VA Black Hills New Veteran Patient Orientation

MISSION: To fulfill President Lincoln’s promise: “To care for those who shall have borne the battle, and for their families and their survivors” by serving and honoring the men and women who are America’s Veterans.

VALUES: (ICARE)

       Integrity: High moral principles, professionalism 

       Commitment: Serve Veterans

       Advocacy: Be truly Veteran-centered

       Respect: Treat all with dignity and respect

       Excellence: Highest quality and continuous improvement. 

It’s an honor and a privilege to provide high-quality, safe health care to over 19,000 Veterans residing in South Dakota and portions of Nebraska, Wyoming, North Dakota, and Montana.

•2 Medical Centers at Fort Meade and Hot Springs

•Inpatient and outpatient services

•Residential Rehabilitation Treatment Program

•9 Geographically Separated Points of Care

•VA staffed Multi Specialty Clinic in Rapid City, SD

•Contract CBOCs located in Pierre, Winner SD, and Scottsbluff, NE

•VA staffed CBOCs in Pine Ridge, South Dakota; Newcastle, Wyoming; and Gordon, Nebraska

•Compensated Work Therapy and Transitional Residences are located in Rapid City, Sturgis and Hot Springs, Pine Ridge, Eagle Butte, and McLaughlin, SD

My HealtheVet is the VA's Personal Health Record. It was designed for Veterans, active duty service members, their dependents and caregivers. My HealtheVet helps you partner with your health care team. It provides you opportunities and tools to make informed decisions.

The VA website is free and open to every Veteran once registered. Here you can learn about your health, treatment options, and what you can do to stay in the best shape possible. You can enter and track your personal health information. You can request refills on-line. You can also link to major sources of health information, review federal and VA benefits, view wellness reminders and send secure messages to your healthcare teams.

To take advantage of all these features of My HealtheVet, you need to register on the website and be authenticated in person at a local VA or self authenticate online.  The authentication process protects your privacy and your personal health information. 

www.myhealth.va.gov  VA's online Personal Health Record (PHR) for Veterans.

MyHealtheVet Features:

• VA prescription reminders
• Secure messaging
• Veterans Health Library
• VA appointments
• Military health history
• Wellness Reminders

For more information visit the My Health eVet webpage or call 1- Monday through Friday from 7a.m. -8 p.m. mountain time.

Virtual Lifetime Electronic Record (VLER) Program

• Share medical records between VA and community providers
• Sign-up at www.ebenefits.va.gov

VA Video Connect (VVC)

To reduce risks to our Veterans and staff during the current coronavirus outbreak, VA offers Veterans the option to use telehealth tools to replace in-person appointments with telephone or video visits.

Video Conferencing Tool

• Web based
• Secure & Simple
• Connects Provider & Veteran
• Any device/ Any location

Video instructions for Veterans: https://www.youtube.com/watch?v=HqhVlt4az-Q

How To Use VA Video Connect

VA Video Connect Web User Guide for Veterans

VA Video Connect has been designed to be user-friendly. If you need help with opening VA Video Connect in your Web browser, connecting with your provider for an appointment, experience any difficulties or need assistance for any reason, call the National Telehealth Technology Help Desk. The National Telehealth Technology Help Desk can be reached at: or Monday through Saturday, 7 a.m. through 11 p.m. Eastern Time.

Receive care from VA without stepping foot into a facility or having to make a phone call. The VA Health Chat App provides easy, online access to chat by text or video with VA staff when you have minor health questions, want to schedule an appointment, have a COVID-19 concern, and more.

https://mobile.va.gov/app/va-health-chat

Use VA Health Chat for immediate answers when:

• You feel ill and unsure about going to an emergency room or clinic
• You have a reaction to a medication
• You have questions about your prescriptions
• You need medical advice for a minor injury or illness, such as:
  • Allergies
  • Congestion/cough/cold
  • Ear ache
  • Fever
  • Rash
  • Sore throat
  • Stomachache

The VA Health Chat team can also help you:

• Find your closest VA facility
• Schedule an appointment*
• Refill a VA prescription
• Send a non-urgent message to your health care team

*The scheduling an appointment option is only available at the St. Cloud locations at this time.

Now that you are enrolled in VA health care, you will be assigned a primary care health care team, called a Patient Aligned Care Team (PACT).

