Navigating Veterans Affairs Community Care

This conversation delves into the complexities and challenges of Veterans Affairs Community Care, highlighting the increasing costs, bureaucratic hurdles, and the impact on veterans' quality of life. The discussion emphasizes the importance of advocacy, communication with elected officials, and the need for systemic reform in the VA healthcare system to better support veterans and their families.

Transcript

Brandy Schantz (00:01.1)
Welcome back to Living Chronic. This is Brandy Shantz and I'm here with Helen Perry. And today we're gonna be talking about Veterans Affairs Community Care. For those of you who are unfamiliar, Community Care is the outside of the VA healthcare that you can receive. You get a referral, they send you out to the community, whatever that might be. And you see a doctor, healthcare professional, it could be, there's a pretty long list of actually.

professionals who do community care with the Veterans Affairs Administration. I've used it myself. But of course, there are some drawbacks. There are some issues that we're currently seeing right now. And this is where the VA seems to be headed. When we talk about privatization, we're talking about sending veterans out to the community. So this is a big topic right now. I'm glad we're tackling this one because

we really need to do our best to explore every hidden and even visible issue associated with privatization of VA care because it affects us the most. So thank you again, Helen. Welcome back. Glad we're going to be talking about this one today. This is important to so many veterans and their families, and you know this better than anybody. So let's talk community care. What is it and why is this important?

Helen P (01:27.582)
Yeah, so, you know, first, I am not a community care expert. It is as with everything, it is a complex system that exists within the VA. And the other thing is that different VA's in different regions operate it differently. And so what may be true for somebody in Texas ends up not being the same for somebody in California or somebody in Washington state or wherever. But what I do do is a lot of advocacy with people who are using community care or experiencing problems with community care or within

in the VA and vice versa and back and forth. And I think right now the slogan that I keep seeing repeated is that community care is VA care. And I kind of disagree with that. There's been a lot of opinion pieces that you can go out and read from people who are far more educated than I am that talk about why that's probably not accurate.

But it's, know, community care is a great opportunity for veterans, especially in rural areas.

who are not near a VA who need access to some service that the VA doesn't offer. Or maybe they have the service, but it's not, you know, they're backlogged or they don't have enough providers or they don't offer like the specific treatment. You know, if you need, for example, I think the example people are most familiar with is like needing a colonoscopy and they have a gastroenterologist at the VA, but they can't get you in for a year, but you need your colonoscopy now. And so they refer people out or orthopedics is another one. The challenges that we're having,

You know, everybody keeps talking about, it's funny because we've seen this shift. you know, in 2024, in January of 2024, there were articles coming out that were talking about, you know, the challenges of the Veterans Community Care Program, the VCCP, and, you know, what it was costing. Like, for example, in 2014, it was costing about $8 billion, and then in 2024, it was costing about $31 billion. And that was about a third of the budget for veteran medical.

Helen P (03:33.39)
services, which is crazy. And there's all this outsourcing, you know, it's kind of outsourcing, right? Like if you're taking care from within the VA and sending it out, then that's an outsource. The problem is, that community care does not necessarily mean that you get seen quicker. Doesn't mean that you get seen by somebody who's more qualified. But now we're seeing, we're seeing like this variety of challenges in that people who have been in community care for a very long time are now having their referrals canceled for no

reason and they can't explain it. Everybody reads the headline and says, well, you know, the current administration has just expanded community care. And then my response would be, that's amazing. I hope that that comes to fruition. But what I've seen as an advocate is that people can't access it anymore, that their referrals are being canceled, that the actual reality of how it's being implemented is changing. And whether that's because the VA is short staffed and so they can't process the referrals or because it's a financial thing and the

of money that they're using is decreasing, know, however, however you look at it, because we as advocates don't always get an answer to that question of why something happened. What I am seeing as an advocate is that people are coming to me and saying, hey, I've been using community care referrals for the last three years, five years, whatever, and suddenly I can't go anymore. They're forcing me back to the VA, but I'm in the middle of a procedure. I'm in the middle of treatment. I'm in the middle of X, Y, and Z. And now they're having to take extra steps to fix

those referrals. The other thing that I'm seeing from a lot of people is they're getting bills. They'll get referred to a community care referral for some, you know, provider for something. They'll get treatment as that community care provider has deemed appropriate and then the VA is calling them and saying, we're not going to cover this referral because we, you know, authorized X, Y, and Z. They did A, B, and C and now you're going to have to pay the deficit and you're going to have to pay this additional amount.

Brandy Schantz (05:31.682)
Mm-hmm.

Helen P (05:32.956)
And a prime example of this is I have a friend that I'm working with. She gets her care through the VA. She recently had a fall and she landed on her arm. And after she fell, she was having wrist pain specifically. And so the VA referred her out to an orthopedic surgeon to be seen for her wrist pain. And as a good orthopedic surgeon does, they x-rayed the joint that was injured and one joint above because that is like a gold

Brandy Schantz (06:01.528)
Mm-hmm.

Helen P (06:02.86)
standard in joint injury. Always the injured and one above. And the other thing with wrists is that a common cause of wrist pain is elbow injuries. If you think about tennis elbow, tennis elbow is pain in the wrist, but it's caused by the elbow. So that's just like some medical, you know.

Brandy Schantz (06:04.962)
Right.

Brandy Schantz (06:14.69)
Mm-hmm.

Helen P (06:19.914)
that's pertinent to the story. So when she was seen by this orthopedic surgeon, they x-rayed the elbow and found that she had a fracture. And they're like, hey, that's what's causing the wrist pain. Like, yes, it's the wrist, but it's actually the elbow. The VA is now refusing to cover that community care referral because she was referred for the wrist and not the elbow. So she now has to go back through the whole process, explain to them.

Brandy Schantz (06:40.59)
Mm-hmm.

Helen P (06:45.436)
And now she's running into problems with the VA because they're saying, you wanted the wrist scene. And she's like, yeah, but it's like a connected thing, right? Like, you know.

Brandy Schantz (06:53.485)
Right.

Helen P (06:54.698)
And so this, is like a prime example of like what's happening with community care. Where it ends up being like a pretty substantial burden on veterans to navigate the policies and procedures, the billing, the follow-up, the referral management. It becomes this like thing the veterans end up having to manage and it's frustrating. And it, you know, it adds to sort of this aversion that people have of using VA healthcare, you know, like

Brandy Schantz (07:06.723)
Yes.

