VA MISSION Act and Veterans Community Care

Veterans are particularly vulnerable when it comes to mental health conditions. This is one of the major consequences of the time they spent in dangerous and life threatening circumstances. Military deployment can be very demanding on the body, but it also takes its toll on people’s mental wellbeing. In some cases, symptoms of mental illness develop long after people have left the force. Due to stigmas and unique characteristics of military life, Veterans tend to self-medicate instead of looking for help.¹

When trying to deal with pain, whether physical or psychological, Veterans turn to use of various legal and illegal substances. Luckily, the use of most substances among Veterans has remained stable or increased only slightly in the last years. The use of alcohol and opioids has remained stable, while there was a slight increase in use of methamphetamine and cocaine. SAMHSA study shows that there are some 3.1 million Veterans with mental illnesses, out of which 1.3 million struggles with substance use disorder.²

The Department of Veteran Affairs (VA) has been trying to raise awareness about the availability of proven treatments in order to encourage Veterans to seek professional help in dealing with mental illnesses. Some important steps have been made in the last years, particularly since the passing of the VA MISSION Act of 2018 which introduced Veterans Community Care Program as a replacement of Veterans Choice Program.³

What Is the VA MISSION Act?

The VA MISSION Act of 2018 was passed in order to improve existing healthcare options for US Veterans and First responders as well as to amend certain weaknesses of previous legislation. One of the chief improvements has been the substantial upgrade of potential options that Veterans have when choosing their treatment options. One of the most common grievances with previous legislation was the quality of customer service which has now been modernized to help Veterans and keep up with ongoing developments.⁴

The Veterans Health Administration (VHA) is the largest division of the VA which is tasked with implementation and delivery of healthcare services to American Veterans. It is the largest healthcare system in the US employing more than 350,000 personnel. It operates almost 1,300 health care facilities around the country, some 170 medical centers and more than 1100 outpatient clinics that serve 9 million Veterans. In 2018 with the adoption of MISSION Act its services have been upgraded both in their scope and in their quality.⁵

Some of the areas that the VA MISSION Act tackles are:³

• VA health system’s capacity to employ and hold onto top medical professionals.
• Establishment of a new benefit called MISSION Act Urgent Care which will be delivered through VA’s network of Urgent Care providers.
• Introduction of “Anywhere to Anywhere” telehealth that extends beyond state boundaries.
• Radical improvement of accessibility of community care for US Veterans.

Veteran Community Partnership is a national initiative and a joint project of VHA, Offices of Geriatrics and Extended Care, Community Engagement/Center for Compassionate Innovation, and Caregiver Support that connects local VA facilities with state and community service providers. Since many Veterans don’t receive health services only from the VA, VCP was established to deliver an improved access to care for Veterans and their dependants.⁶

The MISSION of the VCP is to ensure:⁷

• Further education of the VA concerning existing programs within the community, but also to
• Increase the awareness inside the community of specific needs of the US Veteran population.
• Strengthening and building of new connections between the VA and various local agencies.
• Improvement in accessibility of healthcare services and benefits to Veterans.
• Promote smooth transition and enhanced continuum of Veterans healthcare.
• The provision of improved support to caregivers and their families.

Quick guide to VA MISSION Act Eligibility Requirements

The MISSION Act made changes only to those parts of existing legislation that were in need of improvement without touching those features which were deemed to function properly. In that sense, the Program of Comprehensive Assistance for Family Caregivers has seen an expansion of eligibility which is now more inclusive. At the same time enrollment of priority groups and eligibility requirements for VA healthcare coverage have remained the same.⁸

Under the MISSION Act, basic eligibility rules for Veterans who want to receive healthcare through VA require:⁸

• That they were discharged from service under conditions other than “other than dishonorable discharge”.
• The completion of 1 day of active duty service for personnel who enlisted before 9/7/1980 or who took part in active deployment on or before 10/16/1981 (this includes delayed entry).
• Full 24 months of active service for those who enlisted after 9/7/1980, or;
• For reservists and National guard members who were activated under the Title 10 executive order and completed the full period of required service.