Your PACT provider will provide most of your VA outpatient care appointments and coordinate referrals within the medical center.

Each PACT team consists of:

• Primary Care Provider (PCP)
• RN Care Manager
• LPN
• Medical Support Assistant (MSA)
• PACT extended team members-pharmacists, social workers, psychologists, dieticians, home based care, and others

There are many other supportive PACT members which include social workers, dietitians, psychologists, pharmacists, home based care staff and many others.  Our goal is to provide you with timely, friendly and comprehensive service within the primary care setting.

• Outpatient Addiction Treatment Programs
• Residential Rehabilitation Treatment Programs
• Trauma Services Program (PTSD & Military Sexual Trauma (MST)
• Therapeutic Supportive Employment Services
• Health Care for Homeless Veterans
• Primary Care Mental Health Integration
• Outpatient and Inpatient Mental Health Services
• Suicide Prevention Program
• Tele-mental Health
• Veterans Justice Outreach

A Mental Health Residential Rehabilitation Treatment Program (Domiciliary) provides residential rehabilitative and clinical care to eligible Veterans who have a wide range of problems, illnesses, or rehabilitative care needs which can be mental health, Substance Use Disorder, co-morbid medical, homelessness, vocational, educational, or social. 

Our RRTP Domiciliary provides a 24-hours-per-day, 7 days-per-week (24/7) structured and supportive residential environment as a part of the rehabilitative treatment regime.

Below is a list of specialty services offered here at VA Black Hills. Your primary care provider is your link to obtaining these services so please don’t hesitate to ask.

Some durable medical equipment and supplies are available only by order of the specialty provider who can measure and fit them. 

• Neurology (brain and nervous system)
• Oncology (cancer)
• Orthopedics
• Pain Management
• Podiatry (feet)
• Sleep Medicine (diagnostics/treatment)
• Spinal Cord Injury
• Traumatic Brain Injury
• Audiology
• Dialysis
• Urology
• Cardiovascular (heart & blood circulation)
• Dermatology
• Diabetes and Endocrinology
• Eye Care (Optometry & Ophthalmology)
• Infectious Disease
• Nephrology (kidney)
• Amputee Clinic
• Others

• Chiropractic
• Physical Therapy
• Occupational Therapy
• Speech Pathology
• Recreation Therapy
• Visual Impairment Services Team (VIST)
• Social Work
• Chaplain Services/Spirituality
• Nutrition
• Hospice Care
• Community Living Center
• Pharmacy
• Geriatrics and Extended Care
• Post 9/11 Transition and Care Management
• Voluntary Services

The Black Hills VA provides an array of medical and mental health services to our female Veterans. Some of these services include gynecological services and maternity care.

There is a designated Women’s Health primary care provider at every site, including the CBOC’s, except for Pine Ridge, Gordon, and Newcastle at this time. This should hopefully change soon.

• A full range of medical services are available including mental health, gender specific primary care and specialty care.
• Designated Women’s Health (WH) primary care providers
• Gynecological services
• Maternity care is available for enrolled Veterans through Care in the Community.
• Maternity care coordination is provided by a VA nurse throughout a pregnancy and postpartum.
• A designated Women Veterans Program Manager is available for information and referral. 

  Contact Info:

  Jennifer Hataway-Wallace can be reached at

You are NOT alone – call to speak with a crisis counselor at anytime, day or night.

Suicide prevention is a top priority of the Veterans Health Administration.

The Veterans Crisis Line is for anyone that is concerned about themselves or a loved one.  The service is anonymous and confidential and is designed specifically for Veterans and their families and friends.  Visit www.veteranscrisisline.net or call toll-free 988 press 1 for a one-on-one chat service for Veterans, families, and friends.

Trained VA counselors are standing by day or night.

Anonymous and confidential service provided especially for Veterans & families.

“It takes the courage and strength of a warrior to ask for help”

Are you wondering if someone you know, or love is thinking about suicide? 

Look for these symptoms:

• thinking of talking about hurting or killing oneself
• looking for ways to commit suicide
• consistently talking or writing about death, dying, or suicide
• self-destructive behavior, such as drug use or weapon usage
• feelings or comments about hopelessness
• anxiety, agitation, sleeplessness or mood swings
• feeling like there is no reason to live
• displaying rage or anger
• engaging in risky activities without thinking about them
• increasing alcohol or drug usage or abuse
• withdrawing from family and friends

If you see or feel these symptoms, please seek help immediately.  We’re standing by to help. 988 press 1.

