Review of VA Clinical Guidance for the Health Conditions Identified by the Camp Lejeune Legislation (2015) / Chapter Skim
Currently Skimming:
Appendix B: Guidance for VHA Staff Honoring America's Veterans and Caring for Camp Lejeune Families Act of 2012, Section 102, Covered Clinical Conditions
Appendix B: Guidance for VHA Staff Honoring America's Veterans and Caring for Camp Lejeune Families Act of 2012, Section 102, Covered Clinical Conditions
Pages 79-104
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 79... ...
Appendix B Guidance for VHA Staff Honoring America's Veterans and Caring for Camp Lejeune Families Act of 2012, Section 102, Covered Clinical Conditions 79
|
From page 80... ...
• The law does not give VA authority to cover conditions other than the 15 designated conditions and illnesses and "hospital care and medical services may not be furnished…for an illness or condition of a Camp Lejeune Veterans or family member that is found, in accordance with guidelines issued by the Under Secretary for Health, to have resulted from a cause other than the residence" at Camp Lejeune." VA Camp Lejeune Task Force - Topic: Guidance for VHA Staff Page 1
|
From page 81... ...
Camp Lejeune Veterans and family members who meet the 30 day requirement will be eligible for the Camp Lejeune program. Veterans can enroll in the VA (Category 6 priority VA Camp Lejeune Task Force - Topic: Guidance for VHA Staff Page 2
|
From page 82... ...
This third determination must be made independently for each clinic visit or treatment delivered. Decision point # 1 - Does the Camp Lejeune Program participant have one or more of the covered conditions?
|
From page 83... ...
Covered conditions whose onset occurs at the time of solvent exposure: Hepatic steatosis, female infertility, miscarriage, and neurobehavioral effects have been described in the scientific literature to occur as a result of acute exposure to solvents. The conditions occur during acute exposure or shortly thereafter.
|
From page 84... ...
Another provision of the law directs that "hospital care and medical services may not be furnished…for an illness or condition of a family member that is found, in accordance with guidelines issued by the Under Secretary for Health, to have resulted from a cause other than the residence" of the Camp Lejeune Program family member. Examples of this include: • Current infertility or miscarriage in a woman who resided at Camp Lejeune as a child.
|
From page 85... ...
• Reimbursement of family member bills medical conditions determined to be secondary to a covered condition: VA has determined that it has the legal authority to provide last payer coverage for health care of conditions that are directly caused by one of the 15 covered conditions or their treatment. In order for Camp Lejeune program participants to be reimbursed for health care of a secondary condition, they will need to have their health care providers certify that the secondary condition is caused or exacerbated by the covered condition or its treatment.
|
From page 86... ...
About 80% of spontaneous VA Camp Lejeune Task Force - Topic: Guidance for VHA Staff Page 7
|
From page 87... ...
Neurobehavioral effects: According to the current scientific literature, neurobehavioral symptoms associated with solvent exposure have included acute decrements in concentrating ability and visuospatial skills, fine motor abnormalities, at, or shortly after, solvent exposure. Neurobehavioral symptoms secondary to the contaminant levels in the water at Camp Lejeune would likely have been manifest at the time of exposure or shortly thereafter.
|
From page 88... ...
; it is unlikely that neurobehavioral effects would have persisted and would require treatment at this time. Organic solvent exposure has been associated with various forms of central nervous system toxicity.
|
From page 89... ...
Moreover, if a patient's clinical course of hepatic steatosis is atypical or progresses faster than expected, then exacerbation by TCE, PCE or other organic solvents in the contaminated water should be considered. Points of contact for this guidance: VA Camp Lejeune Task Force - Topic: Guidance for VHA Staff Page 10
|
From page 90... ...
The ATSDR site is http://www.atsdr.cdc.gov/sites/lejeune/ The Task Force co-chairs are Terry Walters, MD, MPH, Office of Public Health, 202-461-1020; Katie Shebesh, Chief Business Office, 202-461-1600. VA Camp Lejeune Task Force - Topic: Guidance for VHA Staff Page 11
|
From page 91... ...
Contaminated Water Supplies at Camp Lejeune: Assessing Potential Health Effects.
|
From page 92... ...
:140-6. VA Camp Lejeune Task Force - Topic: Guidance for VHA Staff Page 13
|
From page 93... ...
2007. Effect of organic solvent exposure on chronic kidney disease progression: the GN-PROGRESS cohort study.
|
From page 94... ...
1 Camp Lejeune Program
|
From page 95... ...
No 5 Documented diagnosis of Yes Go to Infer ty or miscarriage? Algorithm W No 6 Established diagnoses of Yes Go to Chronic Kidney Disease?
|
From page 96... ...
C2 -- - Applicant is administratively eligible for the Camp Lejeune program (has resided in camp Lejeune for at least 30 days between Jan 1, 1957 and Dec 31, 1987, but does not yet have any of the 15 medical conditions specified in the law. 3 Camp Lejeune Program
|
From page 97... ...
occurring in the (See sidebar) setting of hypotension or nephrotoxic agents, No K-4 such as radio contrast or K-5 antibiotics • Acute interstitial nephritis, often due CKD with uncertain etiology possibly due to drugs such as NSAIDs or to exposure to contaminated water.
|
From page 98... ...
Applicant does not have a covered condition eligible for coverage by the Camp Lejeune Program at this time. K5 -- Applicant has Chronic Kidney Disease of uncertain etiology, possibly related to exposure to contaminated water at Camp Lejeune.
|
From page 99... ...
No 3 Identify in the medical record data regarding: BMI, history of hepatitis, alcohol use/abuse, liver disease, H-2 diabetes or metabolic syndrome 4 Is the hepatic steatosis consistent Yes with another condition? (See Sidebar)
|
From page 100... ...
Current hepatic steatosis is due to another cause other than exposure to contaminated water at Camp Lejeune. Applicant is does not have a covered condition eligible for coverage by the Camp Lejeune Program at this time.
|
From page 101... ...
3 Review complete past history including detailed psychosocial evalu on No B-2 4 Are the neurobehavioral symptoms caused by a diagnosed neurologic co : •Alzheimer's disease or other demen a •Amyotrophic lateral sclerosis Yes e n deficit/hypera y disorder •Mul le sclerosis •Parkinson's disease •Red in color discri n •Hearing and olfactory B-3 No 5 Are the neurobehavioral symptoms caused by to another diagnosed cond : •Bipolar Yes •Schizophrenia •PTSD •OCD •Panic disorder B-4 •ADHD No B-5 6 Neurobehavioral symptoms with onset during or around the exposure and with chronic, intermi ent or persistent Return to symptoms since the onset. nt accepted to the program.
|
From page 102... ...
Research to date has not shown any evidence of onset or progression of symptoms after cessation of exposure. Applicant does not have neurobehavioral symptoms as a covered condition and is not eligible for the Camp Lejeune Program at this time.
|
From page 103... ...
W-1 No W-2 3 Infertility occurred during residence on CL. Patient accepted to the Camp Lejeune Program Pregnancy associated with the Yes miscarriage occurred after leaving Camp Lejeune?
|
From page 104... ...
Applicant is not accepted into the Camp Lejeune Program at this time. W4 -- Applicant has medical complications requiring continued medical treatment from a miscarriage while exposed to contaminated water at Camp Lejeune.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.