36C25819R0003-020.pdf

NEW PATIENT

ORIENTATION

HANDBOOK

Phoenix VA Health Care System

650 E Indian School Road Phoenix, AZ 85012

(602)-277-5551

Table of Contents

TOPIC PAGE

Admissions and Benefits/ Eligibility 5, 6 Patient Rights and Responsibilities 8 Primary Care and PACT 11 Telephone Care Program 16 My HealtheVet 17 Pharmacy Services 19 Laboratory Services 25 Health Education Program and Services Directory 28 Health Promotion and Disease Prevention 30 Emergency Car, Suicide Prevention 33, 36 Advanced Directives 37 Specialty/Ancillary Services Long Term Care Mental Health Services Research

Additional Clinical Care Services Women’s Health Program Nutrition Hospitality and Food Services (NH&FS)

Visiting/Traveling Veterans 44 Beneficiary Travel 45 Co-Managed Care, Fee Basis Services 46 Complaints Patient Advocates Veteran Service Representatives Veteran Center Services Ethics Consultation

Additional Veteran Services Social Work Services VA Caregiver Support Program Chaplain Services/Spiritual Care Medical Library Canteen Store Information Desk VA Shuttle Service Smoking Voluntary Service Agent Cashier

Important Telephone Numbers 62

Putting Veterans First!

Mission Statement Honor America’s Veterans by providing exceptional health care that improves their health and well-being.

Vision Statement To be a patient-centered integrated health care organization for Veterans providing excellent health care, research, and education; an organization where people choose to work; an active community partner; and a back-up for national emergencies.

Core Values Integrity, Commitment, Advocacy, Respect and Excellence

Our Goals

• We want to be your provider of choice

• We want you to rate our care as excellent

• We want to partner with you in your health care

• We want you to get all the information you need to understand your medical care and treatment plan

• We want you to know why tests are ordered and how you’ll receive your test results

• We want you to understand your medications and know about their potential side effects

Welcome Welcome to the Phoenix VA Health Care System. I want to personally thank you for choosing our health care system.

We are proud to offer you world class medical care. We lead the nation in preventive health measures, clinical practice guidelines and patient satisfaction. Our Stanford University affiliation further ensures our patients have access to the latest innovations in health care. Many of our staff physicians are also Stanford University faculty members.

We are able to provide comprehensive medical services at ten locations for your convenience.

Some locations also offer a variety of special services.

Your care at Phoenix VA Health Care System starts by assigning you a primary care provider in a Patient Aligned Care Team. Your PACT partners with you in assuring your medical needs are met and that you are referred for any specialty care you require. We hope that you will take advantage of MyHealtheVet, VA’s on-line program that brings a wealth of information to your fingertips.

At the Phoenix VA Health Care System, we never forget whom we serve. We are proud to provide care to our nations heroes - each of you. To ensure we meet your needs, you will receive patient satisfaction surveys. This is your opportunity to tell us what we do well and where we can improve. We want you to be able to rate the overall quality of your care as excellent. You deserve nothing less.

Again, thank you for putting your care in our hands. Thank you for choosing Phoenix VA Health Care System.

Sincerely, The Leadership and Staff of the Phoenix VA Health Care System

About the Phoenix VAMC

The Phoenix VA Health Care System (PVAHCS) proudly serves more than 80,000 Veterans in central Arizona at its main medical center and outpatient VA Health Care Clinics. The medical center provides acute medical, surgical, and psychiatric inpatient care, as well as rehabilitation medicine, and neurological care, and has a more than $450 million annual operating budget.

PVAHCS is affiliated with The University of Arizona College of Medicine. Training agreements are maintained in all of the major clinical specialties, and the facility is allocated 73 resident positions. The medical center is also affiliated with several schools offering a full range of Allied Health training programs.

We are proud to partner with highly qualified health care professionals dedicated to providing high quality care that meet the needs of Veterans. We look forward to serving you and are honored that you have chosen to receive your care at our facility.

Internet Address: http://www.phoenix.va.gov Facebook Address: http://www.facebook.com//PhxVAHealthcare Twitter Address: http://www.twitter.com/PhxVAHealthcare http://www.phoenix.va.gov/ http://www.facebook.com/PhxVAHealthcare http://www.twitter.com/PhxVAHealthcare

Admissions and Benefits

Admissions and Benefits

The Admissions and Benefits Section gathers information required to establish and verify a Veteran’s eligibility for VA health care. The information is also used to decide the Veteran’s priority group. Staff will also check income to find out if co-payments will be charged for medical visits or prescription medications. Some Veterans qualify for cost-free health care services because of a service-connected condition or other factors. However, most Veterans need to complete a financial assessment (Means Test) every year to find out if they qualify for cost-free services. Veterans whose household income and net worth exceed the set threshold, and those who choose not to complete the financial assessment, must agree to pay the required co-pays to become eligible for VA health care services.

Business Hours:

Monday through Friday from 8 a.m. to 4 p.m.

Admissions and Benefits Services Customer Service Line: (602) 222-2621.

Locations:

Phoenix Bldg. 1 Room C125

Every year the VA publishes a booklet, Department of Veterans Affairs Health Care Overview, that has up-to-date information on eligibility, enrollment, and VA health care benefits. This booklet is the authoritative source for describing eligibility and health benefits for all Veterans.