An approach to health care that empowers and equips Veterans to take charge of their health and well-being, and live their lives to the fullest. 

Many chronic diseases can be prevented or improved through healthy lifestyle choices. VA Black Hills has many resources to help you improve your health. Our focus on prevention is probably our greatest commitment to you in providing the highest quality healthcare. We want to help take care of you by ensuring you know how to best take care of yourself, and here you’ll find many programs and self-care initiatives that help you do just that.  While not all programs are available at all locations, we’ll help you find the right one for you and provide it as conveniently as is possible.

8 parts of our health include:

• Working our bodies- to gain energy, strength and flexibility
• Our surroundings- both our physical and emotional surroundings
• Personal development- growing and learning in our personal life and/work life
• Food and Drink- how we nourish and fuel our bodies
• Recharging- getting adequate rest and sleep
• Family, friends and Coworkers- having a support system of caring people, listening and being heard
• Spirit and Soul- growing and connecting
• Power of the Mind- our ability to relax and heal

Each individual person is the center of their health and ultimately makes the decisions about what to focus on. Mindful awareness of our own health and needs and goals helps us move forward to improved health. We’re here to support your health.

• Veterans Health Library

https://www.veteranshealthlibrary.va.gov

• VA App Store

https://mobile.va.gov

• Telephone Lifestyle Coaching

Telephone Lifestyle Coaching is an opportunity to improve health and wellness outcomes by providing Veterans with trained personal health coaches, that have access to CPRS records. It is free to the Veteran and is available 7 am- midnight Mon.-Fri. and 7 am- 5 pm on Saturdays  -- in all time zones.  There are 10 weekly phone visits to work on achieving health goals and overcoming barriers as they arise.

Our VA Black Hills has many offerings for Veterans to participate in improving their own health.

Many of these offerings are listed below, but there are also several others.

Our VA provides a wealth of education on preventive care, such as tobacco cessation, diabetes, COPD, weight management (MOVE!) These are in addition to more holistic classes such as Yoga, Tai Chi, classes where Veterans build fly-fishing rods, leather work…. These are just a few of the offerings that we have.  Our classes have positive effects on the mind, body, and spirit.

If you are seeking your care at a CBOC (community based outreach clinic), we have certain offerings available at those sites and some of these can also be attended using Telehealth or another method.

Ask your Primary Care Team for more information!

• Yoga
• Tai Chi
• Move/Weight Management
• Intro to Whole Health Class
• Taking Charge of My Life and Health Group
• Behavioral Health Groups
• Diabetes Class
• Tobacco Cessation Group
• Caregiver Groups
• COPD Class
• Healing Waters
• Life Skills Group
• Spirituality and Recovery Group

If you are having a medical or mental health emergency, please call 911 or report to the nearest hospital.

If you are having thoughts of harming yourself, report to the nearest emergency room or call the Veterans Crisis Line at 988 and press 1.

We have a 24 hours a day staffed Emergency Room at the Fort Meade Campus.  We have an Urgent Care department located at our Hot Springs campus that is available from 7 am to 7 pm for urgent health issues. 

If you use non-VA emergency services, it is important you notify your Primary Care team as soon as possible.  

For non-VA emergency care, the VA has established guidelines listed below.

In order to use this process though, you must be enrolled for care within the VA Black Hills Health Care System.

It is very important to call VA for any care that is scheduled upon discharge from an Emergency Room or Inpatient stay to assure that you have authorization for any services.

Call our Non-VA Care staff or Care in the Community Staff with further questions.

Guidelines:

• Call the nearest VA within 72 hours of the emergency care and report the emergency care.  Report if you are admitted or were released home.
• Tell the non-VA facility to bill VA first.  We will do our best to cover the care under current laws and regulations.  If VA pays, this is considered payment in full; and the provider of the care may not bill you or any other entity for additional reimbursement.
• Make sure that you follow up with your Primary Care provider for any routine care that is recommended by the non-VA provider.  If you do not have services such as a follow-up appointment pre-approved, VA must deny payment of those unauthorized services.  In many cases, VA will take on the follow-up care needs.

