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“The only thing necessary for these diseases to the triumph is for good people and governments to do nothing.”

    

INCARCERATED VETERANS ARE ELIGIBLE FOR VA MEDICAL CARE AT VA HOSPITALS AND CLINICS

by Thomas P. McCormack

All veterans who have served at least 180 days’ active duty and who have honorable or general discharges are eligible for care at federal department of Veterans’ Affairs (VA) hospitals and clinics.* Veterans need not have served in wartime; be disabled; or have injuries or illnesses arising from their time in service—even though the public and many veterans themselves wrongly believe this is so!

In 2002, Priority Group 5 veterans---those with incomes under $2,025 monthly and assets under $80,000, plus lived-in homes and vehicles of  any value--are entitled to free care (except for a $7 per prescription copayment) after veterans with service-connected health problems are given priority care. Priority Group 7 veterans---those  with incomes or assets above those levels--- are also entitled to care, on a space available basis, but with small, additional copayments (e.g., $7 per prescription, $15 to $50  per doctor/outpatient  visit,  $840 plus $10 per day for each hospital stay).

The federal Department of Veterans’ Affairs (VA) does not deny medical care to qualified veterans merely because they’re incarcerated in prisons or jails. But the VA only provides care at its own facilities’ sites—hardly ever at other locations, much less correctional institutions. (Pilot programs allow some veterans, with advance permission, to get care from non-VA medical providers in Colorado, Wyoming, Idaho, Montana, Utah and parts of central Florida.) Except for needy veterans injured or taken ill while on active duty, neither the VA nor associated non-profit groups provide transportation to VA care.

It is important to note that the VA doesn’t permit armed guards at its medical facilities. While there is no bar to unarmed escorts accompanying persons in correctional custody into VA waiting areas, escorts may well have to negotiate physicians’ consents to accompany inmates into examination and treatment rooms. And there would be even more problems with 24-hour-a-day escorts for hospitalized inmates.

    

Correctional medical staff should also be aware that initial, unscheduled and emergency room visits to VA facilities usually entail waits of several hours to be seen. Considering budgets for transportation and escorts it is probable that only care of high cost patients—such as those with HIV—may be worth the expense of resorting to VA care even for selected inmates. And, after being seen, issuance of resulting prescriptions can mean waits of 2 or 3 hours more---unless the prescription slips are dropped off at the VA’s in-house pharmacy for later mail-out. 

But except for the wait for drugs, regularly scheduled physician visits and procedures for already-enrolled patients usually involve no more of a wait than is the case with private physicians.

Obviously, only those veteran inmates who can be relied upon to refrain from violence and escape attempts can be considered for VA medical care, given the ban upon armed escorts and the likely ban on any escorts for overnight-hospitalized patients. Still, VA care may well be a resource for correctional facilities facing heavy medical expenses because of costly conditions like AIDS.

Since veterans are required to present their discharge papers (DD Form 214s) when first enrolling for VA care, correctional officials need to have those identified as veterans write to the Army, Navy, Air Force, Marine or Coast Guard Liaison Office at the National Personnel Records Center for copies. The address is 9700 Page Boulevard, St. Louis, MO 63132. The veteran must provide his date of birth, Social Security number, service number, dates of service, branch of service, and discharge date.

Callers to 800-827-1000 can get the locations of area VA hospitals and clinics and other benefits information; also see www.VA.gov . “Federal Benefits for Veterans and Dependents”, VA Pamphlet 80-99-1 is available for a small fee from the Government Printing Office. It summarizes the benefits rules and lists all VA medical facilities and the Regional Offices which handle applications for non-medical benefits ; call (202) 512-0132 to order a copy.

 In addition, every state has a veterans’ advocacy office to assist its residents in accessing veterans’ benefits. These small, obscure agencies can be a valuable resource for state and local correctional systems wishing to get VA medical access for appropriate veteran inmates. The Governor’s executive office is the best place to start in locating these little known but vital state agencies.

Helping inmates with potentially serious maladies like HIV can also promote good discharge planning as well. In cases where an eligible, fully disabled veteran is still in custody, he cannot actually collect pension payments for himself while incarcerated over 90 days.

(Correctional administrators should note that-- like the situation with Social Security and SSI payments—the advent of “direct deposit” benefit payments to banks means that inmates may mistakenly or even purposefully continue to receive payments even after incarceration makes them ineligible—leading to loss of control, black market activities and disciplinary problems. State veterans’ agencies can assist authorities in identifying and handling situations where this abuse can occur.)

    

However, where there’s a spouse or minor child in the community VA pension payments may well be payable to them—and this would help meet inmates’ child support liabilities and lower state welfare costs as well. Again, state veterans’ offices and state child support agencies can assist correctional administrators in apportioning VA pension checks in these cases. 

*Those first enlisting after September 7, 1980 must, in addition, serve at least 24 months’total active service unless:

1.      They were activated Reservists or National Guardsmen who served out their full activated tour, even if it was less than 24 months (for a pension, the 90 days’ active service time minimum and one-day-of-wartime rules also apply; but medical care only requires the 180 days’ active service time minimum).

2.      They got early honorable or general discharges before 24 months because of hardship or disability (again, the 90 days’ active service time minimum and one-day-of-wartime rules still apply for pensions; but medical care only requires the 180 days’ active service time minimum).

Thomas McCormack, a Vietnam-era veteran,  wrote the AIDS Benefits Handbook (Yale University Press) and handled benefits eligibility policy at the Department of Health and Human Services and several AIDS and disability organizations.  He now consults for the Title II Community AIDS National Network (T2CANN). Email him at tomxix@ix.netcom.com.