You should have received a copy of this booklet when you enrolled, if not they are available through eligibility. You can also download a copy of the booklet online at http://www.va.gov/healtheligibility/library/pubs/healthcareoverview.

This booklet is a very helpful resource and we recommend you refer to it whenever you have questions about your eligibility for specific health care benefits. It also has frequently asked questions about eligibility and benefits. Additional assistance is available at the following resources:

• Your local VA health care facility’s Enrollment Office

• www.va.gov/healthbenefits

• www.myhealth.va.gov

• VA toll-free 1-877-222-VETS (8387) between 8:00 AM and 8:00 PM ET, Monday-Friday http://www.va.gov/healtheligibility/library/pubs/healthcareoverview http://www.va.gov/healthbenefits http://www.myhealth.va.gov/

Eligibility

Eligibility

Located on the main floor between the Turquoise and Dental clinics

Open Monday – Friday 7:30 a.m. to 4:00 p.m.

Determine Veteran Eligibility

• Interview and verify patients applying for medical benefits

• By using the Veterans income (MEANS Test) and military discharge document(s)

• Enter demographic and income information into the VistA system

• Capture insurance information for processing by (MCCR)

Enroll eligible veterans

• Advises the Veterans of their entitlement to various medical benefits and discusses co-payment requirements of Veterans in priority categories.

• Accurately generates patient data cards (Veterans Identification Card ,VIC)

Veterans can register for healthcare various ways:

In person:

Veterans can walk into eligibility section and register with the assistance of an eligibility specialists.

By mail:

Veterans can mail in an application for healthcare benefits, once processed information is mailed back to the vet.

Online :

Veterans can complete an on-line application, information, once processed information is mailed back to the Veteran.

Who is Eligible

Veterans who enlisted after Sept. 7, 1980 (for enlisted), or who entered active duty after Oct.

16, 1981 (for officers), must have served 24 continuous months or the full period for which they were called to active duty in order to be eligible. This minimum duty requirement may not apply to veterans discharged for hardship, early out or a disability incurred or aggravated in the line of duty.

Reservists or National Guard member and they were called to Active Duty (other than for training) by a federal order and completed the full period which they were called or ordered to active duty.

Veterans with a character of discharge that is Honorable, General or Under Honorable Conditions are eligible for VA health care benefits as long as minimum duty requirements are met.

Veterans given Other than Honorable (OTH) discharges and those upgraded from OTH to General require VARO review and decision before routine care may be provided.

8 Different Priority Groups

Each different group assignment will determine the type of eligibility the Veteran qualifies.

Service connected disability, service dates or yearly income are the primary basis in determining eligibility.

2013 Co-pay Rates

Outpatient Services

Basic Care Services: services provided by a primary care clinician $15/visit

Specialty Care Services: services provided by a clinical specialist such as surgeon, radiologist, audiologist, optometrist, cardiologist, and specialty tests such as magnetic resonance imagery (MRI), computerized axial tomography (CAT) scan, and nuclear medicine studies $50/visit

** Co-pay amount is limited to a single charge per visit regardless of the number of health care providers seen in a single day. The co-pay amount is based on the highest level of service received. There is o co-pay requirement for preventive care services such as screenings and vaccinations.

Patient Rights and Responsibilities The Veterans Health Administration (VHA) and the Phoenix VA Medical Center are pleased you have selected us to provide your health care. We want to improve your health and wellbeing.

We will make your visit or stay as pleasant as possible. As part of our service to you, to other Veterans and to the nation, we are committed to improving healthcare quality. We also train future healthcare professionals, conduct research, and support our country in times of national emergency. In all of these activities, our employees will respect and support your rights as a patient. Your basic rights and responsibilities are outlined in this document. Please talk with VA treatment team members or a Patient Advocate if you have any questions or would like more information about your rights.

I. Respect and Nondiscrimination

• You will be treated with dignity, compassion, and respect. Your privacy will be protected. You will receive care in a safe environment. We will honor your personal and religious values.

• You or someone you choose has the right to keep and spend your money. You have the right to receive an accounting of any VA held funds.

• Treatment will respect your personal freedoms. In rare cases, the use of medication and physical restraints may be used if all other efforts to keep you or others free from harm.

• As an inpatient or nursing home resident, you may wear your own clothes. You may keep personal items. This will depend on your medical condition.

• As an inpatient or nursing home resident, you have the right to social interaction and regular exercise. You will have the opportunity for religious worship and spiritual support. You may decide whether to participate in these activities. You may decide whether or not to perform tasks in or for the medical center.

• As an inpatient or nursing home resident, you have the right to communicate freely and privately. You may have or refuse visitors. You will have access to public telephones. You may participate in civic rights, such as voting and free speech.

• As a nursing home resident, you can organize and take part in resident groups in the facility.

Your family also can meet with the families of other residents.

• In order to provide a safe treatment environment for all patients or residents and staff, you are expected to respect other patients, residents and staff and to follow the facility’s rules.

• Avoid unsafe acts that place others at risk for accidents or injuries. Please immediately report any condition you believe to be unsafe.

