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Marcus Meadows is our guest in this Member Spotlight episode of the Insights podcast.
Meadows, an Air Force veteran, is ambulatory care operations director for the Department of Veterans Affairs in Northern California. He joins us to highlight his experience in healthcare and his commitment to ensuring that veterans get what they need, when they need it, and where they need it.
Editor’s note: The following Q&A has been edited for length and clarity.
Q: What’s your day-to-day focus and what are some things you’re most involved in these days?
A: I oversee all ambulatory care for primary care, medicine, surgery and mental health. Northern California is the sixth largest VA in the country, we have over 255,000 enrolled veterans. And we have 14 sites of care that cover more than 44,000 square miles in Northern California.
My biggest day-to-day responsibility is, I like to refer to myself as Mr. Access. It’s my job to make sure that we have access in-house and we can see veterans. And when we can't see veterans within our wait time standards of 20 days for primary care and mental health and 28 days for specialty care, that we get them out through what I like to refer to as a hierarchy of care. We are partnered with Travis Air Force Base here in Northern California. So we see veterans over at Travis Air Force Base, we have clinical resource hubs across the state of California and Nevada, where veterans can be seen virtually. And then if we can't get them in through our DOD affiliations and partnerships, or with one of the clinical resource hubs, then, of course, the Mission Act allows those veterans to be seen in their local communities by a provider of their choice. So, my job is to make sure that wherever the veteran is seen, they're seen timely, urgently, when necessary, and that they can be seen when they want, and where they want to receive that care.
Q: Since 2020, mental health issues have gone way up. What are some of the ways you address mental health at the VA?
A: We talk about two foundational services in VA: primary care and mental health. Veterans from primary care get fed into specialty care. And then we have primary care, mental health initiatives where veterans see their primary care provider, and if there are any concerns or if those veterans need to be seen today, we do a warm handoff to the mental health providers that are actually embedded in our primary care PACT teams. And then that is a segue for them to get into the various mental health programs that we have. ...
Mental health has kept all of us up and running throughout the pandemic. Not only the patients, but (the VA) also have special engagement functions for the employees here to make sure that throughout that, we were all taking good care of us. In fact, a lot of the educational series that they put on, during that particular time, was to remind us that mental health was also important for us as caregivers. We have the caregiver support program, which is run by our social workers, but is also tied in to make sure that those family members who provide care for our veterans are also able to get the support and services that they need. ... We focus on health, the mental health as well as the holistic health of our veterans, (and) our employees.
Q: You’ve mentioned a warm handoff several times. What does that process look like?
A: Let’s say that Mr. Smith sees his primary care provider today, and so while he's there, the primary care doctor has some concern. It could be with mental health, it could be he's concerned about some blood work … and Mr. Smith lives three or four hours away, he's not really close. We've got him here today, we’d really like to see him urgently, we think that his case is such that we don't want to wait for him to get seen. … So somebody then takes that veteran and walks that veteran over and does a handoff from one clinical service to another clinical service to make sure that the veteran gets where they need to be so that we can get that care taken care of today. Sometimes those warm handoffs are telephone, sometimes they're virtual, most times they're face to face.
Q: How have your experiences as a veteran helped you to be a better healthcare leader for the VA?
A: You understand those veterans who may be dealing with PTSD, because a lot of those veterans were your friends and your battle buddies. Understanding what they've been through, and what they now have to live with every day makes you a little more empathetic to the issues that they deal with. It means that you go out of your way sometimes to make sure that we're accommodating them if they're running into problems. … It's about making sure that they get what they need, when they need it, and where they need it in the community or in a local VA facility. So being a veteran and having the privilege to take care of veterans every day is kind of just like still being in the military without the uniform.
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