Helen P (07:24.652)
Is it actually better for veterans to get care in their communities if they're having to jump through all these hoops and they're getting these outrageous bills? And by the way, those bills can go to collections and it doesn't matter that the VA was supposed to pay, the collections come to you. For people who have clearances, that can affect your clearance, that can affect all sorts of things in your personal life. And so it's...

Brandy Schantz (07:32.494)
All right.

Brandy Schantz (07:41.452)
Right.

Helen P (07:51.014)
It's not necessarily the perfect solution that everybody thinks that it is. Veterans community care is an essential, essential component of VA healthcare. But I think the problem is that now it is being treated as.

Brandy Schantz (07:55.725)
Mm-hmm.

Helen P (08:08.078)
as a scapegoat, a referral system for like, instead of fixing the VA problems, we're just like, just refer them out, refer them out. And the problem is that ultimately is gonna come of that is that there's a finite amount of money that funds the community care program. And so if we're using up all of those dollars, instead of fixing the problems that we have, then we're not actually like, right? We're basically just putting some gum on the flat tire of the car.

Brandy Schantz (08:14.561)
Right.

Brandy Schantz (08:36.556)
Yes.

Helen P (08:37.932)
not actually fixing the flat tire. And so it's this nuanced conversation that I have to play with people of like, well, they're like, well, then we should just get rid of community care. And I'm like, no, no, no, like we need it. We need it for rural veterans. We need it for veterans who have very complex care. You know, we definitely need it and there definitely should be choice for veterans. We should also simultaneously be fixing the VA system so that veterans who can get care within a VA healthcare facility, whether it's a clinic or a hospital,

Brandy Schantz (08:49.41)
We need it.

Helen P (09:07.902)
and making sure that it's appropriately staffed, making sure that they have the resources that they need to provide good care, because I think what you'll find from a lot of veterans is they prefer that, because the VA has benefits, like we've talked about before. They understand toxic exposures. They understand what your MOS means. my god, go talk to a civilian doctor and tell them that you worked in air defense. They have no idea what that means.

Brandy Schantz (09:18.413)
Yeah.

Brandy Schantz (09:34.259)
Well, I am not even kidding you. I had a neurologist. It didn't matter how many times I said to him I was an intelligence officer. I worked as a liaison most of my time in Afghanistan. was going between the presidential palace, NATO. I was always working with, you know, the different leaders at ISAF. he could so so like were you like a truck mechanic? And I'm like, one more time, intelligence officer.

Helen P (09:46.057)
Yeah.

Helen P (09:57.61)
No. Intelligence officer. Yeah. I mean they-

Brandy Schantz (10:02.282)
not even adjacent to truck mechanic, but.

Helen P (10:04.874)
It's a different world and people don't understand it. They don't understand the rank structures. They don't understand, you know, they just, they don't understand. And so there's a lot of veterans who prefer to get their care and who do get better care within the VA system because they are more, you know, like they're familiar with Gulf War Syndrome. They're familiar with burn pits. They're familiar with, you know, some of the unique challenges that come with blast trauma and, you know, all of these kinds of things. And so it's, you

Brandy Schantz (10:10.104)
Right.

Brandy Schantz (10:17.623)
Yes.

Brandy Schantz (10:23.864)
Yes.

Brandy Schantz (10:31.148)
Yes.

Helen P (10:34.828)
the two things are not, they're not the same, they're not synonymous. And I think that the problem that we're gonna start seeing is, this article from a year ago talks about how Congress was already looking at how much money the community care program was costing, right? And I think they were looking at like 34 billion

Brandy Schantz (10:59.298)
Mm-hmm.

Helen P (11:04.748)
to fund community care through like 2026. But again, like is that money actually gonna be there if we're just sending everyone now out to community care and like what's gonna happen if the money stops being there? Because what'll happen is patients will stop getting seen. They'll say, yeah, you can have a community care referral. We just can't pay your bill.

Brandy Schantz (11:25.837)
Right.

Helen P (11:31.836)
And that's really not gonna be helpful for anyone. And like I said, from the advocacy side, what I am seeing is an increase in the number of people who are having their referrals canceled, who are having their referrals unfunded. And for whatever reason, that's just what I'm seeing in as advocate. Maybe there's selection bias, right? Because I tend to work with people who are having challenges and problems accessing care, but I talk to other people as well. And I've had people tell me like,

Brandy Schantz (11:46.424)
Yes.

Helen P (12:01.74)
nope, nope, in community care, it's been working great, no problems. But I have definitely seen an increase in the number of people who are having challenges, you know, with the community care program, getting their bills paid, going to collections, getting their referrals canceled, all these kinds of things. And that's, you know, it's one of those things of like, what's being put out in legislation and what's actually happening in reality definitely are not lining up to be the same.

Brandy Schantz (12:13.346)
Yes.

Brandy Schantz (12:25.346)
are two different. And I should say Joe Plinsler, most people probably don't know his name. He was one of the organizers of the recent Unite for Veterans rally here in Washington, D.C. And he just posted an article yesterday about VA care being under risk because so many doctors and nurses are rejecting working at VA. They're turning down their offers because they just don't view it as a stable job. And that's a problem as well. need

Helen P (12:48.063)
Yeah.

I just saw that.

Brandy Schantz (12:55.17)
We do need both, you're correct. And then of course, when it comes to community care, I didn't realize there were so many issues until I spoke with you. And I probably should have because I've had issues myself, but I've been able to solve my problems by just throwing my hands up in the air and saying, charge TRICARE, because I also have TRICARE for retirees. So when things start going south, call, and I'm just sick of dealing with it, I did that recently with CVS for an urgent care.

visit that VA sent me out to, but VA wasn't paying it. And I kept getting a bill for like $580 for this urgent care visit. And I finally just called them and said, you know what, just put it on my TRICARE, please. And then once I got that $80 copay instead of the, you know, $580 copay, I went ahead and paid it. So I didn't realize that I was using another different benefit in a situation where many people

Helen P (13:39.134)
Yeah.

Helen P (13:42.985)
Right.

Helen P (13:51.38)
break.

Brandy Schantz (13:54.127)
don't have that and they're just trying to get somebody else to, know, the VA who was supposed to pay the $580 bill to actually pay it. Oh no, no, oh.

Helen P (13:57.288)
Right. Pay it. Yeah. And I don't know if you've ever tried to call VA Billing, but it is not, it is not an easy thing to get somebody on the phone to talk to them about.

