[Federal Register Volume 85, Number 136 (Wednesday, July 15, 2020)]
[Rules and Regulations]
[Pages 42724-42726]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-14341]


=======================================================================
-----------------------------------------------------------------------

DEPARTMENT OF VETERANS AFFAIRS

38 CFR Part 17


Update To Access Standards Drive Time Calculations

AGENCY: Department of Veterans Affairs.

ACTION: Guidance.

-----------------------------------------------------------------------

SUMMARY: This Department of Veterans Affairs (VA) document provides 
additional information regarding VA's calculation of average drive 
times for purposes of eligibility determinations for covered veterans 
to access community care through the Veterans Community Care Program.

DATES: Effective August 14, 2020.

FOR FURTHER INFORMATION CONTACT: Joseph Duran, Office of Community Care 
(10D), Veterans Health Administration (VHA), Department of Veterans 
Affairs, Ptarmigan at Cherry Creek, Denver, CO 80209; 
[email protected]; 303-370-1637 (this is not a toll-free number).

SUPPLEMENTARY INFORMATION: On June 5, 2019, VA published a final rule 
at 84 FR 26278 to promulgate 38 CFR 17.4000-17.4040 to implement the 
Veterans Community Care Program established by section 101 of the John 
S. McCain III, Daniel K. Akaka, and Samuel R. Johnson VA Maintaining 
Internal Systems and Strengthening Integrated Outside Networks Act of 
2018 (MISSION Act), Public Law 115-182.
    Section 17.4040 established access standards for purposes of making 
eligibility determinations under the Veterans Community Care Program 
under Sec.  17.4010(a)(4). For primary care, mental health care, and 
non-institutional extended care services, eligibility is established if 
VA cannot schedule an appointment for the covered veteran with a VA 
health care

[[Page 42725]]