The VA Mission Act. The MISSION Act gives Veterans greater access to health care in VA facilities and the community, it expands benefits for caregivers, and improves VA’s ability to recruit and retain the best medical providers.

Veterans enrolled in VHA should work with their VA  Health Care provider to ensure they meet new and improved community care eligibility criteria to include:

• Veteran needs a service not available at the VA Medical Facility
• Veteran lives in a US state or territory without full-service VA Medical Facility
• Veteran qualifies under the “grandfather” provision related to distance eligibility for the Veterans Choice Program (includes these give states- AK, MT, ND, SD, WY)
• VA cannot furnish care within designated access standards
• The Veteran and provider agree it is in the best medical interest
• A VA service line does not meet certain quality standards

Visit www.missionact.va.gov

The grandfather provision is somewhat confusing to our Veterans, not all Veterans are grandfathered due to living in South Dakota. This is only applicable to those that were in a rural location and were drive time eligible prior to Mission Act. For example, a Veteran who lives in Rapid City is not considered grandfathered as there was a CBOC with a doctor who was at that facility making it a qualifying facility. This veteran would not be eligible for services that could be done at Fort Meade for drive time (60 min) for specialty care. 

Access Standards are as follows:

• Primary Care is 30 minute drive time or 20 day access from the clinical indicated date care is needed.  
• For Specialty Care is 60 minute drive time and 28 day access from the clinical indicated date care is needed.  

If care is not needed within 20 or 28 days then wait time is no longer applicable and a Veteran would not be qualified for CITC.

Talk to your healthcare provider or Visit www.missionact.va.gov for more information.

Care can be authorized in the community in certain situations. Veterans can receive preapproved care determined by mileage, wait time, or if the service is not offered here at VA Black Hills. We do accommodate traveling Veterans and vacationers, we can also provide transplant coordination. This is all arranged in our Fort Meade and Hot Springs Community Care Offices. As stated on a previous slide, access standards are as follows:

• Primary Care is 30 minute drive time or 20 day access from the clinical indicated date care is needed.
• Specialty Care is 60 minute drive time and 28 day access from the clinical indicated date care is needed.  

Again, if care is not needed within 20 or 28 days then wait time is no longer applicable and you would not be qualified for CITC for this specific access standard.

Do not attend appointments without pre-approval or authorization. VA cannot pay for care after it is completed.

 If you were previously seen in the community it is possible you may be brought back to VA if services become available after your episode of care is completed.

You will be assigned a case manager in the Care in the Community program that is available to assist you with your questions. You are assigned a case manager by your last name.

Please reach out to your care provider for more information if needed.

• Care can be authorized in the community in certain situations.
• Veterans can receive pre-approved care determined by mileage, wait time, or if the service is not offered at VA Black Hills.
• We accommodate traveling Veterans such as vacationers or “snowbirds”.
• We provide transplant coordination.

(may be available if qualifications are met)

Fort Meade:

•HOPTEL

•BOQ (Bachelor Officers’ Quarters)

•Local Hotel

Hot Springs:

•Local Hotel

*Call Patient Services with any questions.*

Patient Services Fort Meade 1- or 1- or Hot Springs

There is a Hoptel located at the Fort Meade Campus only.  There are 4 rooms available, one bed per room, food is not provided, there is a common area with a kitchenette.

We do not take reservations for these rooms as it is first come first serve basis.

There is also the BOQ at the Fort Meade Campus with a limited number of rooms we can use. There is a fee for the BOQ rooms. Food is not provided in these rooms either. Both campuses, Fort Meade and Hot Springs, also utilize lodging veterans’, in local motels.

Please go to patient services during Monday through Friday 7:30 AM and 4 PM to be lodged. During after hours and weekends, please check in with Patient Services staff sitting in the Urgent Care in Hot Springs, and the Emergency Room at the Fort Meade site.

• Travel assistance is available  through the Veterans Transportation Service.
• This includes travel for VA provided care or approved VA medical services in the private sector.
• To arrange your own travel, call

Veteran transportation goes door to door taking Veterans to VA or Non-VA medical appointments.