Brandy Schantz (14:09.154)
No, again, I would do anything. Just let me at the VA, give me a Lean Six Sigma, a good team, give me some time because my God.

Helen P (14:20.562)
Yeah, it's painful. you know, it's great when veterans, you know, have these backup programs and these backup, you know, if they have TRICARE or they have secondary health insurance or whatever, and they can fall back on that when community care referrals fail. But for a lot of veterans, they don't. They rely solely on the VA programs. And when those programs go to collections,

Brandy Schantz (14:33.773)
Yes.

Helen P (14:43.102)
They're ruthless. They don't care that the VA was supposed to pay. They don't care that, you know, the VA just processed the referral incorrectly. And that comes back on you. It can garnish benefits. can, you know, they can do lots of really nasty things to people that cause them a lot of pain. And, you know, it's it you're just little old you trying to like fix the problem. And so it's, know, it's really important for veterans to be aware of, you know, saving the documents, saving their paperwork that shows the referral.

if they're sending you things in the mail for like explanations of benefits or things like that, know, keep those so that if you end up having problems, you can go back and argue that and fight with them to get them to pay it. But it's, it's there simultaneously the problem of now we're losing VA providers. I saw a statistic recently that said in the past, when people would get hired on at the VA, it was about a 10 % rate of people who would, who would decline those job offers.

Brandy Schantz (15:42.787)
Right.

Helen P (15:42.908)
Now we're up to like 40%. It's a four time increase from what it was of people who do not want to work for the VA because they consider it to be unstable or for whatever reasons they have. I know on the provider side, a lot of providers, we have a healthcare provider shortage in the entire country for physicians and for nurses and for other specialists.

Brandy Schantz (16:04.462)
Mm-hmm.

Helen P (16:13.214)
their you know the VA does pay a lot of money in the past the appeal to people was either from the sentimental component of working with veterans which they felt very attached to or it was the retirement benefits but now as they have whittled you know whittled away at union and union benefits and retirement benefits where there are people who are saying they're not getting paid their benefits when they should have been all of these things people are looking at that and saying it's not it's really not the juice is not worth the squeeze it's not worth it to us to go into

Brandy Schantz (16:21.805)
Right.

Brandy Schantz (16:25.346)
Yes.

Brandy Schantz (16:42.135)
Right?

Helen P (16:43.158)
the system that can be very cumbersome and very difficult to work in. And so they're going other places, which leaves these facilities short staffed, understaffed, know, under resource. And then we rely on more people going to community care to get the things that they need. But again, if the money, you know, the more people that use it, the more money that is going to be required to utilize those resources, which means that we're going to run out of money. You know, I saw another statistic

Brandy Schantz (17:09.229)
Yes.

Helen P (17:13.118)
saying that the VA for this year is already requesting a budget supplement because they're over on their costs, which if we want to talk about cost savings, there was all sorts of financial cuts that were made that were said that they were going to save money for the VA, but that doesn't seem to be happening. In fact, it seems to be costing more money because it turns out when you don't have the right people in the right job to do the work, errors get made, care gets delayed, and all of these things are expensive.

Brandy Schantz (17:28.279)
Right?

It is.

Helen P (17:42.94)
You know, like I know I had an appointment yesterday to have one of my knees looked at. It was supposed to be my right knee. The VA had only listed the left knee. I was like, nope, it's definitely the right. I can tell you for sure. The left knee's already been taken care of, but the right knee definitely needs to get looked at. And they're like, sorry, we're only going to look at the left knee because the VA somewhere said only the, and the way it was written was like left knee, comma right knee, comma left knee, comma, you know, it was like this whole, and I'm sure that that

Brandy Schantz (17:43.746)
Yes.

Brandy Schantz (18:10.605)
Right.

Helen P (18:12.854)
was never even touched by a human. I'm sure that that was probably done by an automated system somewhere that is faulty. And so now the VA is going to have to pay for another appointment when all I wanted to begin with was my right knee to get checked. So all of these things cost money. you know, it's it's really going to start coming down to I would not be surprised if if, you know, similarly to how fiscal budgets worked within the Department of Defense. I'm pretty sure everybody can remember, you know,

Brandy Schantz (18:29.75)
Yes.

Helen P (18:43.044)
August and September rolling around and everybody's like we ain't got no money. We ain't got nothing You can't you can't have printer ink until October, you know October 10 because that's when the new budget hits You know, I I think that that's what we're gonna end up seeing is that when these programs end up running out of money that the VA starts to just Conveniently losing referrals misplacing referrals referrals don't get placed and then it's just delays and cares for veterans and and it's

Brandy Schantz (18:50.155)
Yep.

Brandy Schantz (19:08.31)
Yes.

Helen P (19:12.684)
It's really hard hitting on veterans who are rural, who are way out there, who really don't have another choice for care or who are left commuting 400 miles or whatever to get to a VA just to get access to basic services. And so it's not, I think it has been painted as like this cure all problem or problem solution for Olivier and it's really just not that.

Brandy Schantz (19:23.948)
Yes. Yes.

Brandy Schantz (19:38.486)
Right? Now you're right. And you know, we have these big shortages. So one of the issues I've been having is I can't, I have a nervous system condition, right? Okay. So my nervous system's the problem. I can't get in to see any kind of a specialist at VA. They just don't even have them. I mean, they're so short staffed. The neurologist they did get me in to see was so discombobulated.

Helen P (20:00.457)
Yes.

Brandy Schantz (20:07.287)
And there's one of him and a bunch of students that rotate in and out. So one real doctor, bunch of students, and he was so discombobulated trying to get things together that he called me from his own personal cell phone and then was just horrified when he realized I now have his personal cell phone number. Sorry, doc, but I'm trying to get a hold of somebody. So the only part they can only send me out to community because there's no specialist at VA who specialize in my condition. However, there's also nobody out here.

Helen P (20:25.225)
Yeah.

Helen P (20:31.081)
Right.

Right.

Brandy Schantz (20:37.261)
who has time to take me.

Helen P (20:38.59)
Yeah.

And also because the reimbursement rates for VA community care are similarly very low. And so it's very hard if you have a condition, you know, we're in the same boat with my husband's traumatic brain injury. requires, not only does he require a neurology specialist, but it's like multiple specialists within neurology. So we might see three different neurologists who all have different specialties. And, you know, we do use TRICARE for that because to get it through the VA is like not gonna happen.

Brandy Schantz (20:42.89)
so small.