In addition to this basic set of requirements, there are certain exceptions that make Veterans eligible to receive VA healthcare coverage in case they:⁸

• Were released from active duty or were given a discharge because of Early out, Hardship, or Disability that was sustained or aggravated in line of duty.
• Had a contract for a 15-month enlistment.
• Qualify as having a compensable Service Connected (SC) disability.
• Meet the requirements for falling into the category of 0% SC Non-Compensable National Guard or reservist.
• Experienced a Military Sexual Trauma (MST) during the course of Active duty service or Active duty for training (This also applies to individuals who don’t meet active duty requirements for VA health care coverage).

What Is the VA Community Care Program?

Probably the most important and beneficial change for Veterans in the MISSION Act is the introduction of the Community Care Program which makes significant improvements on previous Veterans Choice Program. With the creation of Community Care, the MISSION Act breaks with the previous VA policy of working with existing community providers only in case of last resort. The rules are less strict now empowering Veterans to choose Community Care even in case of existing VHA providers.⁹

The Community Care Program is delivered through VA’s Community Care Network (CCN). It was established in order to serve as a direct link that connects the VA with existing local Community Care providers. It will help the VA improve its coordination with local providers in order to ensure prompt and efficient delivery of quality care to Veterans and their families and caregivers. Through CCN the VA will be able to obtain healthcare for Veterans in the area that best meet their medical needs.¹⁰

Community Care will be delivered through only 1 customer-service network which will make the procedures much more user friendly and transparent helping Veterans make informed health related choices. It will also achieve an integration of systems that will now work together in exchange of data and knowledge improving previous business procedures. CCN is comprised of 5 regional divisions covering the entire country including overseas territories.⁸

Quick guide to VA Community Care Eligibility Requirements

Through the Community Care Program Veterans will now be endowed with more choice when deciding where they want to receive medical services and care. It is now much easier to receive care from independent private healthcare providers located in their community than before. This way Veterans will be able to combine the best of VA health care system and private treatment facilities that are not part of the VA.¹⁰

In order to use the benefits of private health care providers through Community Care Program, Veterans will have to meet one of following requirements:³

• The VA has determined it’s in the best interest of Veteran to receive care from a community provider since it, for instance, delivers a higher continuum of care.
• Veteran needs specific service that the VA provider can’t deliver in accordance with quality standards set by the VA.
• Available VA service can’t meet its designated access standards, including too long drive times to the facility or too long waiting times at the medical facility.
• If Veterans need certain services that are unavailable and can’t be delivered by existing VA facilities within his driving vicinity.
• If there is no full-service medical facility in the state or territory that the Veteran resides in, for instance the state of Hawaii, or one of US territories like Puerto Rico or American Samoa).
• If on June 5, 2018 the Veteran met eligibility requirements for the “grandfather” provision that was a part of Veterans Choice Program, meaning the Veteran lived in one 1 of 5 states with lowest population (Alaska , North Dakota, South Dakota, Montana, or Wyoming).

Will the VA MISSION Act Provide Coverage for Addiction Treatment?

One of the biggest changes when it comes to treatment of mental illnesses in the US came with the passing of the Affordable Care Act of 2010. It codified 10 essential health care benefits that must be covered by all available healthcare plans on the Marketplace. Treatment of mental health conditions is one of essential health benefits which automatically mandates coverage for Substance abuse disorder (SUD).¹¹

According to SAMHSA’s national survey from 2020, the most popular substance misused by Veterans was alcohol which was used by 4 in 5 Veterans who struggled with SUD in the year 2019. Illicit drugs were used by 1 in 5 Veterans with SUD, while almost 500,000 Veterans suffered from both mental health conditions and substance use problems. The use of marijuana was on the rise, with daily use almost doubling in the 2016-2020 period.²

The VA provides coverage for addiction treatment which uses various evidence-based approaches to treatment, including:¹²

