Director's Message May 19, 2023

 We have a variety of outpatient therapy options that have helped many Veterans. However, not everyone finds outpatient therapy to be enough. For those Veterans who need a little extra help, we offer our PSTD Residential Recovery Program (PRRP).

PRRP is an 8-to-9-week residential treatment program for Veterans and active-duty service members with military-related PTSD. PRRP operates on a “cohort model,” meaning that the same group of patients start and end the program together. The cohort model helps patients to form bonds with one another, which has proven to be a crucial aspect to the healing process. PRRP offers evidence-based group and individual therapy, as well as comprehensive psychiatric and medical care, peer support interventions, and therapeutic recreational activities. The program’s recovery and integrative treatment model is designed to decrease PTSD symptoms and increase effective coping skills.

The lives of many Veterans have been greatly improved by the program. Remember, there are always options for your treatment when you’re struggling with your health. I hope you’ll feel comfortable talking with your doctor and letting them know if you need extra support. Your mental, physical, and spiritual health are our priority.

Public Health Emergency Has Ended

The COVID-19 Public Health Emergency (PHE) has been declared over. Here is an overview of how the end of the PHE will impact VA care and services:

Controlled medications. During the public health emergency, VA clinicians have been able to prescribe controlled medicines to Veterans following a telehealth examination without first having an in-person examination. The Drug Enforcement Agency (DEA) and the Substance Abuse and Mental Health Administration (SAMHSA) have announced a temporary rule that will extend the current PHE related flexibilities for prescribing controlled medications, so VA’s prescribing flexibility will not expire when the public health emergency ends. Additionally, DEA, in concert with Health and Human Services (HHS) and in coordination with the VA, has proposed rules for telemedicine flexibilities beyond the declared public health emergency.

Caregiver assessments. During the pandemic, VA relaxed requirements for in-person initial homecare assessments and wellness contacts associated with VA’s Program of Comprehensive Assistance for Family Caregivers (PCAFC) and instead conducted most of those visits virtually. This flexibility will end on May 11, meaning that all initial home-care assessments and at least one wellness contact per year will now need to be conducted in person. Such in-person visits have already resumed at most VA facilities. VA is actively communicating with all participating Veterans and caregivers to help them through this transition.

Veterans experiencing homelessness. During the PHE, Veterans experiencing homelessness and those participating in HUD-VASH could receive additional direct support from VA – including assistance needed for the safety and survival of the Veteran (such as food, shelter, clothing, blankets, and hygiene items), transportation needed to support the stability and health of the Veteran (such as for appointments with service providers, conducting housing searches, and obtaining food and supplies), communications equipment and services needed to support the stability and health of the Veteran (such as tablets, smartphones, disposable phones, and related service plans), and more. After May 11, 2023, Veterans will no longer be able to receive this type of direct support under this authority. Congress has proposed legislation that would authorize VA to continue providing the assistance described above after the end of the PHE, but for now, we are taking all possible steps to make this transition as smooth as possible for Veterans experiencing homelessness – including offering support through our Supportive Services for Veterans Families program, local Centers for Development and Civic Engagement (formerly Voluntary Service), and community partners.

Reinstatement of pre-pandemic deadlines for VA travel reimbursement. Under the PHE, VA extended the deadline for Veterans and caregivers to apply for travel reimbursement for mileage and other travel expenses to and from approved health care appointments – meaning that Veterans could apply for these benefits beyond the normal 30-day window. This flexibility will end on June 9, 2023. After that date, Veterans submitting a claim for travel reimbursement will have to submit it within 30 days of their VA medical appointment. Veterans will also be required to submit beneficiary travel appeals within 365 days. To learn more about travel reimbursement and eligibility, visit the Beneficiary Travel Self-Service website.

Vaccinations. The SAVE LIVES Act authorized VA to provide COVID-19 vaccinations to spouses, caregivers, and Veterans who are not enrolled in the VA health care system. Following the expiration of the PHE, spouses, caregivers, and Veterans who are not enrolled in the VA health care system will no longer be eligible to receive these at VA. Instead, they are encouraged to stay up to date with recommended vaccines through non-VA providers.