Brandy Schantz (20:57.418)
Yes.

Brandy Schantz (21:09.214)
Forget about it.

Helen P (21:09.548)
Yeah, but on top of that, we have a hard time even with TRICARE finding those providers because they are very difficult to find. They tend to be very, very specialized. They're patient loads. You know, when you have one guy who, you know, works on CTE or TBI or, you know, balance disorders or movement disorders or whatever it may be, everybody goes to that one guy. You know, people are not dumb. They know that they want to see the specialist who actually knows about

Brandy Schantz (21:15.169)
Mm-hmm. Yeah.

Brandy Schantz (21:32.962)
Yeah.

Helen P (21:39.42)
and specializes in that thing. And so the wait times are significantly high. The cost to be seen is significantly higher. The offices themselves can be choosy about which patients they take. And so, you know, it's barriers in care all around. And that's why you see a lot of people now opting to have and opting to pay cash for these appointments because so many people just want to be seen, right? They just want to be seen. They just want to be taken care of. And if they can, they do. I cannot f***

Brandy Schantz (22:03.212)
Yes.

Helen P (22:09.324)
We do the same thing with several of our providers.

Brandy Schantz (22:13.569)
Mm-hmm.

Helen P (22:14.782)
But that is not an option for so many people, which is why it's really important to make sure that our VAs are appropriately staffed and resourced so that when they need to get care, they have access to equitable healthcare. And that's where we're really seeing these cuts, you know, having a negative effect on people. I also think that it's very interesting. We just had a VA survey sent to us and the questions were worded so specifically.

Brandy Schantz (22:44.564)
Right.

Helen P (22:44.716)
to really hit at like, things are great. You don't have any problems, right? And it was just very interesting to me that the way that these questions were worded was done to really kind of elude around any of the issues.

Brandy Schantz (23:05.857)
Yes.

Helen P (23:07.454)
But I will say that we have even noticed the staffing cuts affecting our access to providers, to getting resources, all of those kinds of things. And again, we're blessed in that we have TRICARE. And so we use that predominantly for all of Matt's healthcare because he is so complicated. it's, community care is, it is essential to have.

but we also need to make sure that we're doing it in balance with supporting the system itself for everybody else, you know? And that's where I think, you know, we're gonna start seeing rationing. I think we're gonna start seeing, and we are seeing that, right? Like I'm seeing people who are having, and I would say in the majority of the cases, the rationing that I'm seeing or the cancellation of referrals that I'm seeing are just very poorly thought out. You know?

Brandy Schantz (23:38.741)
Yes.

Brandy Schantz (23:48.758)
Yes.

Helen P (24:02.966)
saying that a provider who, you know, has, you know, like a family practice provider is equivalent to like a women's health provider. And I'm like, no, those are not, not the same thing. Yeah. And like, yes, family practice may be trained in women's health, but that is not the same. And maybe they have a role in, in like, there's just all of these different complexities that go into it. And so I,

Brandy Schantz (24:14.625)
That's not the same, two different things.

Helen P (24:30.642)
I really worry about where we're headed with the community care thing. I think there are big red flags. I see all the headlines that say that the Secretary of the VA, Doug Collins, is making it easier and he's facilitating. We only need one referral. We don't need the double provider referral like we had in the past, all these things. But then what I'm seeing on the ground is an increase in barriers to access to care.

Brandy Schantz (24:48.215)
Mm-hmm.

Brandy Schantz (24:57.324)
Yes.

Helen P (24:58.858)
I worry about is this one of those situations where what is happening in the news and what is happening in reality are just not the same thing. Yeah.

Brandy Schantz (25:08.791)
two very different things. Well, and I think there's also the quality of life component. So I talk about my own mental health quite a bit. I'm very open about it because I suffer greatly. And it's for various reasons. And when we talk about quality of life, I'm not just talking about the pain I'm in. I'm not just talking about the things that I have lost in my life. I'm talking about my everyday life.

What does that mean? Do I actually have access to some health care? Yes. Is it the best always? No. Do I have to work really hard to get there? Very much yes. Do I have the career I love? No, that's gone. Do I have any, are people willing to help me to find a job? I think so. Maybe I think we have services if I want to just randomly find any other job, but nobody's addressed that aspect. And in those two things alone,

There are hours and hours of my day that are taken up with just being the sick person, trying to solve the problems that being sick has hoisted upon me. Just all the stuff that I'm dealing with. And getting the community care referral, trying to get that paid for, realizing it's not going to get paid for, leaning back on my TRICARE to try to pay for something that didn't get paid, finding the person at VA who knows where they are that's supposed to be there to help me find X, Y, and Z.

Helen P (26:13.78)
Yeah.

Helen P (26:19.37)
Yeah.

Brandy Schantz (26:37.869)
My days are all day long being sick, calling some doctor on some sort of hold, on doing this extra work to figure out where I'm supposed to go, doing this amount of research. It's a full-time job with unreal amounts of overtime. And that's where my quality of life is. So when people ask about veterans and depression or suicide,

Helen P (26:43.018)
Thank you.

Brandy Schantz (27:05.685)
or any of these things, I think it's very important that we don't just talk about, they have access to health care. It's important that we talk about what kind of health care, how easy is it to access it, how much work has to go into getting that health care, how much work has to go into figuring out what health care you need. Are you employing not only your own time, but your family's time to help you find the right specialist because there's nobody at VA to help you? How many hours of your day, week,

Helen P (27:33.032)
Yep.

Brandy Schantz (27:34.898)
month go into your own health care. And that's very important to the mental health and well-being of each and every veteran and their family out there because so many of us are spending all of our free time doing this. And sense of self and mental health is very important. Right now, my sense of self is gone. I'm just a sick person because every day of my life is spent.

Helen P (27:44.254)
Yeah.

Helen P (27:49.215)
Yeah.

Brandy Schantz (27:59.202)
figuring out ways around being sick. spoke, you before we started this episode, we talked a lot about exercise, you know, and people from the outside say, but look, you exercised. You're darn right I did. If I don't exercise, I can't move, and then I'm bedridden. Would you prefer me to be bedridden? What am I supposed to do? There are so many hours of my day. Yes, but there's so many, I mean, give me a quality of life. There's so many hours of my day just consumed with being this sick.

Helen P (28:16.958)
But there are so many people that would say yes to that.

