The SCI/D System of Care consists of an integrated network of care based on the longstanding hub and spoke model. SCI Centers serve as the hub. Locally accessible SCI/D primary care is provided at other VA facilities (spokes) within specified catchment areas (see App. A). These long-standing designated catchment areas are generally used for the transfer of Veterans from a local VA or community hospital to the SCI Center (hub) for care. However, in the interest of preserving continuity of care, Veterans with an existing relationship and treatment history at an SCI Center that is outside the designated catchment area will have their preferences respected by the referring and accepting facilities in accordance with VA travel regulations. All VA medical centers have responsibility for the provision of basic medical care, primary care, and emergent medical care for Veterans with SCI/D.