A conversation with Darryl C. Hunter, MD, Kaiser Permanente Radiation Oncology, North Valley Sacramento; colonel, U.S. Air Force Reserves; associate clinical professor, University of California, Davis School of Medicine; and president, Kaiser Permanente Veterans Association, California Chapter
According to the National Alliance to End Homelessness, close to 600,000 people experience homelessness on any given night in the United States. Approximately 9 percent of those individuals — 54,000 people — are men and women who served in the military, with the highest percentage of homeless veterans located in California.
Supporting veterans, active service members and their families is a priority for Kaiser Permanente. The organization is committed to addressing the ongoing and increasing need for specialized medical services, to providing opportunities for meaningful employment and to providing access to vital community-based services for veterans.
“We, as a society, should not allow those who once risked their lives for our protection to live homeless and in shame,” says Darryl C. Hunter, MD, with Radiation Oncology for Kaiser Permanente Sacramento. Dr. Hunter hosts an annual Veterans Day Health Fair for homeless veterans. In 2014, the American Medical Association awarded him the “ Pride in the Profession Award,” which honors physicians who aid underserved populations in the United States.
He is the founder and managing partner of the Sacramento Community Cancer Coalition, which provides cancer screenings, vision exams and dental care to the underserved communities of Sacramento, California. He co-founded the Sacramento Community Veterans Alliance, which is committed to connecting veterans to the health care benefits earned through their sacrifice and service. He founded the first California chapter of the Kaiser Permanente Veterans Association, a multi-cultural business resource group that advocates for the health, rights and respectful treatment of veterans and active duty service members. He also created the Dr. Ernest and Arthella Hunter Foundation, which provides scholarships to outstanding pre-medical students who provide community service to the underserved.
We spoke with Dr. Hunter earlier this month.
What was the catalyst for launching the first Veterans Health Fair?
Through one of my veteran organizations, I learned that at least 40 percent of our local homeless population, at the time, were men and women who once served in the military. We, as a society, should not allow those who once risked their lives for our protection to live homeless and in shame.
Through my appointment as a member of the volunteer faculty of the U.C. Davis School of Medicine, I knew about the student-run Willow Clinic, an organization that provides free health care to Sacramento’s homeless population. We decided to collaborate on strategies to address the homeless problem, with our focus on homeless veterans, by raising awareness in the community on days when society celebrates the contribution of veterans and honors those fallen. The result was our Veterans Health Fair, first launched on Nov 11, 2010; we are now in our sixth year.
How has the fair evolved?
Our initial partnership included Kaiser Permanente, Vision Services Plan and the U.C. Davis student-run Willow Clinic. We now host a health fair on Memorial Day, in addition to Veterans Day, and we have expanded our offerings. Services include general medical care, vision exams, dental care, prostate cancer screening, massage therapy and care bags for patients.
We also invite representatives from the Veterans Administration Homeless program to provide veterans with information about housing assistance opportunities. We have provided care for more than 400 homeless members of the community since 2010.
What have you learned, while working at Kaiser Permanente, or at the health fairs, about caring for veterans?
Many of our Kaiser Permanente members who have served are unaware that they may have chronic conditions connected to their time of service. Further, they may be eligible for financial and health benefits through the Veterans Administration due to these service-related conditions. I routinely query my patients regarding time of service so that I can assist in identifying and connecting them to those earned benefits when applicable.
What are the most challenging — and rewarding — aspects of treating veterans?
The most rewarding, but also heartbreaking, aspect of treating veterans is to discover that we are providing the first “welcome home” for some of our veterans. One of the most challenging aspects is communication — finding new ways to notify homeless veterans, who most need our services, that we are offering free health care.
We have been fortunate to secure a reliable host site for our events during the past three years, and we are also able to provide a limited shuttle service from a local homeless shelter to our clinic site. But challenges still exist. The homeless population is migratory so it’s always difficult reaching them on the day of the event and, since we know follow-up visits are a challenge, we try to provide as many services as possible on the day of the fair or in a single visit to the Willow Clinic.
What current research or developments regarding veterans care are most exciting?
I am encouraged by the Veterans Choice Program, signed into law on July 31, 2015. The program, which is a positive step forward in caring for our veterans, allows veterans to receive care at non-VA facilities if they have been waiting more than 30 days for VA medical care, or if they live more than 40 miles from a VA facility and face one of several excessive travel burdens.
Kaiser Permanente doesn’t qualify under current law to receive non-HMO patients through the Veterans Choice Program but we, along with the majority of health care providers, must prepare for an increase in returning veterans seeking care at our hospitals and medical centers. We must ensure care providers are equipped with the education and training to provide culturally responsive care that addresses and treats the unique conditions within our veteran population.
One of the ways our local Kaiser Permanente Veterans Association is meeting this challenge is by sponsoring a series of training opportunities for Kaiser Permanente physicians addressing health topics specifically related to caring for veterans, such as traumatic brain injury and post-traumatic stress disorder.
How can Kaiser Permanente provide better to care for veterans and support for families and caregivers?
Kaiser Permanente is in the process of adding a veteran designation to patient records in the electronic health record. The designation will help care providers ask the right questions at the first point of contact, to ensure we can provide the most appropriate care.
Once we can, as an organization, identify those who have served, we need to create a systematic way to identify the unique health care needs and conditions that have resulted from exposure to the battlefield or other experience while serving. From there, we must ensure we have the resources and personnel needed to care for those conditions.