Remember the Public Health Emergency is over.  COVID Is not.  It is still a deadly infection.  Protect yourself and your ohana accordingly.

Safe Travels

As we head into summer vacation in the coming weeks, many families will take their kids on trips to places like amusement parks, relatives’ homes, and national parks. I would encourage you all to remember that the flu and COVID-19 are still out there. To be safe, consider getting vaccinated before you travel. Remember to bring masks for airplane trips, and hand sanitizer to wipe down surfaces in public places. Staying healthy should always be a priority when you travel! The CDC has put out some additional tips to keep your family safe when you travel, which you can read about here. May you all have a healthy summer!

Mental Health Awareness Month

One of my top priorities is the mental health of our Veterans. I’d like to remind everyone that we have a new number for the Veterans’ Crisis Line: 988, then press 1. You can also call VAPIHCS and make an appointment with one of our mental health providers at 1-800-214-1306. Remember that Congress also passed the new Comprehensive Prevention Access to Care and Treatment (COMPACT) Act, and it has the power to help millions of Veterans receive emergency care for free. No matter their VA status, Veterans can receive free emergency care at any health care system if they’re in a suicidal crisis. Help is there if you need it, and I hope you won’t hesitate to ask.

Soldiers are taught to be tough. We were never supposed to admit to having emotions, because emotions get in the way in combat. It can be hard to let that mentality go. Yet, we know that combat can cause physical, mental, and spiritual wounds to a person. We know that there is damage done, and you might need help to fix it. It’s okay to ask for help. That’s what the VA is here for. We exist to help you, and I want you to take us up on it.

Mental health isn’t just about those who are in crisis. It’s also something that we must take time to practice every day. We know that getting in some physical activity can help with your mental health, so think about getting up and taking a walk. Have a swim in the ocean. Find a way to incorporate physical activity into your daily life. Additionally, it can help to spend time in nature. For some, that might mean hiking to a waterfall. For others, that might mean peacefully sitting on the beach. Whatever you like to do when you go outside, just make sure that you get some time out of the house. We can all benefit from incorporating good habits for improved mental health into your routine. Consider going to our Whole Health website and learning about ways to be happier and more fulfilled as you go about your day.

Thoughts from Chaplain Richie Charles

Born on Maui in 1946, Eddie Aikau became a revered surfer and lifeguard, leaving an enduring legacy. His prowess as a surfer at Waimea Bay, facing 40-foot giant waves, solidified his fame. Eddie's triumph in the 1977 Duke Invitational Contest further cemented his legendary status within the surfing community.
Beyond his surfing accolades, Eddie embodied the spirit of aloha, which truly became evident in his work as a lifeguard. Waimea Bay is known for its powerful currents and high waves which could put even experienced surfers at risk if they’re not careful. But Eddie's skill shined as a lifeguard. It has been said that Eddie went on 500 rescue missions to save others from drowning, and out of the 500, not a single life was lost.

In 1978, Eddie joined a 30-day, 2,500-mile voyage with the Polynesian Voyaging Society from Hawaii to Tahiti, mirroring the ancient Polynesian migration route. During the journey, the canoe suffered a leak and capsized near Molokai. Eddie valiantly paddled away on his surfboard to seek help for the crew members, but tragically, he never returned. Despite extensive search efforts, Eddie's whereabouts remain unknown.

Eddie Aikau provides us an inspirational legacy of service. Although temperamentally reserved, in the waters, Eddie came alive – for when he served in the ocean, he was in his element. What is your element? What are your passions? Though counterintuitive, it is often true that when we serve the needs of others, especially in our passions and gifts, it leaves us with a deep, profound sense of fulfillment.

Eddie serves as a reminder that one of the noblest pursuits of life is to use our energies to uplift others. We may not be skilled surfers or lifeguards, but each day presents us with new opportunities to do something, however small, to uplift someone around us.

One Team, One Ohana!
Adam M. Robinson, Jr., MD, MBA, CPE
Director, VA Pacific Islands Health Care System
VADM, MC, USN, (RET)
36th Surgeon General, USN

Stay Informed

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