VA Resources for Health Care Providers

Do you take care of seriously ill Veterans who receive some of their care at the VA?

What should you know about advance care planning at the VA?

  • VA Advance Directive
  • VA Surrogacy rules
  • VA Life-Sustaining Treatment Decisions Initiative

VA Advance Directive

VA Surrogacy rules

The order of surrogate priority in VA is as follows:

  • Health Care Agent (as per Durable Power of Attorney for Health Care)
  • Legal Guardian or Special Guardian (appointed by a court of law)
  • Next of kin, 18 years of age or older, in the following order of priority:
    • Spouse
    • Child(ren)
    • Parent(s)
    • Sibling(s)
    • Grandparent(s)
    • Grandchild(ren)
    • Close friend

VA Life-Sustaining Treatment Decisions Initiative

VA Life-Sustaining Treatment Decisions Initiative\Started in 2017 as a national quality improvement initiative to promote personalized, proactive, patient-driven care for Veterans with serious illness. Its desired outcome is that the values, goals, and life-sustaining treatment decisions of Veterans with serious illness are proactively elicited, documented, and honored.

The VA’s electronic medical record includes:

  • Life Sustaining Treatment Progress Note Template and a
  • Life Sustaining Treatment Order Set

The Life Sustaining Treatment Progress Note Template allows a standardized way of documenting the patient’s capacity to make decisions about life sustaining treatment, surrogate information, the availability of other advance care planning documents such as advance directives and POLST, the patient’s understanding of his/her medical condition and prognosis, the goals of care, and the participants in the conversation.

The template links to the Life Sustaining Treatment Order Set. These orders are valid across VA Health Care Facilities, both for the inpatient and the outpatient setting. Orders can be written for the event of cardiopulmonary arrest, and for circumstances other than cardiopulmonary arrest (e.g., mechanical ventilation, feeding tubes, transfers to hospital/ICU.)

See also: VA Resources for Veterans and their Loved Ones

The Healthcare Planning Tools is a VA dedicated website with podcast, videos and documents that help veterans and their loved ones to navigate the issues you may face.

Other Resources:

Col. Ron Han, Director of State Office of Veterans Services, provided an overview of their mission in OVS and provide information how Veterans can get connected with benefits and entitlements. This is a joint effort with Bristol and the We Honor Veterans program.

What veteran home care options are available in the community? How can we partner with providers to help navigate veteran benefits & services for the seriously ill?” Please join Kōkua Mau’s own Dr. Emese Somogyi, Palliative Care Physician, VA Pacific Islands Healthcare System, to hear about their programs. Dr. Katie MeltonAmanda Wong (APRN) and Dr. Lavonda Nakamoto graciously agreed to participate to address other support services (e.g. HBPC, H:HHA, etc) that may be provided by the VA.