Maintaining Internal Systems and Strengthening Integrated Networks (MISSION) Act Goes into Effect

Hook Law News | Jun 6, 2019 | Shannon Laymon-Pecoraro, CELA

Signed into law on June 6, 2018, the MISSION Act is designed to strengthen the ability of the Department of Veteran’s Affairs (VA) to deliver easily accessible high quality care at VA facilities, virtually, and in the community. The MISSION Act went into effect on June 6, 2019.

The MISSION Act came after a study in 2014 that revealed hundreds of thousands of veterans were waiting weeks, sometimes months, for medical appointments at VA health facilities, with some veterans dying while they waited for an appointment.

The law requires the VA to establish new quality and access standards for care received outside VA facilities. While the MISSION Act will better integrate the VA with community health care providers and tackle issues associated with the VA’s outside care program, ultimately expanding health care options, the MISSION Act is also designed to maintain the VA’s infrastructure for those who receive care at VA facilities. To do so, the MISSION Act requires the VA to review its medical centers and clinics to determine whether they are properly structured to serve the veteran population, and put assets and resources into locations that will benefit veterans most.

A key component of the MISSION Act was to provide urgent care benefits to Veterans while promoting choice and access to timely, high-quality care. Rather than being required to go to a VA facility emergency room for urgent care issues, the MISSION Act allows veterans to go to civilian urgent care facilities. To receive care, and have the VA cover the cost, the following conditions exist:

  • The care provider must be part of the VA’s contracted network of community healthcare providers
  • Must be for urgent care –  preventative care or dental services will not be covered
  • You must be enrolled in VA healthcare and have received care through the VA within 24 months
  • You may be charged a copayment, of  up to $30,  for your urgent care visit which will be billed by the VA, not the care provider
  • A prescription for more than a 14-day supply must be filled by the VA and there may be copays for prescriptions filled outside of the VA

There are additional benefits under the MISSION Act, such as access to the caregiver program for veterans who have incurred or aggravated serious injuries while serving in the activity duty military. Additionally, the VA must provide access to community care if the VA does not offer the services required by the veteran, there is not a full-service medical facility in the state in which the veteran resides, or the veteran was eligible for care in the community under the 40-mile rule in the Veterans Choice Program. There is also a responsibility for the VA to ensure its care providers are using “evidence-based guidelines” for prescribing opioid-based painkillers.

Ask Kit Kat: Feeding Hummingbirds

Hook Law Center: Kit Kat, what is appropriate to feed hummingbirds?

Kit Kat: Well, first of all, there are many types of hummingbirds. Bee hummingbirds are extremely tiny. They are the tiniest of hummingbirds. Rufous hummingbirds make very long migrations relative to other migratory birds. Anna’s hummingbirds fly faster than some space shuttles. So all in all, this is a very varied species.

With that said, if you happen to live in an area with hummingbirds, how can you encourage them to stay, and what should you offer to feed them? Experts say the best thing to provide hummingbirds is an environment rich with insects and flowers. Salvias, penstemons, monkeyflowers are excellent examples. In the past, it was thought that feeders containing sugar water was the way to go. However, scientists now realize that is probably the worst thing that can be done. One has said, “Feeders in landscapes with fewer insects are akin to fast-food drive-thrus doling out 32-ounce sodas and nothing else—a quick hit of energy but little substance.” Moreover, sugar water can go flat, especially in hot weather. If used, it should be changed often. Lisa Tell, of the UC Davis Hummingbird Health and Conservation Program, comments, “If you wouldn’t drink it, then it’s not great to offer them.” Also, feeders should not be placed too close to a window to prevent the birds from injuring themselves.

Hummingbirds are an important part of our ecosystem. They help to pollinate about 7,000 species from Alaska to Argentina. In turn, the plants they help to thrive, provide nourishment for mammals that we humans consume. It’s the circle of life—and we owe these tiny avians a great deal! (Nancy Lawson, “To feed or not to feed,” All Animals, March/April/May 2019, p. 30)

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