WASHINGTON—On March 4, VA announced its first coronavirus patient—a veteran at the Palo Alto VAMC. Seven weeks later, the system had 6,363 reported cases and 400 inpatient deaths nationwide.
As of press time in late April, at least 132 VA facilities had treated patients for coronavirus, and at least 70 had reported at least one death. In addition, approximately 2,000 VA employees had reportedly been infected, and thousands more were self-isolating following exposure.
The VA hot spots mirrored their civilian counterparts, with the highest rates in New Orleans, Manhattan and the Bronx in New York, and East Orange, New Jersey. Those four areas accounted for more than 25% of VA cases. While hospitals in those high outbreak areas struggled to keep up with demand —and VA hospitals across the country saw their numbers steadily rise —legislators and VA officials worked to provide more supplies, staff and funding for the strained system.
The $2.2 trillion dollar CARES Act included $19.6 billion for VA. That included over $14 billion for medical services, $2.2 billion for expanded telehealth care and $2.1 billion to support an expected increase in demand for community care, specifically emergency room and urgent care.
The legislation gave VA the ability to bend existing regulations to accommodate facilities and veterans striving to adhere to social distancing. For example, it waived the requirement that VA state homes maintain a 90% occupancy in order to receive benefits. The reasoning behind the waiver is because homes will find it difficult to maintain social distancing between residents if at full or near-full capacity.
It also allows VA to enter into short-term agreements with telecommunications companies to subsidize support for mental health services through VA’s Video Connect Service, as well as other providers.
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VA reported a massive increase in veterans opting for telehealth services while they sheltered in place and avoided VA facilities. Over 47,000 virtual appointments were held in March—a 200% increase from the month before. Mental healthcare and consultations delivered by phone rose from 40,000 in February to 154,000 in March—an increase of 280%.
“VA is open for business, and we continue to provide same-day mental health services and mental health screening for veterans at-risk who require attention,” declared VA Secretary Robert Wilkie in a statement. “There is no doubt VA’s early embrace of new technology is aiding veterans, and I applaud VA healthcare workers and veteran patients for embracing it.”
VA also is working with the American Red Cross to provide more than 7,400 Facebook Portal devices to veterans and their caregivers and families. The hope is that the smart-screen video call devices will help alleviate the social isolation veterans might be feeling during the pandemic.
“Our goal is for veterans to feel less isolated through more communication. We believe this technology will help veterans who might otherwise be unreachable.”
The CARES Act also provided Economic Impact Payments to all citizens based on their 2018 or 2019 tax returns. However, some veterans who receive VA benefits and whose annual income falls below a certain amount are not required to file tax returns.
Following reports that many of these veterans were afraid they would be left out, VA began working with the IRS to make these payments automatic for nonfiling VA beneficiaries. In an effort to ease veterans’ financial worries, VA also suspended debt collections and is providing increased time for veterans filing claims to submit their paperwork.
“We want veterans to be focused on their health and safety,” Wilkie said. “That’s why we’re taking action to give those with pending debts, claims and appeals greater flexibility during challenging times.”
By mid-April, VA had also opened its doors to dozens of nonveteran COVID-19 patients, with VA leaders saying they were committed to making 1,500 beds available to accommodate the rolling stream of requests from the Federal Emergency Management Agency. The VA’s New York Harbor facility had the highest nonveteran patient population, with 80 patients, 30 discharges and 5 deaths.
With demand at an all-time high, VA has moved aggressively to fill staffing gaps. The department has launched a national hiring campaign to attract registered nurses, respiratory therapists, anesthesiologists, housekeepers and other professionals who fill critical roles in the treatment of COVID-19 patients.
Between March 29 and April 11, VA hired 3,183 new staff members, 981 of whom were registered nurses—a 37.7% increase from the two weeks prior. According to Wilkie, VA expected to hire another 4,500 staff members during the last week of April and the beginning of May.
According to VA, many of these new hires come from healthcare systems that have seen temporary layoffs due to the pandemic. The department also has invited retired healthcare workers to work for VA, waiving the salary restrictions that would normally apply.
To shore up staffing levels at the most impacted facilities, VA implemented its Disaster Emergency Medical Personnel System. The agency put out a call for VA employees who have experience in intensive care, medical and surgical units, as well as biomedical technicians with expertise using ventilators. In exchange for a 14-day DEMPS deployment in high-risk areas workers have been offered a $5,000 bonus.
VA officials stressed that this was not unique to the pandemic and was a “normal and routine” part of the agency’s response to local and national disasters.