II. Information Disclosure and Confidentiality

• You will be given information about the health benefits you can receive. The information will be provided in a way you can understand.

• You will receive information about the costs of your care, if any, before you are treated. You are responsible for paying your portion of any costs associated with your care.

• Your medical record will be kept confidential. Information about you will not be released without your consent unless authorized by law (an example of this is State public health reporting). You have the right to information in your medical record and may request a copy of your medical records. This is provided except in rare situations when your VA physician feels the information will be harmful to you. In that case, you have the right to have this discussed with you by your VA provider.

• You will be informed of all outcomes of care, including any potential injuries. You will be informed about how to request compensation for any injuries.

III. Participation in Treatment Decisions

• You, and any persons you choose, will be involved in all decisions about your care. You will be given information you can understand about the benefits and risks of treatment. You will be given other options. You can agree to or refuse treatment. You will be told what is likely to happen to you if you refuse treatment. Refusing treatment will not affect your rights to future care but you take responsibility for the possible results to your health.

• Tell your provider about your current condition, medicines (including over-the-counter and herbals), and medical history. Also, share any other information that affects your health.

• You should ask questions when you do not understand something about your care. Being involved is very important for you to get the best possible results.

• You will be given, in writing, the name and title of the provider in charge of your care. As our partner in healthcare, you have the right to be involved in choosing your provider. You also have the right to know the names and titles of those who provide you care. This includes students, residents and trainees. Providers will properly introduce themselves when they take part in your care.

• You will be educated about your role and responsibilities as a patient or resident. This includes your participation in decision-making and care at the end of life.

• If you believe you cannot follow the treatment plan, you have a responsibility to notify your provider or treatment team.

• You have the right to have your pain assessed and to receive treatment to manage your pain.

• You and your treatment team will develop a pain management plan together. You are expected to help the treatment team by telling them if you have pain and if the treatment is working.

• As an inpatient or nursing home resident, you will be provided any transportation necessary for your treatment plan.

• There are many research opportunities available for you to participate in. Participation in research is voluntary and your decision will not affect your VA health care or benefits.

• You will be included in resolving any ethical issues about your care. You may consult with the medical center’s Ethics Consultation Service and/or other staff knowledgeable about health care ethics.

• If you or the medical center believes that you have been neglected, abused or exploited, you will receive help.

PRIMARY CARE

Primary Care through Patient Aligned Care Teams

At the Phoenix VA Health Care System we are committed to providing you with the best possible health care. To help us achieve this goal, we would like each Veteran to have an assigned primary care team, or a Patient Aligned Care Team (PACT). This is a team of health care professional to plan for whole-person care and life-long health and wellness. A primary care team consists of a Primary Care Provider (PCP), who is a physician, nurse practitioner, or a physician assistant. There is also has a registered nurse care manager, a Licensed Practical Nurse and a clerk assigned to each team. Our goal is to have you be seen by a member of your primary care team, when you want and need to be seen. This team will address all your health care needs including arranging and coordinating any referrals to specialists.

During the first visit:

• The patient will meet his/her assigned provider.

• A physical examination will be done. The primary care provider will determine if there is a need for additional diagnostic testing (which may include lab work, x-ray, etc.).

• A complete medical history will be obtained.

The first primary care visit is an important one. This is the time for the patient to develop a relationship with his/her provider and get acquainted with other members of the primary care team. Patients may also receive health education materials and guidance that may include:

smoking cessation, depression screening, weight and exercise education, flu vaccine and/or pneumovax, diabetes and colon cancer screening.

Additional screening and education is available based upon specific diagnosis and individual patient medical needs.

In primary care, a. strong emphasis is placed on preventive health maintenance. Primary care providers conduct the necessary physical examinations and screenings for you to maintain optimum health.

First-time visit reminders

• Bring completed forms from your enrollment appointment

• Bring any records from outside doctors’ visits and bring all of your medicines to your first visit.

• You can take an active role in your health care in many ways:

• Give your treatment team accurate and complete information about:

• Your current health problems

• Your concerns about your health

• Past illnesses

• Hospitalizations

• Your medicines, including over-the-counter and herbals

• People that help you with your health care needs at home

• Other matters related to your health

• Bring a list of your questions and concerns.

• Please arrive early to allow time for check-in, the taking of your vital signs and health screening. This Health Screening Appointment is scheduled 20 minutes before your Primary Care appointment.

• Come at least two hours early if you need to have laboratory work or X-rays done. If possible, have your laboratory or X-rays completed a few days before your visit so the results will be available for review by your team.

• When you are due for an appointment with your primary care team, you will receive a post card in the mail asking you to call 1-800-554-7174 option #3 and the Patient Scheduling Unit can help to schedule an appointment at a time convenient for you. If you have any health care questions or want to pass along any information to your health care team, you can call your PACT team directly or call 1-800-554-7174 and press option #4. Additionally, you can register for a MyHealtheVet www.myhealth.va.gov account and send a secure email to your health care team.

• Walk-in appointments are very difficult to accommodate so we strongly encourage you to call the Telephone Care Program about any urgent medical needs and avoid inconveniencing veterans who have scheduled appointments.