Brandy Schantz (28:28.375)
person and doing the right kind of physical therapy so I can get out of bed. Plus calling the 600 doctors and the insurance company and VA and getting this person on the phone. There are people in this world that just wake up in the morning, go to work, come home and then have free time. Who are they? What are you doing? I envy you. What's your biggest problem? Do you hate your boss? Wow. I wish I could have that problem.

Helen P (28:44.829)
I know. I know. I mean, we...

Helen P (28:50.588)
I mean, I tell people now that, you know, I spend probably it's it's it's increasing every month, I swear. But I right now I'm about 30 hours a week of case management for Matt, you know, and that's not including my kids or me or anyone else or anything else that needs to get done. That is 30 hours a week of referral management, medication management, prescription refills, insurance authorizations, you know, checking all these kinds of things. And you're right, it's exhausting. And people frequently do not talk about

the bureaucratic burden that is placed on veterans and families, very specifically families, because frequently it's not the veteran who takes on that load. It's a caregiver who then has to do it because like, you know, similarly in my case, can't, Matt can't. And so, you know, I can remember at one point the VA saying, you need a case manager to deal with this. And I remember a case manager called me and she said, you know, you got injured, you know, it's been like 10 years now, you know, all these kinds of things.

Brandy Schantz (29:24.973)
Yes. Yes.

Helen P (29:50.464)
She's like, you know, he's not getting better, right? And I was like, you don't say. You're kidding. Are you trying to tell me this is my new normal and I need to get used to it? Thank you. Super aware. Also asking for help. And the long and the short of that conversation was they did not help and they are not helping. And so I continue to do everything. But when, you know, I cannot even begin to, and I know it's the same for you, is like,

Brandy Schantz (29:54.921)
Really?

Helen P (30:17.322)
The weight that it puts on you of like, need to call the insurance company, but to get ahold of TRICARE, I have to call directly at 8 a.m. and make sure I call the one human. I have to make sure I get the authorization, but where did that authorization go in my email? And I gotta pull it out and print it out. My office has stacks of medical records and referral and medication authorizations and all of these different things. And oh, you need this authorization. I don't even wanna tell you what we had to do to get Matt CPAP last month.

Brandy Schantz (30:29.953)
Yes.

Helen P (30:47.356)
exhausting and it wears on people and this this workload increases with community care because so many veterans are having to manage the referral authorization process from the VA and I mean that's a that's a very small part of what many other families you know with significant injuries and illnesses have to navigate but it's exhausting and there's no help my god so help me if you have a billing question and you try to get ahold of VA billing

Brandy Schantz (30:48.694)
It is.

Brandy Schantz (30:54.72)
Mm-hmm.

Brandy Schantz (31:12.179)
No, nothing.

Helen P (31:17.236)
or you try to get a hold of a community care billing. Your option is the patient advocate, and hopefully they can get you in touch with the right person. literally every answer, every problem that happens now in the VA, it's the patient advocate. Call the patient advocate. Call the patient advocate. You have a problem with burial benefits? Call the patient advocate. You have a problem with accessing healthcare? Patient advocate. You have a problem with medication refill? Patient advocate. You have a problem, I mean it's, and those poor people, those poor people are literally trying to do the best that they can,

Brandy Schantz (31:22.443)
Yes.

They're not.

Brandy Schantz (31:32.662)
Yes.

Brandy Schantz (31:42.343)
Everybody. Yeah.

Helen P (31:47.068)
But like you call a civilian health center and it's like, if you have questions about billing press one and then you talk to Donna and billing or you, you you can like navigate through that process. The VA, I have never had luck doing that. And you know, it's.

Brandy Schantz (31:52.907)
Yes.

Brandy Schantz (32:01.129)
No. Well, you can't even do simple things with the VA. Things add up, right? So they accumulate. This is a cumulative problem. You have all this stuff coming at you and it's cumulative. You can't even just make an appointment online. Now I did see somewhere that there is a new fancy tool in my va.gov health, the former healthy vet, whatever they're doing.

Helen P (32:08.372)
Yeah.

Brandy Schantz (32:30.123)
tried to make an appointment with my dermatologist, because I'm supposed to come in, because I have a giant ugly mole that does not look good. But right now, the only way to make an appointment with them is they call me. So if I miss that phone call, well. So now I'm just back there. try, I was like, fancy new tool. Let me see. Nope, not for Derm. Sorry, guys. Only for primary care. And I'd be willing, I didn't try it, but I'd be willing to bet I can't actually get an appointment through primary care either. I could be wrong, but.

Helen P (32:37.044)
Great.

Helen P (32:42.569)
Yes.

Helen P (32:54.888)
The problem, we have had that problem with scheduling so often because they'll be like, all right, we'll see you back in six months. And I'm like, great, let me look at my schedule so we can figure out when to get him in. And they're like, no, we'll just call you and assign you an appointment. And I'm like, I got things to do. He's got other providers to see. We had 125 appointments last year.

Brandy Schantz (33:05.335)
We'll call you.

No.

Brandy Schantz (33:13.483)
What, and I can't guarantee you I can answer my phone at all times. One, as you should probably know, I'm kind of sick, so I'm in doctor's appointments a lot and procedures. can't answer my phone during those times. Two, I'm following directions well. I have a nervous system condition. Turn off all the devices. I do that, I actually do that. I meditate, I turn off the devices. I'm following directions.

Helen P (33:17.747)
I know.

Helen P (33:36.03)
Yeah.

Brandy Schantz (33:40.255)
You always call me during that time. Stop it.

Helen P (33:43.87)
There is the VA, you know, even for people who, you know, even if you just have routine problems with the VA that they need, you know, this idea that there's not a person that you can call back and just talk to, I think is absurd. think that we could solve like a solid 40 % of the VA's issues if we would actually just start like connecting people to people again, you know, like a scheduler and, you know, a front office clerk, like with a belly button you can push of like, this is the person who works here.

Brandy Schantz (33:56.141)
It's asinine.

Brandy Schantz (34:05.505)
Yes.

Yes.

Helen P (34:13.804)
And, you know, like, even just for people who have a job. I mean, I don't know about you, but at my job, I can't just, like, drop everything in the middle of seeing a patient in the emergency department to, answer my phone. Like, excuse me, sir, I realize you're in your own emergency, but, let me go talk to the VA, because I don't know when they'll call me back. Yeah. And so it's, you know, it's, there's all of these things with it that are just, you know, I feel like...

Brandy Schantz (34:29.494)
Exactly.

The VA has finally called me.