• Proven psychological therapies which help patients through counseling and motivation building, like Cognitive Behavioral Therapy (CBT), Dialectical behavior therapy (DBT), Motivational Interviewing (MI), and Motivational Enhancement Therapy (MET).
• The use of FDA approved medication that reduce cravings and help managing withdrawal symptoms in procedures like Medically managed detox and Drug substitution therapy, or Medication-assisted therapies (MAT) which aim at full-patient recovery.
• Regular Outpatient and Intensive Outpatient Programs for people who for some reason can’t or don’t need to submit to full hospital rehabilitation and can be counted on to maintain regular attendance.
• Inpatient and Partial Hospitalization Programs (PHP) that are designed for severe users or those suffering from Co-Occurring Disorders (COD), also known as Dual Diagnosis, who have lost the ability to make informed decisions or function on their own without professional attention.

How Can I Use the VA Mission Act?

The first thing to do is to check the eligibility requirements in order to enroll in the VA healthcare program. After that you will have to schedule an appointment with a VA clinician to look into your case and determine the specifics of your exact medical condition. Since mental health issues differ from person to person there are various approaches that can be modified to meet the needs of very different cases and individuals.¹³

Some people are severe users while others are relative new-comers, some use hard, life-threatening drugs like heroin and cocaine while others consume marijuana. All these cases require different procedures and varying intensity of treatment. This is why only a doctor is qualified to look into each case and provide a suitable rehab recommendation. After the doctor’s appointment you must notify the VA so they can send you the necessary medical document you need to make the next step.¹⁴

Where Can I Find MISSION Act and Community Care Providers?

One of the easiest ways to find VA providers is through the VA’s online facility locator that offers a quick search of rehab centers depending on the type of care you need and their national location. When looking for a rehab center, remember that you have to choose one which is a part of VA’s Community Care Network. You can also contact the VA and ask them for a recommendation.¹⁴

You can also check out the American Addiction Centers (AAC) since they are the nation’s leader in rehab treatment solutions and also partner with the VA as a part of a network of Community Care providers. AAC offers different types of recovery services that can be adjusted according to individual preferences and medical needs. AAC’s also proud of its unique 90 Day Brand Promise that gives up to 30 additional days of treatment to people who experienced relapse after completing 90 days of treatment in one of their facilities.

When it comes to Veterans, AAC has a special program that is designed to tackle their substance addiction issues with special focus on distinctive military culture and needs of Veterans. This program is called Salute to Recovery and it takes into account the burdens of life in service. It then uses this knowledge to develop solid strategies that foster sound decision-making and responsible and lasting lifestyle changes helping nurture healthy and sober individuals. The Salute to Recovery program is provided in 2 facilities.

Desert Hope

Desert Hope Treatment Center is a top-of-the-line rehab facility providing proven recovery programs for Veterans. It is located in Las Vegas, Nevada and offers a calm and structured environment that is designed to help people achieve full recovery. At Desert Hope discrimination is prohibited and people are encouraged to draw strength from their peers and various support groups. It has plenty of recreational options in addition to a number of resort-like amenities. Desert Hope specializes in:

• Veteran and First Responder Salute to Recovery Substance Abuse Programming.
• Family Therapy.
• Individual Therapy.
• Medical Detoxification.
• Aftercare Support.

Recovery First

Recovery First is located in the sunny city of Hollywood which is a part of the Miami metropolitan area in Southern Florida. Recovery First is a premium alcohol and drug addiction recovery center that offers customized rehab programs with tailored plans to suit different individual needs. Veterans are provided with a personalized in-house trauma track that will aid their recovery, putting them on track to achieve long-lasting sobriety after the treatment is over. Among other things, at Recovery First you’ll get:

• Salute to Recovery VA Community Care Programs.
• Co-occurring Mental Health Disorder Treatment.
• Medication-Assisted Treatment (MAT).
• Partner Genetics-Informed Addiction Treatment.
• Family Support.
• Individual and Group Therapies.
• Eye Movement Desensitization and Reprocessing (EMDR).