The Presidents FY 2018 budget request proposes $186.5 billion for the Department of Veterans Affairs (VA) www.va.gov and includes $82.1 billion in discretionary funding largely for healthcare. The budget request provides a $4.6 billion increase in discretionary funding for VA healthcare to improve patient access and timeliness of medical care services for about nine million enrolled veterans.
The budget requests $9.7 billion for community care which is up $2.4 billion from 2017, plus an additional $2.9 billion in new mandatory Choice Program https://www.va.gov/opa/choiceactt funding.
The VA is requesting $4.1 billion for IT services which includes investments needed to strengthen cybersecurity, modernize veterans’ EHRs, and improve veterans’ access to benefits. This also includes an investment of $340 million for information security to protect information and improve the VA’s information networks resilience.
The Veterans Health Administration (VHA) www.va.gov/health monitors quality and safety for health information systems and will focus on eHMP, an intelligence and user experience platform. eHMP is not an EHR since eHMP can sit on top of one or more EHRs and supports clinical content. VHA needs eHMP to transition from VistA to any other EHR-like capability including the Digital Health Platform.
eHMP v2.0 will be made available to 3,500 clinical users in VHA. The VHA’s new team management tools in eHMP will allow clinicians do more care management. This will enable VHA to take better care of more patients with a fixed budget and to better manage clinic schedules.
The goal for 2018, is to implement VistA 4 projects by the end of 2018 and deploy more eHMP capabilities to support veteran tailored care plans.
According to the budget request for 2017-2019, there are plans to deploy and provide an award for a modernized EHR, but these plans are dependent upon the Secretary’s decision expected July 2017.
Today over three million enrolled veterans live in rural and highly rural areas, which make up approximately 33 percent of all veteran enrollees. The VA’s Office for Rural Health (ORH) www.ruralhealth.va.gov budget request for FY 2018 is $250 million for rural health projects.
Projects funded through the ORH include home-based primary care, training and education of medical residents in rural clinical settings, equipment for rural Community Based Outpatient Clinics, transportation for rural veterans, and home-based therapies.
ORH partners with the Veterans Health Administration to promote Enterprise Wide Initiatives (EWI) that offer VA facilities serving rural veterans initial funding to produce new and innovative programs to increase access to care. Examples of EWIs involve Tele-Primary Care and Tele-Mental Health Hubs, and clinical pharmacy staffing for clinics.
ORH also works closely with the VHA Health Services Research & Development (HSR&D) www.hsrd.research.va.gov and the VHA’s Quality Enhancement Research Initiative (QUERI) www.queri.research.va.gov. VHA researchers are going to implement programs capable of evaluating and identifying rural veteran healthcare disparities and work to improve healthcare access challenges faced by rural veterans.
The FY 2018 budget request calls for $8.4 billion for veterans’ mental health services, which is an increase of 6.0 percent above the 2017 level. The VA provides mental health services ranging from treating a variety of common mental health conditions in primary care to more intensive interventions in specialty mental health programs for more severe and persisting mental health conditions.
Mental health services are provided by having mental health professionals embedded in Patient Aligned Care Teams (PACT) to help assess patients along with primary care doctors and medical staff. The VHA also provides intensive recovery-oriented individual and group treatments plus inpatient care for the most serious mental health issues.