Helen P (34:43.582)
There's so much with the VA where like it is a financial fix that needs to happen. It needs to be funded. needs to be staffed. It needs to be these things. There are so many other things that are just like process improvement and you know, it has become this like ultra mega conglomerate system that just like doesn't work for anybody. It doesn't work for the staff. It doesn't work for patients. It doesn't work for the American people who are like funding these things, you know, and it's it's you know, I so wish that we could just like

Brandy Schantz (34:54.284)
Yes.

Brandy Schantz (35:05.281)
No.

Brandy Schantz (35:09.963)
Yes.

Helen P (35:13.356)
Maybe instead of looking at like, I don't know, like whether we're treating, I don't know, maybe instead of like focusing on some of these, like maybe we need to restructure the EMR. Maybe we should just fix the phone system. Or here's another one. When Matt was going through the process of getting accepted into the caregiver program, they needed all these records sent.

Brandy Schantz (35:31.179)
Yeah.

Helen P (35:39.518)
They wanted us to fax these records. We're talking hundreds of pages to the VA, fax them very specifically. The freaking fax number didn't work. And when you would call, they would say, well, that's because there's only one fax number for the entire system. So you just have to keep trying. So I'm standing at a UPS, asking them just to hit send repeatedly, trying to get in on this fax system. Like that's just nonsensical.

Brandy Schantz (35:55.426)
He

Helen P (36:08.616)
You're telling me that we don't have like a records upload system. You're telling me that the government didn't just pay millions, if not billions of dollars to have this like EMR system that like, you know, should have allowed the system to like import records. Also, by the way, my one of my huge complaints for that system, and this is actually coming out with community care is that those records are actually not getting sent back to the VA. And so when those records are not getting sent back, it's as if you never got seen. And so they can't close out the referral or

Brandy Schantz (36:09.073)
It is.

Brandy Schantz (36:33.047)
Right?

Helen P (36:38.54)
to if there's other things that need to get done. that's like a huge, so now again, another burden on a veteran to go and like make sure you get the note, make sure you get the right note. Cause if you don't work in medical care, you might not realize that there's a difference between an appointment summary and the actual clinical note that gets written. And so there's all of these things that like, again, it just like, they just like keep tossing it onto the veterans and the families of like, here you go, here you go.

Brandy Schantz (36:54.22)
Yep.

Brandy Schantz (37:01.453)
And we don't have time. And that's, you know, we've talked about this before on the show. You know, the military in general still seems to have this idea as if it's, you know, 1954 and there's this spouse that's there to take care of the home fires while you're, you know, out doing the things. And it just doesn't exist. I have no full-time homemaker to do all this stuff. And it just continues on through your time as a veteran.

Helen P (37:14.858)
Yeah!

homemaker. Yep.

Helen P (37:26.142)
Yeah.

Brandy Schantz (37:29.419)
You know, and you have these things that are full-time jobs. They're like, well, don't you just have a family member to do it? Excuse me. No, I do not actually have a family member to do this. My husband has a full-time job also. Nobody's here to just take care of me. And do you honestly think, even if I did have family to do that, do you really think that it's incumbent upon my family to take away from whatever they're doing in their life, to spend every waking moment of their life taking care of me now? No, no.

Helen P (37:55.978)
100%. That is what they do expect. That's what they expect.

Brandy Schantz (37:59.032)
exactly what they expect.

Helen P (38:00.03)
There's a great book that just came out called A Live Day written by Carrie Fuget. She was a young wife to a Marine veteran or Marine service member who ended up wounded in Iraq and then he subsequently passed because of his injuries and complications. And in that book, she talks about extensively what it was like to essentially be a spouse thrown into this world of he is now your responsibility, you will take care of him. And the obligation that is put on

Brandy Schantz (38:26.797)
Yes.

Helen P (38:30.004)
to families, whether you are capable, qualified, willing, all of these things, I highly recommend that book to anybody who just wants to get a perspective of like what it is like on the flip side of people who come out with injuries and illnesses because it is very much the expectation of the government that a family member step up to provide total care.

Brandy Schantz (38:46.913)
Yes.

Brandy Schantz (38:58.06)
Yes.

Helen P (38:59.884)
When there is not a family member, I can tell you that it is very ugly. You're talking about people being assigned as wards to the state. Their quality of life is terrible. I mean, it is not a good existence when there is not family involved. But it is 100 % the expectation of the government that these families just magically become sole caregivers. I can't even tell, people will talk about the caregiver program that exists.

Brandy Schantz (39:22.593)
Yeah.

Helen P (39:29.804)
for family members who are doing this, you know, like we're in the caregiver program, we're in the lowest tier. So it supplements us about $1,800 a month and it's different in the areas that you live, but ours is about 1,800. I'm a nurse practitioner. If I was out working a full-time job, I'd be making 150,000, 175,000, 200,000 in some areas of the country. You can't tell me that that is equitable or even equal.

Brandy Schantz (39:57.388)
Right. Yes. Yeah.

Helen P (39:59.706)
You know, and while I am very grateful, very grateful to have the increased support, it is not the same. It's not the same and it's still not meeting all of our needs.

Brandy Schantz (40:13.549)
It's not the same. It's not equitable and

Brandy Schantz (40:19.381)
Right, and if we're talking about quality of life, mental health care, wellness, all of these things that we need to be talking about, we are allowed, disabled people, family members, caregivers, we are allowed a comfortable life just like you. We are allowed a comfortable life just like you. You like to get off work and do whatever it is you want to do, relax, know, switch everything off, you wanna just.

Helen P (40:35.678)
Yes.

Brandy Schantz (40:46.101)
lay on the couch if that's your choice, you want to go for a run, you want to go on vacation, whatever it is you want to do, we're allowed to do that as well. And this idea that suddenly because you are disabled, all enjoyment should cease to exist, just gone, all things that could be fulfilling. I should just be thankful that I have healthcare and be happy about it. It's ridiculous.

Helen P (41:02.824)
cease to exist. Yeah.

Helen P (41:10.248)
Yeah, yeah. I mean, we have this problem all of the time with people who, you know, they'll see, they'll see Matt, you know,

go out and do an adaptive sports event or, you know, we take a family trip somewhere and they'll say, but he's disabled. Are you really, you know, should he really be doing this? And it's like, what do you, what do want me to do? Like put them in a bed and let them die. And I think honestly, that is very much the expectation. I think it is for a lot of people and for the VA included, you know, we're very lucky in that we have, you know, some great, you know, support staff with the VA who are very supportive of the fact that I'm still very active with Matt, that I take him out to do things.

