I want to see a doctor I don't have to drive to Big Spring every time or out here to the clinic."
Smith has been part of the program for three years and depends on its services to maintain his health, including keeping his diabetes under control.
As part of his health plan, Smith -- who is 100 percent disabled -- gets nursing, physical therapy, dietitian, psychology and pharmacy services brought to his home. He said he's never had trouble getting appointments through the program.
A VA physician supervises a health care team that, depending on need, makes quarterly visits to a veteran's home.
The HBPC comprises a medical director, or main physician, two nurse practitioners, 14 nurses, two social workers, two psychologists, two dietitians, two physical therapists and one pharmacist.
"It's pretty much a mobile clinic; primary care taken to the home," said Jessica Paul, director of the HBPC program and medical foster home program. "We have locations across West Texas and the Permian Basin -- Big Spring, San Angelo and Abilene."
Each location has its own team, and patients have access to all the same services, she added.
"We try to target veterans who have more of the chronic disease states that need a little extra support. ... We really take a holistic approach to health care with our veterans," she said. "We target not just that person, but what is their environment like?"
All enrolled veterans are eligible if they meet the clinical need for the service and it is available, since HBPC is part of the VHA Standard Medical Benefits Package.
Eligible veterans are given a health care plan that includes:
* Primary care visits at home by a physician, nurse practitioner or physician's assistant
* Care management through a nurse practitioner, physician's assistant, or nurse
* Coordination of services by a social worker
* Therapy visits from a physical, occupational or speech therapist
* Mental health services
* Nutrition counseling from a dietitian
* Help managing medicine
Veterans with complex health care needs or who need help with activities of daily living such as bathing, dressing, fixing meals or taking medicines are eligible for the program. The VA also recommends the program to veterans who are isolated or if their caregiver is experiencing burden.
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"Right now we're not putting (a limit on) mileage," Paul said about service area eligibility. "Typically, we say about 65 mile radius (from a VA hospital), but we do have individuals outside of that, and we base it on need. So we still go out and evaluate that veteran to see if our services will be appropriate for them, and if we can truly help them."
HBPC has been offered at the Big Spring VA since 2006 and has received a positive response from veterans participating.
"They love the program. They love the services. They love the fact that we can go to their home and that they have someone personally that they can talk to instead of getting a recording or having to wait weeks or sometimes days to get into a clinic. They have direct contact with our nurses."
Paul said she hopes to double the 138 veterans the program is serving within the next year.
"We are currently trying to expand our home based primary care program," she said. "We do want to get more veterans in; we think this is a great program that the VA offers."
In the comfort of his living room, Smith joked around with nurse Mary Ann Calvert, who took blood samples from his arm.
Calvert has been working with Smith since he started the program and has built a strong friendship with him and his wife, Patsy.
"Veterans don't have trust coming into our program, and that's a huge thing to (work through)," she said.
Cultivating relationships is a large part of providing good care for veterans, and it's done by visiting them over time, Calvert explained.
Smith credits the program with how well he is doing and how much more beneficial and convenient it is for him not to travel because of his limited mobility.
"I guess if it wasn't for this program I'd be in a nursing home somewhere," he said. "If (veterans are) eligible for it they need to get on it. Ask their VA nurse or check with the VA in Big Spring."
(c)2018 the San Angelo Standard-Times (San Angelo, Texas)
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