Union Community Health Center

The U.S. Department of Veterans Affairs (VA) has historically operated programs that allow it to purchase care from the private sector; the federal 2018 Mission Act significantly expanded eligibility and made it easier for veterans to access private care. As a result, VA officials estimate that 50% of the VA’s health care budget will soon be directed to reimbursement for private care.

Veterans are increasingly choosing to access their primary care at federally qualified health centers (FQHCs); nationally, FQHCs serve nearly 400,000 veterans, representing a 76% increase between 2008 and 2020. Yet an NYHealth-supported study shows that only 2% of private providers in New York State fully meet all the readiness criteria for delivering high-quality, culturally competent care to veterans. Other research highlights issues with the VA’s reliance on the private sector, including a lack of coordination between VA and private providers, scheduling delays, and challenges to ensure quality standards that are on par with VA care. NYHealth supported Union Community Health Center’s work in 2019 to design and pilot a unique model to coordinate care between its FQHC and the local Bronx VA medical center. In 2022, NYHealth awarded Union a grant to assess how to scale up its model to other FQHCs that serve sizable veteran populations.

Under this grant, Union will partner with the Community Health Care Association of New York State (CHCANYS) and individual FQHCs to conduct surveys, focus groups, and stakeholder interviews to assess the overall status of veterans’ health care within New York’s FQHC community. It will identify specific FQHCs that are candidates for scaling the care coordination model, including ones that are positioned geographically to serve a considerable population of veterans and have the capacity to increase service availability. Among a select group of engaged FQHCs, Union will conduct a readiness assessment to understand whether they currently screen for veteran status, how well they understand the needs of the veteran population, and their capacity to establish partnerships with a VA hospital and other veteran-serving community partners. Based on the assessment phase, Union will determine the scope and scale of development needs and identify technical assistance and trainings that are most aligned with the interest and capacity of FQHCs. Recommendations will inform Union’s development of a tailored curriculum for training and technical assistance in the future.