VA Maine Health Care System-Togus operations modifications

AUGUSTA — VA Maine Health Care System operations are adapting because of the emergence of the COVID-19 virus to maintain a healthy environment for veterans, family members, and staff.
In an effort to confront emerging challenges related to COVID-19 transmission, the VA Health Care System-Togus is initiating emergency measures to prevent avoidable transmission of illness within the medical center. Updates on VA COVID-19 cases can be found on the national VA Public Health page, at publichealth.va.gov/n-coronavirus. In order for VA Maine to provide continuity of care to veterans, officials are asking that anyone tested for the coronavirus (COVID-19) at a community health care facility or is contacted by the Maine CDC, please communicate to those organizations that you have received care through the VA Healthcare System.

ELECTIVE PROCEDURES
The VA is rescheduling any non-urgent elective surgeries/procedures. Dental procedures that are not urgent or emergent will also be rescheduled. Veterans to whom this applies are being contacted. Current plans are to reschedule to after June 1. Ccontact your clinical team should you have questions.

TRANSITIONING TO VIRTUAL CARE
All VA Maine sites of care remain open at this time are are working to reduce face-to-face outpatient clinical encounters to only those that are deemed time-sensitive and clinically necessary. The efforts are to ensure we maintain the safety of our veterans.
Face-to-face outpatient visits for all clinical services, including primary care, mental health and specialty care, will be assessed for conversion to virtual care. In order to accomplish this goal, clinical staff will review all scheduled appointments to determine if the appointment can be switched to a VA Video Connect or telephone appointment. If the type of care is not appropriate for VVC or telephone (i.e., dental care or endoscopies), the provider should follow up with the veteran to reschedule his/her appointments for no sooner than 60 days in the future of the cancellation date. Upon being called, veterans being asked to either switch clinically appropriate appointments to VVC or telephone or postpone the appointment, veterans will be asked two follow up questions: whether they need medication refills and whether they have any needs that need to be addressed sooner than the VVC, telephone or postponed appointment.
If a veteran is at risk of imminent harm by not seeing a clinical provider face-to-face, then a face-to-face appointment will remain in place. In order to ensure that our urgent care clinics and emergency departments are not overwhelmed, it is critical that we ensure veterans are still able to see their clinical providers for urgent needs.

EXTERNAL TRIAGE UNIT
Working with the Maine Emergency Management Agency, the Maine National Guard erected a tent outside the Togus campus’ Emergency Department on March 18. The tent will serve as an External Triage Unit beginning March 23.

PRESCRIPTION REFILL REQUESTS
The pharmacy is switching to an all mail-order system in order to limit exposure to COVID-19. Outpatient Pharmacy will ONLY honor emergent prescription needs for in-person pick up. Emergent prescriptions include post-surgical, emergency department and discharge medication needs. All other medications and supplies will be mailed. Veterans may request refills and renewals by:
* Contacting the refill line at 207-623-5770.
* Mailing in refill slips.
* Pharmacy Call Center at 1-207-623-8411 option 1.
* Requesting them through My HealtheVet. Alow 7-10 days for prescription delivery. Veterans may request expedited shipments and may request changing routine medications from 30 day fills to 90 day fills by:
* Pharmacy Call Center at 1-207-623-8411 option 1.
* Using My HealtheVet and choosing “Ask a Pharmacist.”
VA Pharmacy cannot send patients 90 day fills of controlled substances, some supply items and certain high risk medications. Pharmacy will not fill more than 90 days’ supply of maintenance medications or honor early refills.

VISITOR RESTRICTIONS
The following visitation safeguards are in place:
* Visitors/guests are not allowed in any site of care.
* Outpatients should come to VA appointments alone, if possible.
* Veterans coming to the hospital or any clinic for health care/procedure can bring one adult family member/caregiver with them who is not sick. * No one under the age of 18 is permitted.
* Visitors are not allowed to visit the Community Living Center on the Togus VA campus. Visitation is only granted to those who have a veteran that is on hospice care at the CLC, if the visitor is trained to assist with care of the veteran or is needing to be trained to assist with the Veteran’s upcoming discharge from the CLC.
* Entrances to the Togus VA Medical Center and Community Based Outpatient Clinics will be limited; staff are screening people for symptoms of fever, cough, or shortness of breath before entry.
* Exceptions may be made for visitors of patients to include those who are in critical condition or in end-of-life situations. Additional policies restricting visitors may be put in place on certain specialty units or as conditions warrant.
Visitors can call to speak to inpatients by calling the operator at 207-623-8411, dial 0, and ask for the inpatient/veteran by name to be transferred. All patients and visitors are reminded to wash hands with soap and water or use alcohol-based hand sanitizer before and after visitation or appointment.
Officials also encourage all patients to allow for extra time to get to appointments with the required screening. “We appreciate all support and understanding as we plan, prepare and respond to this emerging public health concern,” VA officials said. The VA will initiate screenings for all who enter medical center buildings and clinics. The screenings will help ensure the VA is protecting its population of hospitalized Veterans, the teams that care for them, and families of all involved. “We fully recognize this will cause some inconveniences, but the safety of those we care for must be the priority.”

AUTHORIZED ENTRY POINTS, HOURS OF OPERATION
Togus Campus:
* Veterans & visitors will enter through building 200 main entrance, (access: 24/7; Building 207 gazebo side entrance (aeccess: 6a.m.-7:30 p.m.; Building 205 circular driveway (access: 6 a.m.-5 p.m.).
* Staff will use Building 200 main entrance during weekend, holiday, evening and night hours.
* Staff will enter through Building 235 glass entranceway (access: 5 a.m.-4 p.m.); Building 207 gazebo side entrance (Access: 6 a.m.-7:30 p.m.); Building 205 circular driveway (access: 6 a.m.-5 p.m.).
* Staff in standalone buildings will be screened upon arrival by supervisor.
Outpatient Clinics (CBOCs): Veterans, staff, and visitors will be screened upon entrance to the clinic. Any changes will be announced as soon as we have information to share.
For more informationm, visit maine.va.gov and the VA’s Facebook page.