Brandy Schantz (41:35.585)
Yeah, I think that's what they want. Yeah.

Helen P (41:51.228)
But there are so many other people who just think that like, you know, well, if he can, you know, if he can go for a walk, he can have a job. And I was like, well, ask him to play on the walk. Yeah, yeah, not quite, you know, not, seems he's there, but it's, you know, it is, it is a huge problem, the judgment. And this comes back to like the advocacy and awareness piece that I'm always like, you know, like rah rahing about is that

Brandy Schantz (42:03.925)
Not exactly the same thing. Yeah.

Helen P (42:19.868)
I don't really think in, you the American public has some awareness of of like post-traumatic stress to some degree. And they they have some level of awareness about, you know, war wounds and things like that. But I don't think that there is actually a good understanding.

of what this life is like. And I have said so often that I really think that what we need is like, you know, the pit to do an episode about the complications of veteran care and the burden that is placed on families and like what the reality looks like because I think if people could see it and really understand it.

I think that the approach to veteran benefits, to support resources, to programs like Medicaid and Medicare, to all of these other things, I think it would change because I think it would really help to open people's eyes about the reality. We've had all of these sort of stigma, stereotypical.

Brandy Schantz (43:17.719)
Yes.

Helen P (43:31.058)
pictures created, know, people watched American Sniper and then thought that they knew everything about veteran suicide and violence in the veteran community, you know. And I just don't think that it really gives an accurate portrayal of what's happening. I think it's part of the picture, but it's not all of it. And I think we need so much more of it in order to actually start seeing change. Because I think as it stands,

Brandy Schantz (43:39.276)
Right.

Brandy Schantz (43:48.066)
Yeah.

Yes.

Helen P (44:01.514)
the only thing that people really know are these like stigmatized, know, sort of, you know, we've created these boxes and like veterans need to fit into these boxes or else it like, you know, it doesn't exist to them. And we just really have not done a good job of like, you know, sharing the lived experiences of people and like what that looks like. And I, it's just, you know,

I would love to see somebody include those on the episodes to really give people an idea of like, what is going on and you know, how much work goes back on the families because I think it's just not, I don't think people really realize, like I don't think anybody has an idea until you're actually in it.

Brandy Schantz (44:41.164)
Yes.

Brandy Schantz (44:47.597)
No, and that's just it. I mean, that's why I try to be as open as I can about my own mental health struggles, my sense of self, because it's just, we cannot emphasize enough how difficult it is when your entire life, your entire identity is being disabled or sick. And your entire life as a family member is dedicated to caring for this disabled and or sick person. It is demoralizing. You know, it's so difficult. I, I,

Helen P (45:02.366)
Yeah.

Brandy Schantz (45:17.537)
I say the same thing to everybody. And again, I just want to be open about it. I'm a member of Dignitas, which is an assisted suicide program in Switzerland. They will take people who are not terminal. I always keep that as an option. And I want to make it clear. The reason is not just my pain that makes my life not sustainable. It's the way that society deems me to that I should have to live.

Helen P (45:27.977)
Uh-huh.

Yeah.

Helen P (45:40.65)
Yeah.

Brandy Schantz (45:47.278)
with no enjoyment, no, you know, I'm just this disabled person and I'm constantly living each and every day on a phone trying to fix some billing issue, trying to get that referral, trying to get that referral to say the exact thing it's supposed to say. It's exhausting, I can't do it anymore. I'm not sure if I will go there one day or if, you know, maybe I will live out a much longer life, hopefully with the work that so many great people are doing to make veteran care better.

Helen P (45:47.358)
Yeah.

Helen P (45:58.186)
Yeah, it's disheartening.

Brandy Schantz (46:16.461)
Hopefully we can get a better healthcare system. Hopefully we can get a solution to what we're going through. But the fact of the matter remains, everybody says they want to do something about, know, support the veterans, support the veterans, support the troops. Well, if you want to do that, and let me just take a moment to extend this to everybody. Sick and disabled people in this country deserve a life as well.

Helen P (46:22.408)
Yeah.

Helen P (46:29.406)
Yeah.

Gotta do it.

Helen P (46:39.604)
Yeah, they do. And it's hard because I think that a lot of people don't realize that, you know, quality of life is more than just a roof over your head.

Brandy Schantz (46:41.698)
We really do.

Brandy Schantz (46:53.783)
Yeah.

Helen P (46:54.446)
And right, is it is there's Maslow's hierarchy of needs. It's all encompassing. There's all of these, you know, emotional support, spiritual support, fulfillment, purpose, all of these things. And, you know, I know that especially for Matt and I think first probably for you and probably for so many other veterans, it's like every year that those things just get whittled away. And you can do veteran programs, you can do you know, we do adaptive sports. We can do things that, you know, give him back.

Brandy Schantz (47:17.025)
Mm-hmm.

Helen P (47:24.38)
a little bit of that sense of connect, you know, connectedness with veterans, all those kinds of things, and then we get criticized for it, you know, and we face scrutiny because we're doing these things.

Brandy Schantz (47:30.785)
Yes. Yeah.

Helen P (47:37.898)
And it's really, I mean, I think that's where, from my perspective, a lot of like the, just want to move out into the middle of the woods and tell everybody to, you know, F off. I'm so tired of, you know, we've been living in this journey now since 2014, so 11 years, and it gets tiring.

Brandy Schantz (47:47.202)
Yeah.

Helen P (48:00.36)
to have to, you and I have no problem telling our story. I have no problem telling people what's happened to him. You know, I frequently have been known to say he got blowed up too many times and, you know, sort of make a joke out of it. Cause if I don't laugh about it, I'll cry about it.

Brandy Schantz (48:14.561)
Yeah.

Helen P (48:15.816)
But you're right, the quality of life people, our whole statement has always been our goal is to thrive, not just survive. But I will honestly tell you in the last two years, we've just been surviving. And there...

Brandy Schantz (48:25.09)
Yes.

Brandy Schantz (48:28.685)
Mm-hmm.

Helen P (48:31.114)
There are not resources for me as a caregiver. I mean, there's the caregiver program, but like, God forbid that I needed therapy through the VA, because like that would never happen. Luckily, I have my own resources and benefits and access to services that I can use for my own wellbeing, because otherwise it wouldn't happen. My kids, you know, we just got done with the Hidden Helper Summit with the Elizabeth Dole Foundation and Operation Second Chance. And, you know, looking at other military families who are disabled,

Brandy Schantz (48:40.075)
Right.

