Don’t forget the VA’s role in emergency preparedness

Congress is considering numerous bills that would defund and ultimately privatize the Veterans Health Administration (VHA). One of the things many political representatives seem to have forgotten is the role the VHA plays in responding to emergencies like wildfires, hurricanes, volcanic eruptions, and other natural disasters that occur all too frequently throughout the United States.

One of the four missions of the Veterans Health Administration is responding to national emergencies. This also goes along with delivering clinical care to veterans, conducting research that benefits veterans and all Americans; and teaching the nation’s health care workforce.

{mosads}In Puerto Rico, for example, the San Juan VA Medical Center was one of the only functioning hospitals to after hurricane Irma and Maria devastated the island.

It could continue to help patients because it’s mission is to be well prepared for emergencies, equipped with backup generators and well stocked with supplies.

Over the past four weeks in California, I have watched the San Francisco VA Health care System utilize its well developed emergency infrastructure to respond to the series of fires that devastated Northern California in October.

When it became clear how serious the outbreak was, the hospital set up a Hospital Incident Command service and mobilizing hundreds of staff to reach out to employees and veterans.

VHA employees instantly began calling staff and veterans to make sure they were safe. When the Santa Rosa Community Outpatient clinic that serves over 9400 veterans-to close, the VHA knew that thousands of veterans could be impacted.

VA staffers from all over Northern California went into action and contacted almost 6,000 veterans. The most pressing need would be getting medication. Incident commander and nurse practitioner MaryAnn Nihart — who has been through this kind of drill during other fires — understood that one of the most pressing needs would be to provide veterans with life saving medication.

When you’re racing out of your house or apartment with the flames of a wildfire hurtling toward your house, one of the first things you leave behind is your medications.

We’re not talking aspirins or antacids here. We’re talking insulin, heart and blood pressure medications, anti-depressants and anti-psychotics. Because of its state of the art electronic medical records and its well established disaster pharmacy relief plans, the VA has a mechanism to immediately access patients’ charts to find out what meds they need, in what doses. The VHA activated contracts with community pharmacies to make sure that veterans were able to fill their prescriptions.

The VHA vet centers brought mobile clinics into Santa Rosa to seek out veterans and VHA social workers scoured shelters and evacuation centers to find veterans who did not respond by phone. The VHA also recognized that the Santa Rosa clinic would not be able to reopen unless the air inside the facility was breathable and brought air scrubbers to cleanse it of smoke and toxins.

Veterans Benefit Administration staff went into action to make sure veterans had access to their benefit and pension checks. Staff also ascertained and dealt with the kind of psychological stress that is a by-product of a natural disaster.

When the acute survival phase of the emergency had passed, and the command incident closed that was not the end of the response. During the recovery period, staff called thousands of veterans they had not been able to reach by phone to make sure they were okay and had their needs met.

Mental health staff are now dealing with real mental health impact which will be felt in the days, weeks and months to come. All told 117 veterans lost or had serious damage to their homes. The day after his house burned down, Air Force Veteran Victor Negron, the administrative officer of the Santa Rosa clinic, arrived at work to help other veterans.

He was wearing flip flops, shorts and a tee shirt, which was all he had after evacuating his house just minutes before the fire hit. Negron told me the ability to help other veterans is what has kept him going.

The kind of rapid emergency response the VA launched is only possible in an integrated health care system, which has the infrastructure to deliver supplies, information, and clinical staff support to a population of patients whose health care needs and whereabouts they can quickly ascertain. If the VHA is dismantled, step-by-step as the Trump administration proposes, veterans will be forced to fend for themselves, without the social safety net they have now, which serves them well, both day to day and during major emergencies.

Suzanne Gordon is the author of The Battle for Veterans Healthcare: Dispatches from the Frontlines of Policy-Making and Patient Care.