The Togus Veterans Administration Medical Center is preparing to begin accepting veterans transported by ambulance starting January 1, 2026, after a federal directive required VA hospitals with emergency departments to receive ambulance patients or face a downgrade that would significantly limit hospital services.
Under the federal mandate, any VA facility operating an emergency department must accept ambulance arrivals. Facilities that do not comply would be reduced to Level 2 urgent care status, eliminating operating room access and inpatient capacity.
Officials say Togus VA Medical Center is working toward readiness by the January 1 deadline. The emergency department is open 24 hours a day, seven days a week, but the hospital will accept only veterans eligible for VA care. Spouses, family members, and mass-casualty incident patients will not be transported to the facility.
Draft transport decision guidance, updated October 28, 2025, outlines significant limitations in the care Togus VA can provide. Veterans should not be transported to the facility if they are suffering from ST-elevation myocardial infarction, traumatic injuries, obstetric or gynecological emergencies, or if they are dependent on dialysis. EMS crews must call the hospital before transport to determine whether Togus VA is the most appropriate destination.
Patients must verbally confirm that they are veterans eligible for VA care and that they wish to be treated at Togus VA. EMS units are required to contact the hospital prior to departure to review the patient’s condition and confirm that no exclusion criteria apply.
MaineGeneral continues to provide 24/7 emergency coverage for cardiac, trauma, obstetric and gynecological, and dialysis patients. Togus VA offers emergency evaluation and stabilization but does not have the capacity to provide emergency hemodialysis.
The guidance has been provided to the board for awareness only, with no action required. Hospital staff will work with regional and associate regional medical directors to finalize and publish transport decision guidance for each of Maine’s four EMS regions in accordance with Maine EMS prehospital protocols.
Veterans considered appropriate for transport to Togus VA include those experiencing psychiatric or behavioral health emergencies, including suicidal ideation, substance use disorders requiring detoxification, general illnesses such as nausea, vomiting, weakness, infections, ear or tooth pain, and sexually transmitted diseases, breathing problems related to chronic conditions; non-penetrating eye injuries, non-hemorrhagic gastrointestinal or genitourinary issues, and medical device complaints or malfunctions.