provider for the required care or service: (i) Within 30 minutes 
average driving time of the veteran's residence; and (ii) Within 20 
days of the date of request unless a later date has been agreed to by 
the veteran in consultation with the VA health care provider. For 
specialty care, eligibility is established if VA cannot schedule an 
appointment for the covered veteran with a VA health care provider for 
the required care or service: (i) Within 60 minutes average driving 
time of the veteran's residence; and (ii) Within 28 days of the date of 
request unless a later date has been agreed to by the veteran in 
consultation with the VA health care provider. VA noted in Sec.  
17.4040(b) that to calculate average driving time from the veteran's 
residence in paragraph (a) of the section, VA would use geographic 
information system software.
    In the preamble to the final rule, VA explained that it was not 
detailing in regulation a specific methodology for calculating average 
drive time because it was more veteran-centric to maintain operational 
flexibility to refine and improve VA's average drive-time calculations 
in response to experience, feedback and changing real-world conditions. 
See 84 FR 26278, 26299. This final rule further stated that as VA 
gained more experience with administering the Veterans Community Care 
Program and received feedback from veterans regarding their experience 
with the program, VA anticipated refining the tool to calculate average 
drive times as well as VA systems to improve our consideration of 
actual conditions that affect travel to receive care and services and 
to provide more information to veterans regarding calculation of 
average drive times. See 84 FR 26278, 26301. This notice serves to 
inform the public that VA is will change the geographic information 
system software used to the calculate average drive times under Sec.  
17.4040.
    Description of Changes in Calculating Average Drive Times: As 
described in the final rule establishing the Veterans Community Care 
Program (84 FR 26278), VA uses a variety of factors, including 
distance, route options, and speed limits to calculate the average 
drive time between the veteran's residence (as noted in VA's enrollment 
system) and VA facilities that offer the type of care needed by the 
Veteran. The calculation is similar to the calculations used in popular 
commercial mapping software used for point-to-point driving directions 
and estimated travel times. The calculated average is used to determine 
whether the veteran is eligible for community care based on drive time. 
The final rule also stated that, in response to comments that requested 
clarification on how VA will calculate average drive times, that some 
detailed information regarding average drive time calculations and 
algorithms is proprietary, and VA was unable to disclose the full 
method used to make the calculations. See 84 FR 26278, 26300.
    VA recognized the concerns voiced by veterans and members of the 
public at the time we launched the Veterans Community Care Program 
regarding how we calculate average drive time and whether we are making 
the best estimates of average drive times. This notice about planned 
refinements is the result of VA's efforts to continue improving how we 
calculate this important component of eligibility.
    VA is refining the average drive-time calculations in the online 
Decision Support Tool (DST) to improve eligibility determination 
results and response times based on feedback received from veterans and 
VA staff regarding their experiences with the Veterans Community Care 
Program since its implementation on June 6, 2019.
    Effective August 14, 2020, VA will use a new geographic information 
system within DST. Under the new system, VA will determine drive times 
between two addresses by developing ``service areas'' around all VA 
facilities, which are bands surrounding the facility that reflect drive 
times in ranges of 10-minute increments, starting with 0-10 minutes, 
going up to 81-90 minutes. The applicable drive-time standards depend 
on the type of care being requested (i.e., the veteran can get needed 
care within 30 minutes' average drive time for primary care, mental 
health care and extended care services under Sec.  17.4040(a)(1)(i) or 
within 60 minutes for specialty care services under Sec.  
17.4040(a)(2)(i)). Users of the system will get an estimate of the 
drive time between the veteran's residence and the VA facility in a 10-
minute range under the bands, instead of a single-time estimate as in 
the current system. Covered veterans whose residence address is within 
a drive-time service area range that exceeds the drive-time standards 
for the type of care being sought would be determined to be eligible 
under Sec.  17.4010(a)(4).
    The new system will use historical traffic patterns in all 
searches. The system will calculate average drive times based on 
historical traffic patterns on Wednesdays at 10 a.m. at the veteran's 
local time for all searches. We have selected this time and day of the 
week to reasonably approximate times that veterans would be traveling 
for appointments, while working within the capabilities of the system 
and the available data. Historical traffic data will be updated two to 
three times per year to reflect changes in local travel patterns.
    Veterans will benefit from this change in two ways. First, VA 
believes the new system will better reflect the actual conditions that 
affect the time it takes for veterans to travel to receive care and 
services because of the way that historical traffic data will be used 
and how average travel times will be calculated. Second, we can now 
offer more information to veterans and the public regarding how VA will 
calculate average drive times under this new system. While VA is 
primarily making this change to improve eligibility determination 
results and response times, it will also impact eligibility under the 
access standards for some veterans. VA believes the result will be an 
overall increase in eligibility.
    We note that the average drive time is only one element of covered 
veterans' eligibility for community care. Since VA established the 
Veterans Community Care Program on June 6, 2019, covered veterans have 
also been eligible for community care under other criteria (see 38 CFR 
17.4010, Veteran Eligibility). For example, covered veterans who would 
not be considered eligible for community care based solely on the 
average drive time element of the designated access standard criterion 
may still be eligible for community care if the veteran and his or her 
VA provider agree that it is in the best medical interest of the 
veteran to receive community care. We remain committed to ensuring that 
covered veterans are referred to community care where it is in their 
best medical interest, and veterans with concerns about whether they 
should be referred to the community are always welcome to discuss their 
options with their VA providers.
    Although we are changing the method of calculating average drive 
times in our DST tool, which may affect some individuals' eligibility, 
this notice is not changing VA's designated drive time access standard 
under Sec.  17.4040. The average drive times that establish eligibility 
under the designated access standards criterion will remain the same 
after VA updates the average drive-time calculation tool.
    VA continues to believe it is more veteran-centric to maintain the 
operational flexibility to refine and improve VA's calculations in 
response to experience, feedback and changing real-world conditions, 
rather than to detail in regulation a specific

[[Page 42726]]

methodology or considerations that could constrain VA's ability to 
improve the calculation of average drive times in the future. For that 
reason, we will continue to update the public through documents in the 
Federal Register about any changes to how we calculate average drive 
times for the Veterans Community Care Program.

Signing Authority

    The Secretary of Veterans Affairs, or designee, approved this 
document and authorized the undersigned to sign and submit the document 
to the Office of the Federal Register for publication electronically as 
an official document of the Department of Veterans Affairs. Brooks D. 
Tucker, Acting Chief of Staff, Department of Veterans Affairs, approved 
this document on June 23, 2020 for publication.

Jeffrey M. Martin,
Assistant Director, Office of Regulation Policy & Management, Office of 
the Secretary, Department of Veterans Affairs.
[FR Doc. 2020-14341 Filed 7-14-20; 8:45 am]
BILLING CODE 8320-01-P