Many veterans don’t enroll for health care with the Department of Veterans Affairs.

In one survey of aging Utah veterans, “70 percent had never accessed the VA,” said Kris Patterson-Fowler, chief of Home & Community Based Services at the Jonathan M. Wainwright Memorial VA Medical Center in Walla Walla.

That’s a head scratcher and something the VA seeks to change with an outreach effort called Cover to Cover. The VA Salt Lake City Health Care System in Utah launched a pilot in 2013 and now the Walla Walla center has joined the program, along with VA facilities in four other states. The program especially targets older veterans who need home-based health services.

This isn’t an addition of services. There are already a smorgasbord of home-based programs — 13 in all — including access to home health aides, respite care, hospice, caregiver support, adult day care, palliative care and home-based primary care.

However, many veterans don’t use those programs or any other VA services.

“There are misunderstandings,” Patterson-Fowler said. “Some veterans believe that if they didn’t serve in conflict, if they weren’t in war, they are not eligible for service.”

With the Cover to Cover program, the VA relies on community agencies that serve the aging population to spread the word to veterans that they are missing out.

“They ask the question, ‘Are you a veteran?’” Patterson-Fowler said.

If the veteran says yes, he or she is told of the array of VA services on tap and given information about eligibility. If they wish to enroll, they are fast-tracked into the system.

Patterson-Fowler said her own father, a Vietnam veteran, didn’t enroll into the VA system until the very end of his life. The retired commercial airline pilot had considered VA health care as something for veterans who didn’t have insurance, said his daughter.

As he lay dying of cancer at the Kadlec Medical Center in 2008, he finally decided to enroll.

“When my dad was dying, he had all his private insurance and his Medicare benefits,” said Patterson-Fowler, who has worked at the Walla Walla VA for 13 years. “He’d never tapped in to VA resources. We were talking about it. He really couldn’t go home to Wallowa Lake to die. He really needed inpatient care. We expedited the enrollment process.”

Her father was moved to the Walla Walla VA two weeks before his death — it had an inpatient unit then — and he received end-of-life care.

About 18,000 veterans are enrolled in the Walla Walla VA’s service area, which includes Umatilla County.

Eva Morales, administrative officer for Walla Walla’s Home and Community Based Services programs, is helping implement Cover to Cover. Morales, a veteran, said it took her years to actually enroll even though she worked for the VA.

“As a veteran myself, I was one of those 70 percent up until a few months ago,” she said. “One day I just decided I should.”

She knows there are plenty of others out there who could benefit.

“I have friends in the community who think it’s too much of a hassle or they don’t think they deserve it,” Morales said. “Or they’re afraid of the paperwork – they think it’s a monster.”

She said the enrollment process is increasingly more user friendly.

“With the new online system, it’s relatively easy,” she said. “It’s still a task, but it’s not that difficult.”

Brian Westfield, director of the Walla Walla VA, said the in-home programs such as Home Based Primary Care keep veterans in their homes and away from the emergency room. Technology plays a part.

“We can put an apparatus in their home on their phone system. On a daily basis, it’ll start beeping at them. They’ll need to go to the phone and answer questions such as “What is your weight today?” and “Any difficulty breathing today?”

He said registered nurses who monitor the responses will call the veteran if something isn’t quite right.

Some VA services aren’t offered by Medicare or private insurance.

“One of the very unique things that VA is able to offer that Medicare doesn’t provide and that hospice isn’t able to do is that when an individual is receiving in-home hospice care and care rises to a point where they are no longer safe to be in the home, the VA pays for end-of-life care in a nursing home,” Patterson-Fowler said.

The Walla Walla VA contracts with nine nursing homes in Hermiston (Regency), Lewiston, La Grande, Walla Walla, Tri-Cities and Yakima and is looking at establishing new contracts in Pendleton, Selah and Colfax.

Another program — the Homemaker Home Health Aide program — allows for a non-skilled caregiver to go in and help veterans with such activities as toileting, showering, dressing, grooming, laundry, meal prep and transportation to medical appointments.

“That allows them to stay in their home,” Patterson-Fowler said. “Private insurances usually do not cover this. Medicare doesn’t cover that service either. This is a unique service the VA can offer to our enrolled veterans.”


Contact Kathy Aney at or call 541-966-0810.

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