Letter to Sloan Gibson, Acting Secretary of Veterans Affairs - Access Received Closer to Home Program

Letter

Dear Acting Secretary Gibson:

We write in strong support of extending the Access Received Closer to Home (ARCH) pilot program and the services provided through ARCH at Cary Medical Center. Rural veterans in northern Maine depend on this program, and any disruption in services would amount to a tremendous hardship for many Veterans and their families. On May 22, the Senate Appropriations Committee approved legislation directing the VA to continue providing medical care through ARCH in fiscal year 2015 using existing authorities. In light of this recent action, we urge you to take immediate steps to ensure that veterans who access VA-covered health care services through ARCH do not experience a lapse in access to care.

In a hearing before the Senate Appropriations Subcommittee on Military Construction and Veterans' Affairs on March 25, 2014, former Under Secretary of Health Dr. Robert Petzel testified that the VA's relationship with Cary Medical Center has been very successful in terms of providing specialty care. He further pledged that the VA would continue its relationship with the hospital, which he dubbed a "wonderful community asset." In an April 8, 2014, response to our previous letter on this matter, Dr. Petzel also noted that VA was preparing for the expiration of the Congressional authority for ARCH. He highlighted the development of a new program, Patient-Centered Community Care (PC3), which he argued would offer essentially the same services as those provided by ARCH.

Unfortunately, to date Cary Medical Center has been unable to participate in the PC3 program because the rate of reimbursement offered by Health Net Federal Services is not affordable. According to Cary Medical Center, Health Net has offered reimbursement rates that would cause the Center to operate at a financial loss. In contrast, Cary Medical Center has maintained that it would gladly participate in PC3 if reimbursements would allow it to cover costs. A letter from Cary Medical explains this matter further and is enclosed for your reference.

PC3 has been operational in Maine for two months, but statistics show that it is not meeting the needs of highly rural veterans who are most in need of this program. According to the VA's own data, in the first month of its operation not one veteran in Maine had used PC3 during this time period. We are concerned that the low rate of reimbursement offered by Health Net could preclude PC3 from being an adequate successor to ARCH.

We have long known the ARCH program in Maine to be a model for the nation. Given current recent allegations of widespread mismanagement in the VA, we firmly believe the successes of the ARCH program should be considered as part of any deliberations with respect to reforming VA practices.

Again, we urge the VA to take immediate steps to implement the provisions included in the Senate Appropriations Committee-approved Fiscal Year 2015 Military Construction and Veterans' Affairs funding bill. We respectfully request that you provide our offices, no later than July 1, with a response detailing the steps VA will take to ensure the continuation of the ARCH program in the coming fiscal year.

Thank you for your prompt attention to this important matter.

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