Primary Care Clinics (Main Hospital) 650 E. Indian School Road Phoenix, AZ 85012

DIAMOND

Services include Primary Care, Mental Health, Nutrition, Social Work Building 8

(602) 277-5551 ext. 12640

EMERALD

Services include Primary Care, Mental Health, Nutrition, Social Work Building 8

(602) 277-5551 ext. 14193

GOLD

Services include Primary Care, Mental Health, Nutrition, Social Work Building 8

(602) 277-5551 ext. 15212

TURQUOISE

Services include Primary Care, Dermatology, Allergy, Compensation and Pension Building 8

(602) 277-5551 ext. 15951

AMETHYST

Services include Women’s Health, OEF/OIF Building 1

(602) 277-5551 ext. 16359 for Women’s Health and ext. 16750 for OIF

COPPER

Services include Spinal Cord Injury Clinic, Anticoagulation Clinic Building 1

(602) 277-5551 ext. 17786

JADE/OPAL

Services include Mental Health, PTSD, Substance Abuse, SARRTP and Homeless program Building 1

(602) 277-5551 ext. 12752

TOPAZ

Services include Neuropsychology, Compensation and Pension Building 8

(602) 277-5551 ext. 16451

Community Based Outpatient Clinics (CBOC):

GLOBE-MIAMI

5860 S. Hospital Drive, Suite 111 Globe, AZ 85501

(928) 425-0027

NORTHWEST

13985 W. Grand Ave., Suite 101 Surprise, AZ 95350

(623) 251-2884

PAYSON

1106 North Beeline Highway Payson, AZ 95370

(928) 472-3148

SHOW LOW

5171 Cub Lake Road, Suite C380 Show Low, AZ 85901

(928) 532-1069

SOUTHEAST

6950 E. Williams Field Road, Bldg. 23 Mesa, AZ 85212

(602) 222-6568

THUNDERBIRD

9424 N. 25th Ave.

Phoenix, AZ 85021

(602) 633-6900

The Ambulatory Care Clinics are closed on the following holidays:

• New Year’s Day

• Martin Luther King Day

• President’s Day

• Memorial Day

• Independence Day

• Labor Day

• Columbus Day

• Veterans’ Day

• Thanksgiving

• Christmas

Partner With Your VA Providers & Patient Aligned Care Team (PACT)

Veteran-Centered Care

VA provides Veterans with care that is patient-centered, data-driven, continuously improving, team-based, accessible, timely, comprehensive, coordinated, and provides continuity of care over time.

• We will focus all our efforts on giving you what you need.

• We will treat you with dignity and respect.

• We will ask you about and honor your values, preferences, and needs.

• We will provide safe, high-quality care that is designed for you.

• You will receive the right care, at the right time, in the right care setting.

• We will coordinate your care to make sure we meet your needs.

• We will explain your health problems and treatment options in ways you can understand.

• We will teach you about self-care and help you learn to manage your health problems.

Telephone Care Program (TCP)

If you have a health care emergency - call 911

For urgent health concerns, an Advice Nurse is available 24 hours a day, including weekends and holidays.

602-222-6550

The Telephone Care Program (TCP) gives you access to an Advice Nurse who can assist you with the following:

• Give health care advice (option 4).

• Help you decide if you should come to the clinic or hospital.

• Suggest things you might try for home care.

• If the problem is urgent, Telephone Care can make you an appointment with the

Ambulatory Care Clinic or your primary care provider or team for that same day or the next day.

• Answer questions about your appointments including canceling and rescheduling.

Additionally, a Patient Services Assistant can:

• Make, change or cancel appointments (option 1)

• For Pharmacy (option 3)

Cancelling Appointments

If you are unable to keep an appointment, please cancel it by calling the Telephone Care Program. Thousands of appointments were lost last year due to “no shows.” By calling to cancel your appointment at least 48 hours in advance, you will open up a space for another Veteran to be seen.

For health care emergencies – call 911. VA does not provide emergency transportation to the hospital. Whether or not VA pays for an ambulance is determined AFTER you have been evaluated in an Emergency Department.

My HealtheVet www.myhealth.va.gov My HealtheVet is a site that provides Veterans and their families with excellent and reliable patient education as well as the latest VA news. Information about Veteran’s services and benefits is also available (go online to website above or call 602-277-5551 ext 1-3934 for assistance).

After registering with My HealtheVet you will be able to:

• Refill prescriptions online

• Keep personal activity and food logs

• Monitor your personal health data, such as blood pressures and pain levels

• Maintain your own self-entered personal health record

There are different types of accounts that you can register for, all free of charge.

Basic Account: This type of account does not require you to have your identity authenticated **. With this type of account you can:

• Add information to a personal health journal about over-the-counter medications, allergies, military health history, medical events, tests and allergies

• Record and track personal information such as contact information, emergency contacts, health care doctors and providers, and health insurance information

• Record and track personal health measurements (blood pressure, blood sugar, cholesterol, heart rate, body temperature, weight, pain level, etc.) in Vitals & Readings

• Print a wallet ID card with the personal information entered into the personal health record

• Use VA Blue Button (Download My Data) to view, save download and/or print your self-entered information; then share this with your caregiver, non-VA provider or others you trust

Advanced Account: This account is only for VA Patients. It is a higher level of access to features offered in My HealtheVet. It provides you the ability to view some information in your VA and/or Department of Defense (DoD) records. This account does not require that you have your identity Authenticated*. However, when you register as a VA Patient, your profile information is linked to VA/DoD records. When this happens, you are given an Advanced Account. If you are a VA patient, this type of account lets you refill your VA prescriptions online using My HealtheVet.

