The VA MISSION Act represents a significant overhaul of the Veterans Affairs (VA) healthcare system, aiming to improve services for the 9 million enrolled veterans across the United States. Here's a breakdown of how the Act works and the process for veterans to access community care.

Core Components of the VA MISSION Act

Recruitment and Retention: The Act enhances the VA's capability to attract and keep healthcare professionals.

Telehealth Advancements: Authorizes telehealth services across state lines, providing "Anywhere to Anywhere" care.

Expanded Community Care Access: Veterans gain increased access to non-VA community care providers, if they meet certain criteria.

New Urgent Care Benefit: Eligible Veterans can access urgent care from a network of community providers, allowing for timely medical attention.

Eligibility for Community Care

As a veteran, if you meet specific criteria, you have the option to receive care from providers within the VA’s community care network, with the VA covering the costs. However, choosing community care does not limit you from seeking services at VA facilities; it simply adds more options for your healthcare.

Obtaining Community Care Referrals

To access care from a non-VA provider, follow these steps to get a referral and schedule an appointment:

1. Provider Search: Start by searching for an in-network community provider. If you face difficulties or the preferred provider isn't in-network, your VA healthcare team can assist you.
2. Referral Request: Request a referral from your VA healthcare team. The VA will review your request to confirm eligibility and discuss your needs, after which they will prepare your referral, which can take up to 14 days.
3. Scheduling the Appointment: Once you have your referral, you can either schedule the appointment yourself or ask your VA team to do it. If you book it yourself, inform your VA team within 14 days so they can coordinate with the community provider.
4. Authorization Letter: After scheduling, you’ll receive an authorization letter from the VA, detailing your approved care, provider information, and duration of the authorization.
5. Attend Your Appointment: The VA will share your medical records with the community provider. Bring any additional requested medical images to your appointment.
6. Managing Follow-up Care: If ongoing care is approved, monitor your appointments and the authorization timeframe. For further care beyond the approved period, you or the provider must request a new referral.

Engaging with the Community Care Network

Veterans can initiate this process by sending secure messages to their VA providers, managing appointments, and staying engaged with both their VA healthcare team and community providers.

The Broader Impact of the VA MISSION Act

Ultimately, the VA MISSION Act, through establishing the Community Care Network, empowers veterans to have greater control over their healthcare, ensuring they can access timely and efficient services, whether within the VA system or through community providers. It’s an essential step towards a more flexible, veteran-focused healthcare system.

Mission Act Criteria

• A Veteran needs a service not available at any VA medical facility.
• A Veteran lives in a U.S. state or territory without a full-service VA medical facility. Specifically, this would apply to Veterans living in Alaska, Hawaii, New Hampshire and the U.S. territories of Guam, American Samoa, the Northern Mariana Islands and the U.S. Virgin Islands.
• A Veteran qualifies under the “grandfather” provision related to distance eligibility under the Veterans Choice Program.
• VA cannot furnish care within certain designated access standards. The specific access standards are described below:
• Drive time to a specific VA medical facility:
  • Thirty-minute average drive time for primary care, mental health and noninstitutional extended care services.
  • Sixty-minute average drive time for specialty care.
    • Note: Drive times are calculated using geo-mapping software.
  • Appointment wait time at a specific VA medical facility:
    • Twenty days from the date of request for primary care, mental health care and noninstitutional extended care services, unless the Veteran agrees to a later date in consultation with his or her VA health care provider.
    • Twenty-eight days for specialty care from the date of request, unless the Veteran agrees to a later date in consultation with his or her VA health care provider.
  • The Veteran and the referring clinician agree it is in the best medical interest of the Veteran to receive community care based on defined factors.

If you, or a Veteran you know, is struggling with mental or behavioral healthcare concerns, you can contact the VA directly by dialing 988, and selecting option 1, or by texting “838255.  If anyone is experiencing a medical or psychiatric emergency, please dial 911.