By Rachael Tolliver-IRAHC PAOSeptember 10, 2018
Ireland Army Health Clinic, in preparation for its move into the new structure, will start transitioning retirees to the civilian healthcare network sometime in the near future. The first of these groups of beneficiaries will receive a letter, some as soon as Oct. 1., notifying them of the transition and the help available to them.
IRAHC leadership, the Veterans Administration and area network partners will speak to retirees at a town hall Sept. 18 from 5-7 p.m., at the American Legion located at 1251 Ring Road, Elizabethtown. The discussion will include a question and answer period and a healthcare education presentation where experts will talk about how to navigate the network, find a doctor and explain the similarities and differences between military and civilian healthcare processes.
The U.S. Army Health Facilities Planning Agency clinic construction guidelines and Title 10 Public Law only allow room for current active duty Soldiers and their family members, with consideration to military readiness support.
Col. Kevin Bass, IRAHC and Fort Knox Medical Department Activity commander, noted that the Army's focus on military readiness is one of the driving forces behind some of its recent changes, as Army Medicine continues to build medical readiness.
"The size of the clinic depended on how many active duty personnel and their families are on Fort Knox," explained Bass. "And if the force grows again in the future, then the current design can be expanded upon--there is space in reserve to create a medical campus should that occur.
"Military treatment facilities are able to see retirees on a space available basis, and Ireland has done that for years," he added. "But with a new clinic being built and the restrictions placed on its construction, we will not have the space to see retirees when it's finished."
However, Fort Knox MEDDAC still has a mission to ensure that all its beneficiaries have access to timely, quality health care, said Bass. The solution lies within its area network partners.
"We have spent a considerable amount of time visiting our network partners to let them know what changes we face and to discuss how they can help with patient access to care," he added. "A number of physicians over the years who have practiced at IRAHC are now at area hospitals as civilian doctors and are pleased to be able to offer their services to our beneficiaries as they transition."
But these changes aren't without history.
When Ireland Army Hospital was opened in 1957, medical advancements were not where they are today. Many procedures, surgeries and exams required large blocks of time, and a variety of different tests--all of which needed vast amounts of space. And, it served as a community hospital for several years when the area was still quite rural, transportation was still slow and there wasn't a hospital in the local community.
However, as medicine improved over the years, better equipment and techniques meant shorter hospital stays, if any at all. And with the development of the local area came several hospitals and clinics that routinely specialized in areas the Army, as a rule, did not.
Then the Army commissioned a hospital study in 2014 to determine the actual workload for some of its smaller hospitals in order to understand where hospital verses clinic services were really needed in order to "right-size" the military healthcare system.
As reported in the June 9, 2016 edition of the Fort Knox Gold Standard, the results of this study combined with the Army's restructuring plans meant that Ireland's status as a hospital would change to that of a clinic. Those changes would include the elimination of the inpatient treatment, the emergency room and obstetrics, and the staff who served those departments.
Some of those considerations--as discussed in a second story published July 28, 2016--were that of the ER cases Ireland staff saw, about 82 percent of them were really immediate care cases. This means the staff was underutilized and their skills as ER specialists were getting rusty.
The story also said with a true trauma hospital at the University of Louisville, all the trauma cases were being taken there anyway. After Ireland reduced its cardiac staff several years ago, emergencies such as strokes and heart attacks also were being seen at local hospitals who had skilled staff that regularly see such emergencies.
With a network close by that offered quality and timely specialty care, there wasn't a need to keep ER within the Ireland footprint, or construct a large facility.
With these changes in mind, Ireland leadership formulated a plan to ensure its beneficiaries could receive timely access to care. As that relates to the retiree beneficiaries the staff wanted their patients to have the providers patients preferred, and the proper assets on hand for a smooth transition.
The gateway to ready-assistance for this conversion is called the Beneficiary Transition Cell and according to Tina Birch, the chief of the Managed Care Division, the BTC will act as a bridge between IRAHC and network primary care providers to facilitate a smooth transfer of care.
"The BTC will help meet each patient's needs with items like scheduling a transition appointment with a patient's current primary care manager. That way we can make sure medications, lab-work, and referrals are up to date," she explained. "Other things we can do to assist include coordinating the initial new network PCM appointment, providing benefit information to include Tricare options, cost and claim information and assisting patients obtain their medical records."
Birch said that for a retiree to take the initiative and find a primary care provider is an effort she applauds, but she still encourages all retirees to come to the BTC for a consultation.
"I love the fact that some of our patients are venturing out to the network themselves, but we still want to visit with them at least once," she said. "A lot of times the new doctor won't be able to see them immediately and when they do they will want to review the patient's records and see them once or twice more before deciding to continue medications or treatments.
"So by seeing us we can make sure they have enough of their current meds on hand, and get a doctor's appointment for follow up care at IRAHC before they are transitioned out to the network. We want to make sure they are well taken care of during the transition and don't fall through the cracks."
Also, any retiree who served in active military service may qualify for VA healthcare benefits. The BTC staff can help retirees get in touch with the local VA and start the consideration process. If the VA determines a veteran is eligible for benefits and enrollment is an option, BTC staff can help provide resources to complete the process.
She said one of the reasons the BTC is an important component in the transition is that many beneficiaries are unfamiliar with the use of network providers and the changes associated with the process.
"Establishing a healthcare support cell with personnel who are available to assist and provide resources will improve outcomes and lessen the anxiety related to the change," she noted. "We have worked closely with many of our network partners to ensure there is complete area support. So if there is something a beneficiary needs, we have a number of contacts to turn to for help in getting them set up."
For information about the town hall or more information about the BTC please call 502-624-0278 or email at firstname.lastname@example.org.