Premium Account: To get this type of account you need to go through Authentication** and have your My HealtheVet profile information linked to VA/DoD records.

With a Premium Account you may use My HealtheVet to:

• View VA Chemistry/Hematology Lab results

• Receive information on your VA Appointments, including email reminders

• View VA Allergy and Adverse Reactions records

• Receive VA Wellness Reminders

• View additional parts of your VA health record, as they become available

• Use the VA Blue Button to view, save download and/or print your VA health and DoD

Military Service Information. You can also share this with your caregiver, non-VA provider or others you trust

• Use Secure Messaging to communicate online with your VA health care team. You may send messages to request or cancel VA appointments. Use it to ask about lab results or find out about a medication or health issue. Or simply to discuss other general health matters

** Authentication is a process by which the VA verifies a Veteran’s identity before allowing access to their health record. You may do this in-person at the VA or your local CBOC. It may also be done online on the My HealtheVet website with detailed instructions (www.myhealth.va.gov).

Pharmacy Services Introduction to Pharmacy

Location: 1st Floor – Ambulatory Care Center (no pharmacies at CBOCs)

Hours: Monday through Friday: 8 a.m. – 6 p.m. (Except federal holidays)

The Phoenix VA Outpatient Pharmacy strives to provide excellent customer service to our Veterans. The team efficiently fills and dispenses your medicines, and can assist with any medicine related questions you have. Additionally, pharmacists located in the clinics work directly with your medical providers to best manage your medicines and offer appointments for many conditions including; diabetes, high blood pressure, and high cholesterol.

Medicine Dispensing

MAIL out:

- A VA mail order pharmacy fills and mails most medicines which are often received in about 5 business days. Most are tracked with delivery confirmation.

- Always update your address to ensure accurate and timely delivery. If you plan to be away from your regular mailing address, you should provide the VA with the dates and address of your destination so that medicines and other VA mail can be delivered there. The VA will mail medicines to any address within the United States.

WINDOW pick-up:

To keep the wait as short as possible, pharmacy fills only URGENTLY needed NEW medicines for pick-up. Medicines are NOT filled until you have spoken with a pharmacist. When you arrive at the pharmacy, take a number from the machine based on your need.

1) Take a seat in the pharmacy waiting room until your number is called.

2) After speaking to a pharmacist or technician, wait for your name to appear on the waiting room “display board”, and then present your ID at the “pick-up” counter.

Veteran photo ID is required to pick up any prescriptions.

3) Consider making other medical center stops (e.g. Lab, X-ray etc…), while your prescription is being filled.

Pharmacy Refills

All refills are mailed to reduce pharmacy wait times for NEW and URGENT medicines. To account for mailing time, request your refills at least two weeks before you will run out of the medicine. Our computer system calculates the correct date for your prescription to be mailed based on the date of your last refill.

Internet Refills through My HealtheVet:

Go to www.myhealth.va.gov or see My HealtheVet section above to learn more about My HealtheVet.

Telephone Refills:

1. From a touch tone phone, call:

• 602-222-6598 (Phoenix area)

• 1-800-359-8262 (toll-free)

2. Type your entire Social Security number and press the # key

3. Press 2 for Pharmacy

4. Press 1 to order refills

5. Enter the prescription number (no letters) that is located on the label (see sample) followed by the # key. Use your most recent prescription number when ordering. Older numbers will not work, even if the medicine is the same.

6. If you have more refill requests, stay on the line and press 1 when instructed.

Mailing Refill Requests:

1. Sign and date the refill slip included with each medicine.

2. Mail the slip to the pharmacy with the address label provided.

3. Refill slips can also be returned using prescription refill request boxes located outside the pharmacy and emergency department.

4. Allow additional processing time when requesting refills this way.

Refilling refrigerated medicines

Some medicines must be refrigerated. These medicines can be delivered to your home by UPS in Styrofoam boxes with a cold pack. There are two ways to refill refrigerated medicines:

1. For UPS: Request refill by telephone, internet, or refill slip as you do with non-refrigerated medicines. If the medicine cannot be mailed, a pharmacy representative will contact you. Refrigerated medicines can only be delivered to a physical address. If your mailing address is a PO Box, call 602-200-2379 to either pick up your medicine or provide a physical address for UPS delivery.

2. For window pick-up: Due the packaging requirements, refills for refrigerated medicines can be picked up instead of mailed. Request pick up in advance by calling 602-200- 2379. Your medicine will be ready in 2 working days. When you come in, say that it is refrigerated.

Vacation requests – early refills

If you have travel plans within the United States and will run out of medicines before you return, call your PACT line or the Pharmacy Helpline to request your refill(s) be sent to you before departing. For controlled substances and mental health medicines, your provider must approve the early fill before pharmacy can send it. Or you may provide a temporary address to receive all mail from the VA during that time. Please note, the VA cannot mail medicines out of the country. If you plan to be out of the country you will need to work with your provider to either obtain additional medicine prior to your departure or have a friend or family member receive your medicine refills in the United States and mail them to you.