• Average 400 trips per month
• Utilizes 4 wheelchair vans
• Have sent drivers as far away as ND, WYO, Colo, NE
• No charge to Veteran
• Like to have 48 hours notice when possible. The more notice the better.
• For last minute requests we will try to support but no guarantee

• Travel eligible Veterans can be reimbursed.
• Call Patient Services to see if you qualify
• Ambulance bills:  VA does not always pay

Beneficiary Travel

Fort Meade /7034

Hot Springs:

Questions about Beneficiary Travel can be addressed by VA travel clerks.

VA does not always pay.

Veterans must meet Beneficiary Travel eligibility and medical necessity unless –

• Inside VA walls or
• Under VA Auspices

If a Veteran lives in approved highly rural counties there is not a charge for transportation when transported by Prairie Hills Transit.

Beneficiary travel processes an average of 3500 claims per month for travel reimbursement to BT eligible veterans.

Reimbursement is not immediate as we are a  “cashless” facility so money is transferred to your account or provided in the form of a bank card which may take up 15 business days to receive.

Call patient services to see if you qualify!

1. Notify a member of your healthcare team.
2. Request to speak with a Service Line Patient Advocate in the area where you are receiving care.
3. Ask to speak with the area Supervisor.
4. Ask to speak with the Service Chief.
5. Speak with a Patient Advocate.

Here at the Black Hills VA, we have Patient Advocates on staff at both the Fort Meade and Hot Springs campuses.  If you have a concern, first make contact with your care team. Your primary care team is available to assist you with any questions or concerns, as your first point of contact.

If you ever feel a concern is not being addressed by your treatment team, you may choose to contact the Patient Advocate.    The Patient Advocate is available to any patient or family of a Veteran seen at VA Black Hills Health Care System.

The Patient Advocate can help you resolve an issue if it is not adequately resolved by your care team.

1. Complaints- through the Director’s Office
2. Clinical Disputes- through the Chief of Staff
3. Clinical Appeals- through VISN 23

Patient Advocates are located at the Fort Meade and Hot Springs campuses.

Safety to our staff and veterans is of the upmost importance. Each VA medical center in Fort Mead and Hot Springs have VA officers on site.

To call VA police:

• Fort Meade   
• Hot Springs  

It is important to observe facility prohibited items including:

• Guns
• Knives
• And explosives.

Feel free to ask police for consideration of other items not listed. Ask if you don’t know.

• A service animal means any dog that is individually trained to do work or perform tasks for the benefit of a person with a disability.
• The individual with the service animal is responsible for the service animal at all times while on VHA property including providing water, food, and bathroom breaks for the service animal as needed. 
• Service dogs may be removed from VA property if they are not under the control of their handler or show aggressive behaviors.
• Service dogs in training, emotional support animals, and therapy animals are not considered service animals.
• If the service animal may be a health or safety risk to patients, visitors, VA staff or other employees, or other service animals, VHA staff will make a decision based on risk on a case by case basis.

For Veterans interested in how to file a claim for service-connected disability, there are a few options.  It’s important to remember that VBA typically handles anything regarding benefits, and the VHA typically handles anything with healthcare. 

• Contact a Veterans Service Officer (VSO)

https://vetaffairs.sd.gov/veteransserviceofficers/locatevso.aspx

• Contact Veterans Benefits Administration (VBA)  1-
• eBenefits website:  https://www.ebenefits.va.gov

VBA handles anything with “benefits”

VHA handles anything with “healthcare”

Work with eligibility to determine your priority or eligibility group. The enrollment and eligibility staff will be able to answer any questions you have on your eligibilities.

Patient services staff are available at both the Hot Springs or Fort Meade campuses, Monday thru Friday, 7:30 AM to 4PM.

While visiting patient services, please ask about getting a Veterans Health Identification Card.

• Contact Eligibility for questions related to your covered services at :

  Fort Meade: or

  Hot Springs:

• Based on your specific eligibility status, you will be assigned a priority group.

In an effort to improve Veterans’ health care experiences, we have added self-service kiosks to some of our locations to streamline appointment check-in and to allow you to manage your own health information. The VetLink kiosks are very similar to systems used in airport terminals.

Kiosks are a great way to check in for your appointments! Consider using them during your visits to our facility! Kiosks are located at our Fort Meade, Hot Springs, Rapid City, Winner, and Scottsbluff locations.