00:00The Chair now recognizes Representative Sherr-Feliz McCormick for five minutes for any questions you may have.
00:06Thank you so much, Chairwoman, and thank you so much for your testimony.
00:09It's truly an honor to be here listening to your testimony.
00:13I do have a background in home health also. I am second generation, and I kind of miss being in there and finding solutions to these problems.
00:21And I do believe also that community care is imperative to serving our veterans.
00:26However, we do need to have bipartisan legislation that can help us fill in those gaps.
00:31So I was very delighted when I heard what Dr. Hunter was talking about.
00:34The need for standardization as far as to make sure that we have accessibility,
00:39but also communicating what is going on with the community care doctors,
00:43specifically getting on-time or real-time information for our patients,
00:47which even in the private side and community care, we're still trying to get up to date.
00:51So I wanted to talk to Dr. Hunter a little bit more about that.
00:54What recommendations would you put in place so we can actually bridge that gap,
00:59specifically when it comes to community care and our veterans' offices?
01:04Thank you so much for that question.
01:06As we said, we know community care is vital, but we know there needs to be better direct communication
01:11so that patients are receiving that same quality integrated coordinated VA care that leads to better outcomes.
01:18So if we look at recommendations that can improve this, one is having the same types of care standards
01:26that are required for community care providers as for VA health care providers.
01:32This is seen very clearly in the mental health area where when a patient is seen internally to VA direct care,
01:39VA direct care mental health providers are required to set a evidence-based course of care for that patient
01:46that hits very significant benchmarks that are there.
01:49When they're referred out to the community, they were referred out for a time-based episode of care.
01:54So six months, 12 months, and then it's reevaluated.
01:56But right now, there is not a requirement to actually share back with the patient care team what the decided course of care is.
02:04And in fact, all that's required is a yes, this patient showed up for an appointment, and it's either improving or not improving.
02:12So first and foremost, to strengthen this is to set the same standards for evidence-based care for VA care and community care
02:20and require that transparency so that all providers within the VA system know what the course of treatment is
02:27across all sorts of specialty care that are provided.
02:31This is one very specific example for mental health care, but we see this happen in other forms of care as well.
02:36Now you touched upon the problems that we're having with electronic medical records.
02:40My other subcommittee is technology modernization, and I really hope that we can have a joint hearing so we can be discussing this together.
02:48And so I know we already have strains in even getting the VA's system up to task and up to snuff.
02:54So I know it will be challenging for us to do that with community care.
02:58But do you have any recommendations that you can give us when it comes to electronic medical records?
03:03I think we do need to take a very close look at the current implementation of electronic health records within the VA.
03:10We know it is plagued with problems from the get-go.
03:14This is an area that I am new in this seat.
03:17I've been a CEO here for a month, but it is one of the things that I have really wanted to dive into
03:22to be able to provide those better recommendations to you all as to how we can effectively modernize the VA
03:28and create better synergies and more seamless communication between VA and community care,
03:32and would love to work with your office to do just that.
03:35Thank you. I want to pivot a little bit over back to our home health issues that are happening.
03:39So when I was the CEO of a health care company, what we did, we also had rural areas,
03:44Clewiston, Belle Glade, and we were servicing there.
03:47We had huge issues when it came to recruiting health care professionals to get out there.
03:51But also we did have a good number of Medicaid recipients.
03:55Now, do you have any Medicaid recipients who are actually with your organization?
04:00We have very little in our particular organization. We are a stand-alone home care agency.
04:06So right now we are looking at $1 trillion in cuts when it comes to Medicaid.
04:10And so I have deep concerns about the compound effects with the cuts that we have in the VA
04:15combined with the $1 trillion in Medicaid cuts
04:18and how we are going to keep organizations like yourself who play such an imperative role
04:22in making sure that our veterans can actually retire at home with dignity with their family
04:28but still get their services.
04:30So could you touch on some of those effects for your organizations, other home health care agencies
04:35that will be servicing our Medicaid patients and our veterans?
04:39Sure. Of course, as I stated, we, our particular payer mix, we have very little of the Medicaid.
04:47And so for us personally, it won't have a large impact.
04:51What we do is, as with any other agency, is we try to meet everybody's needs.
04:57In our particular area, we're not hearing feedback on that.
05:00Well, I have a few more seconds, and I just wanted to ask you this one question.
05:03One of the things I'm hearing from home care agencies is that they have real concerns about the people
05:08who are going to be kicked off of Medicaid.
05:10They can't abandon those patients.
05:11How do you transition that person who is homebound, cannot get up, can't take care of themselves?
05:16How do you rip their insurance, and how do you leave them there?
05:20So have you guys thought about that transition process?
05:22Are we just going to abandon these patients to leave them to themselves?
05:25Well, if I can circle it back to the VA, we are actually actively seeing that now with our veterans,
05:32where on the VA services, where they've lost homemaker services, home health aid services,
05:37due to internal cuts within the VA, we are seeing that they've lost access to care.
05:43And so I think it's already happening within the VA, but this started a year ago,
05:48based off of decisions within the VA.
05:51Thank you very much.
05:52Your time has expired.
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