No Refills Remaining

When your prescription has ZERO refills or expires before a refill is due, the automated refill system will not process your refill request without approval from your provider. To avoid running out of medicine, make requests well in advance using one of these options:

1) Audio-renewal:

Call the pharmacy refill line (see above). If that clinic enrolls in audio-renewal, an automatic request is sent to your provider and you are notified on the phone of this. If the clinic is not enrolled, you are transferred to the pharmacy VA helpline.

2) Call PACT team:

For medicines from your primary care provider (PCP), call your PACT team directly. Give the name of the medicine needed and a request is sent to your PCP for review.

3) Secure Messaging:

Once registered for secure messaging in My HealtheVet, you can send a message to your PACT team with a list of the medicines that you need renewed.

4) Pharmacy VA Helpline:

(602) 222-6598 or 1-800-359-8262

Pharmacy sends a renewal request to your VA provider for review.

5) Controlled Substance Line:

602-200-2378

Controlled substances, such as narcotic pain medicines, have limited refills. For these medicines, you will need to call in for a new prescription (renewal) more often. For your convenience, the Controlled Substance Voicemail is available to leave your request. A note is sent to your VA provider for review.

Controlled substances are delivered by UPS and require an adult signature. If you prefer to pick-up your controlled substance, please specify a pick-up date on or near the day you are due to run out of the medicine. The pharmacy will hold it up to one additional working day. If not picked up by then, it is automatically sent to you by UPS.

This phone number may be used for refill requests of controlled substances for window pick-up. You must call 2 business days before your requested pick-up date, and it must be on/near the due date for the pharmacy to fill it. If you do not pick-up the refill by 1 day after your requested pick-up date, it is returned to stock instead of being mailed.

Pharmacy Benefits

Formulary

A formulary is a list of medicines available to treat your medical condition. This list of medicines is approved by a national group of highly trained VA physicians and clinical pharmacists after reviewing the results of medical studies. If you require treatment with a medicine that is non-formulary because you either did not respond to or did not tolerate the formulary medicines, your VA provider can submit a request for review by a clinical pharmacist.

Tablet Splitting Policy

The VA requests certain medicines to be split-in-half to conserve costs. Tablet cutters are available from the pharmacy at no cost. Only medicines that are safe to cut are included.

Returning medicines

Federal law prohibits returning medicines. Check which medicines your provider is ordering at your appointments since pharmacy cannot accept medicine returns or refund copays.

Transferring medicines to the VA

The VA does not accept prescription transfers from outside pharmacies. If you are transferring your prescriptions to the VA, your VA provider may need to replace some of your current medicines with alternatives on formulary.

Bring the following to your medical appointments to assist your VA provider:

1) Current list of medicines including over-the-counter and herbal medicines.

2) List of any medicines that you had side effects to in the past.

3) Copy of recent medical records, including labs, from your private doctor(s).

It is your choice to obtain medicines prescribed by a Non-VA provider at an outside pharmacy or to change to those provided by the Phoenix VA.

Dual Care/Co-Management

We encourage you to obtain ALL of your care through the VA, but we recognize some situations where you may choose or need to have some care provided in the community. Receiving health care by both VA and non-VA providers is called Dual Care or Co-Management. The following is required for the VA to provide you with safe and effective medicines:

1) See your VA provider at regular intervals.

2) Accept medicines that are on VA formulary.

3) Give your VA provider the name and phone number for your private physician.

4) Give your VA provider current updates on hospital admissions, test results and visits to your private physician.

5) Sign a release with your private physician so your VA provider has access to outside records and information about your healthcare.

The VA pharmacy CANNOT fill prescriptions written by a non-VA doctor unless you have a VA fee-basis approval for medicines. If a private physician gives you a new prescription or changes a prescription, you must contact your VA provider and provide written medical records. Your VA provider will order the medicine to be filled by the VA pharmacy if he/she agrees that the medicine is safe, appropriate and available on our formulary.

Non-VA Hospital/ER Visit Medicines

If you were admitted to an outside hospital or ER, you should request a copy of your medical records from that hospital and provide these to your VA provider.

Medicine Copayment

Depending on your eligibility, you may have a copayment for your medicines. The copay charge for medicines is based on the day supply and does not depend on the mediation. Most medicines are sent as 90 day supplies, so tell your pharmacist if you prefer 30 day supplies.

Refer to Eligibility for possible copay amounts.

Additional Resources

For more information, visit this website that addresses many Frequently Asked Questions:

http://www.southwest.va.gov/Pharmacy/General_Questions_About_Your_Medicines.asp

Important Phone #s

Request a refill: Pharmacy Helpline 602-222-6598 (Phoenix area) 1-800-359-8262 (toll-free in Arizona)

Controlled Substance Voicemail 602-200-2378 Refrigerated medicine line (for window pick-up) 602-200-2379

PACT team phone # (fill in yours at PCP visit) PACT team fax # (fill in yours at PCP visit)

Other clinic phone #s (fill in any of yours here) My HealtheVet website www.myhealth.va.gov http://www.southwest.va.gov/Pharmacy/General_Questions_About_Your_Medicines.asp

Laboratory Services Introduction to Laboratory

The Phoenix VA Laboratory strives to be a model of clinical and organizational excellence. Our mission is to provide quality care to our Veterans. Services are delivered in a timely and professional manner. The Laboratory is accredited by the College of American Pathologists (CAP) and the American Association of Blood Banks (AABB). The Laboratory is also inspected by the Food and Drug Administration (FDA) and the Joint Commission.