Helen P (49:01.068)
disabled in whatever way and the impact that that has on military children and the children of disabled veterans is huge. And the lack of resources, you we've kind of joked that you know, Matt could go on a thousand fishing trips if he wanted to. But if we want resources for our kids, if we want help bringing extra support into the home to help with our kids and the

Brandy Schantz (49:11.596)
Hmm.

Helen P (49:31.048)
that they don't get access to the same things because their dad is significantly disabled. That is not a thing. There are no organizations. The VA does not treat children in the home as uniquely having needs in the event that a veteran is severely disabled. it's this whole, again, it's that, it's this concept of everybody wants these veterans to just barely make it.

Brandy Schantz (49:38.411)
Mm-hmm.

Helen P (49:58.61)
just barely, just barely make it. Just, and you know, sometimes even then like the VA is like, you know, savings, you know, and it's, it's, it's, it's exhausting. It's exhausting emotionally. It's exhausting physically. You know, in our family, we have started, we have two very young children. We have started to have some very serious conversations about

Brandy Schantz (49:59.138)
Yep. Just be alive. Just be alive.

Mm.

Helen P (50:26.91)
Where do we put our priorities? For the last two years, our priorities have been keeping Matt alive. And that has meant hundreds, literally hundreds of doctor's appointments, some of which we're waking up at 3 a.m. for. I'm carting kids to a daycare, you know, at two in the morning, all these kinds of crazy things. But our kids have suffered because of it. And we have started to have this conversation of like,

Brandy Schantz (50:31.746)
Yes.

Helen P (50:52.018)
At some point they have to be a priority. At some point, thriving and quality of life has to be a priority. And if that means that appointments have to get put off, then we're going to have to do that because, you know, either the VA has to step up and start providing transportation and a case manager and somebody to accompany to appointments and all these things, or it just has to wait because I am one person and my children are little humans and their needs and wants matter and my needs and wants matter.

Brandy Schantz (50:54.668)
Mm-hmm.

Brandy Schantz (51:10.263)
Mm-hmm.

Helen P (51:21.932)
and Matt's want for quality of life matters. And, you know, I have long said, you know, on the TBI side of the house, it's very much palliative care. They cannot fix his brain.

Brandy Schantz (51:22.124)
Yes.

Helen P (51:34.182)
So we need to look at quality of life very seriously and what that looks like. But unfortunately, so many of the policies of the VA are surrounded around compliance. And so if he's not going to these appointments or getting this blood work, all these kinds of things, then they threaten you with benefits. And so it becomes this punitive system. And it's exhausting. I mean, it's absolutely exhausting.

Brandy Schantz (51:37.089)
Mm-hmm.

Brandy Schantz (51:45.121)
Yes.

Brandy Schantz (51:56.268)
Yeah.

Helen P (51:59.24)
And it's just, you know, again, I really wish we had a better way of telling these stories for people to see in a way that the non-military community could understand it. I don't think people just have no idea. They think they know. They watch some Jack Reacher TV show and they think they have an understanding of it. And it's, you know.

Brandy Schantz (52:12.171)
Right.

Brandy Schantz (52:16.705)
Yeah.

Helen P (52:27.902)
The reality is just so much more heartbreaking than I think they can ever comprehend.

Brandy Schantz (52:31.99)
Yeah.

Now you're right and hopefully you know we're talking about a lot of issues in this series. Maybe you know we do another one where we really try to focus in on finding some solutions and putting together some good research around some of these things because again we can't you know we we need a strong Veterans Affairs health care system. We also need the community care. We cannot

just leave this up to privatization and only community care. also cannot defund one or the other. We need these funded and well cared for. So, you know, hopefully if veterans out there have been having issues with community care, you know, this is what's happening. We understand that getting a hold of VA billing is very difficult and we're all going through it.

But again, as we've mentioned in each one of these episodes, please contact your representative in Congress and tell them, you know, we are having issues with our community care. My referrals have been rescinded. I am not getting my care paid for. I cannot afford to pay out of pocket for healthcare because the VA did not get funded appropriately.

Helen P (53:49.392)
I would say even if your experience is just that you're annoyed with the wait times, write your representative. They are required to read their mail, whether they do or not, but they are technically legally required to read whatever you send to them.

Brandy Schantz (53:56.363)
Yep. Yep.

Helen P (54:04.916)
call your representative. Every elected official on their website has a link that will say help me with a government entity. You can click on that. You can fill out the information. A caseworker will hopefully call you back. That is technically the official way to get help from your elected officials is to use their little help lines that they have on all of their websites. You can also use entities like resist.bot, which will let you text it. If you look it up on Google, it'll send a text to your phone and then you can text

it and it will text out or mail out or email out whatever you want it to say to your elected officials. It makes it really really easy. They even have like form letters if you want to use those. There's a free version and a paid version. There are lots of different ways that you can reach out to elected officials but the thing is and I will say this as an advocate, the thing that I hear the most from elected officials is that they didn't know there was a problem because nobody communicated that to them. You have

Brandy Schantz (55:02.646)
Yes.

Helen P (55:04.85)
to tell them if it's great and there's perfect and you're having no problems write that too but like please be writing your elected officials even if you just want to give them an update on your day like whatever it is you need to be writing your elected officials to let them know about the problems because otherwise they think everything is hunky-dory and there's no changes that need to be made so you know just i i cannot i cannot say that enough i know it takes time i know it's annoying like send an email do whatever you need to do

but make it heard that you are having difficulty accessing care. Because without it, on the advocacy side, it is so much harder for us to get changes made when they don't know that there's a problem. So.

Brandy Schantz (55:48.141)
Absolutely. Well, thank you again. We have so much work still to do. But this is so important. I'm so glad that we're doing this series because, know, this is very important time period. And as Americans are being torn apart by all of our perceived differences, it's so important that the military, that the veteran communities realize that we have more in common than we have different and we need to stand together no matter what.

Helen P (56:16.306)
Absolutely, absolutely.

Brandy Schantz (56:17.963)
Right now, we need to fight for our benefits. We need to fight for our healthcare. We need to fight for our lives. This is about us. We are one. I don't care who you are. You're a veteran. You're my family. Let's do it together.

Helen P (56:29.008)
Absolutely. Absolutely.

Brandy Schantz (56:32.205)
Thank you again. Until next time, join us at Living Chronic.