Main Phoenix VA Hospital (see CBOC information for laboratory hours and locations)

Outpatient Laboratory: is located in the Ambulatory Care Clinic (ACC), room A2302, across from the elevators and radiology on the 2nd floor.

Hours for the outpatient lab are 6am-4:30pm, Monday-Friday. After 4:30pm, you will be directed to go to the inpatient laboratory, which is open until 8pm.

Inpatient Laboratory: is located in the main hospital on the second floor near the B elevators.

The inpatient lab is for ambulatory inpatients, STAT and special procedure tests. Please do not go to the inpatient lab for service before 4:30pm unless you have a STAT order or need a special procedure test and are directed to go there by a staff member.

Hours for the inpatient lab are 7am-8pm, Monday-Friday and by appointment on weekends and holidays. If you are scheduled for a clinic visit on the weekend, you can come to the inpatient lab without an appointment between the hours of 7am-8pm.

General Information: When you leave from a clinic visit, the Medical Support Assistant (MSA) should print you out a future appointment schedule called “Your Next Step of Care”. If your provider ordered lab work, that paper will have your lab information under the header “LABORATORY STUDIES”. The clerk might also write your lab order numbers on a 3X5 card.

NOTE: all lab orders must be placed in the computer by your provider. Your provider should tell you when they would like you to return for lab work. The actual day that you return is usually not critical, but check with your patient care team (PACT) team before you leave if you have any questions. The paperwork will tell you if you need to be fasting and contains your lab requisition order number(s). PLEASE bring your lab order number with you when you come to the lab. If anyone in a clinic says you do not need that order number because it is in the computer, that is true, but the check-in process will be faster if you have your lab order number(s) with you.

You do not need to schedule an appointment to come to the lab M-F. It is first-come, first-serve. Also, you can go to any of the Community Based Outpatient Clinics (CBOC’S) to have your blood drawn, if that is more convenient for you. The blood at the CBOC’s is transported to the main facility for testing. Note: there are some special tests that must be drawn at the main campus.

Fasting Labs: Only a few tests require fasting (e.g. glucose, lipid panel, triglyceride). It will say on your paperwork if the lab is fasting or your provider/team member will tell you to fast. If it says to fast, please do not eat or drink anything for 8-12 hours before you come to the lab. You may drink water only and check with your provider about what medications are OK to take while fasting. If you do not need to fast, the best time to come to the lab is in the afternoon.

We try to keep your wait time to less than 20 minutes, but a wait time may be as long as an hour during our busiest times (typically from 6-8am). Please plan accordingly.

What to expect: You will go to the window to sign in. The lab person at the computer will ask you if you have your lab order number if you did not write it on the check-in sheet. If you do not have it, they will look for orders under your name. They will print your labels and if a urine test was ordered, they will ask if you can provide a urine sample. If you say yes, they will give you a cup and ask you to go to the bathroom. Bring the sample back to the front area and then if you need blood work, they will tell you to go have a seat and wait to be called back. When your name is called for blood work, the tech will call you by your last name. Follow the tech back to the lab chairs and have a seat. The tech will ask for your full name and last 4 of your ss#. They will look for the best site to obtain a specimen, put on gloves, palpate for a vein and clean the area. If you any concerns regarding having your blood drawn, please let staff know. The tech will obtain your blood specimen(s). Please note that they make take several vials, depending on what lab test is ordered by your provider. The vials may be a different color or the same color.

Each lab instrument requires a specific type of specimen and that is determined by what the lab test is detecting (serum, plasma or whole blood). Sometimes the blood needs to go to different areas and is the same type of vial, so that is why you might have vials of the same color. The vials must be labeled in your presence. Please note that each label has a barcode on it. That barcode will be used to identify your specimen throughout the testing process. You will then be thanked and told you can leave.

Test results:

The lab strives to have routine work completed within the next business day and STATS done within one hour from the time the blood is bought to the main lab for testing. Specialized tests may take days to a week to be completed (occ. longer).

The lab is not able to tell you your lab results. The provider that ordered the test is responsible for providing you this information because they must interpret this information in relation to the rest of your clinical picture. Routine lab results should be communicated to an outpatient within 14 days of the lab results being available. Some lab results are also available in My HealtheVet. They will transmit three (3) days after the test results are available to the provider.

It is best that the provider(s) discuss the lab results with you so that you can understand what it means in relation to your clinical history and current health status.

Patient concerns: If you have an issue with anything during your visit to the lab, ask for the Lead Phlebotomist, Phlebotomy Supervisor or the Laboratory Manager (602) 277-5551 ext. 1- 7895. We want each and every visit to be a positive experience. Getting your blood drawn is not the most pleasant experience, but you should expect the staff to be proficient, helpful and polite at all times. We are thankful for your service to this country and you deserve our respect and assistance. There are pamphlets with our contact information available in the lab in case you have any further questions or concerns.

Health Education Programs and Services Directory The listed programs and services are offered through the Phoenix VA. Being in involved in these programs will help you:

• Maintain your health and well-being

• Learn to manage health problems you may have

• Offer opportunities to meet other Veterans

Speak to a member of your PACT if you have any questions or interest in any of these programs.

They can answer any questions or help you contact the person in charge of the service.

MOVE is a national weight management program designed by the VA NATIONAL CENTER FOR

HEALTH PROMOTION AND DISEASE PREVENTION (NCP), a part of the Office of Patient Care Services, to help veterans lose weight, keep it off and improve their health. The PVAHCS has various modalities to assist with weight loss efforts. These range from telephone visits to individual appointments and home based programs. Interdisciplinary groups are available for weekly education/accountability. Schedule an appointment with your Primary Care Dietitian and/or visit the website for more information: https://vaww.move.med.va.gov/

Diabetes Education The PVHACS has many programs and resources available for Diabetes education and treatment.

Individual counseling, group medical appointments and classes are available throughout the week and the main facility as well as the CBOCs. Check with your clinic Dietitian for more information or PACT team to get scheduled.

Be Tobacco Free Quitting smoking is the single most important thing you can do to improve your health and protect the health of your family members. Tobacco in any form is harmful to your body.

Avoid second-hand smoke as well. There is no level of second hand smoke that is risk free. The Phoenix VA offers a complete smoking cessation program with

For tips on how to quit, go to:

You Can Quit Smoking Now. http://www.smokefree.gov*.

http://www.prevention.va.gov/ https://vaww.move.med.va.gov/ http://www.smokefree.gov/

Heartsavers First Aid Class Date: Quarterly- 2nd Wednesday- March, June, September, & December Time: 7:30 – 11:30 a.m.

Location; Building T-7 Enrollment: Pre-registration is required. To enroll call 602-277-5551 ext. 6970 or 7508

CPR Family and Friends Date: Quarterly- 2nd Wednesday- January, April, July, & October Time: 7:30 – 11:30 a.m.

Location: Building T-7 Enrollment: Pre-registration is required. To enroll call 602-277-5551 ext. 6970 or 7508

Health Promotion and Disease Prevention For more information go to:

National Center for Health Promotion and Disease Prevention website http:/www.prevention.va.gov

Strive for a Healthy Weight

If you need to lose weight, losing even a little will help. If you are a normal weight, maintain it.

Keeping your weight in control will help you stay healthy now and in the future. To find the weight that is healthy for you, find out what your body mass index (BMI) is. Your BMI tells us your body fatness based on your height and weight.

Body Mass Index = Weight in lbs x 703 Height in inches x Height in inches

To stay at a healthy weight make sure the number of calories you eat and drink is balanced with the amount of activity you do. Slowly decrease the amount of calories you have a day and increase your physical activity.

• Eat Wisely:

Eat wisely to make the most of your health. Eat a variety of food including fruits, vegetables, and whole grains. Limit salt, fat, sugar, and alcohol intake.

• Be Physically Active:

Get up and get moving. Avoid inactivity. Some activity is better than none. Aim for at least 2 ½ hours of moderate-intensity aerobic activity each week. Every 10 minute session counts. If you are out of shape, start slowly and work your way up. Physical activity will give you more energy, more strength, and can decrease your risk for certain health problems.

Get Screening and Immunizations

Preventive services such as immunizations and screening tests are very important to your health. Which immunizations and screenings you need will depend upon your age, gender, health status, and family history. Talk with your health care provider about what screening tests and immunizations are recommended for you.

For a list of recommended services for men and women, go to this website:

• Men: Stay Healthy at Any Age http://www.ahrq.gov/ppip/healthymen.html http://www.ahrq.gov/ppip/healthymen.html

• Women: Stay Healthy at Any Age http://www.ahrq.gov/ppip/healthywom.html

Manage Stress

If you are having a hard time dealing with life’s demands, we call this “stress”. A lie without any stress would be boring, but too much stress can be a problem. Pay attention to stress. Learn about ways to help you reduce our stress. Some ways to manage your stress is to get physically active, think positively, enjoy fun activities, and to learn relaxation skills. The Phoenix VA offers classes and individual therapy to help our Veterans manage their emotions and stress.

Limit Alcohol

If you choose to drink alcohol, drink in moderation. For women this means no more than one drink a day and for men no more than two drinks a day.

One drink is:

• 12 ounce regular beer or wine cooler OR

• 8-9 ounce malt liquor OR

• 5 ounce of table wine OR

• 1.5 ounce 80-proof hard liquor

Avoid “binge drinking”. Binge drinking is having more than three drinks on one occasion for women and adults over the age of 65 OR more than four drinks on one occasion for men. If you have any questions or are concerned about your drinking, talk to your health care team about getting help.

Be Involved with Your Health Care

Take an active role in your care. Work with your health care team to improve your health.

Ways that you can be involved are

• Ask questions if something is not clear

• Share your ideas and beliefs about your health problems

• Tell your team what treatment options you prefer

• Take part in decisions…