Plan will keep localVA up with growth<BR>

PRESCOTT – The atmosphere was positive Thursday when CARES Commission members came to the Prescott VA Medical Center to review the Arizona, New Mexico and west Texas plan to improve health care for veterans.

The plan for that area, called VISN 18 in the VA system, was the only proposal that the national VA review board didn't send back to local authors for revision, said Terry Atienza, acting director of the Prescott VA hospital.

That's because the review board recognizes Arizona as a growth area and because the proposal that VA planners developed for the area is realistic and "doable," he said.

The CARES effort, which stands for Capital Asset Realignment for Enhanced Services, is a 20-year program that the VA is undertaking to transform the national health care system to meet the health care needs of veterans during the next century.

Each of the 21 VISN areas submitted a proposal to revamp their facilities and services to better serve veterans. That means that some areas will grow, and other areas with duplicate, or "dual," facilities will see some closures.

"Over the past century or so, VA has accumulated an infrastructure of more than 5,000 buildings and 15,000 acres of land that the Government Accounting Office told Congress wastes almost $400 million each year," said Anthony Principi, secretary of veterans' affairs.

"When implemented, CARES will revamp our infrastructure. Savings will be reinvested in doctors, nurses, modern health care facilities and equipment to ensure that today's and tomorrow's veterans receive quality health care. In many locations, CARES will result in additional facilities and resources," he said.

The proposal for the Prescott VA campus includes increasing the number of acute medicine beds from 25 to 44 – which means reactivating the third floor of the hospital for acute care patients – and establishing a specialty medicine center on the campus.

Both plans for the Prescott VA hospital would help ease the workload for the Phoenix VA hospital because it would reduce referrals from Prescott to Phoenix. Fewer veterans who live in northern Arizona would have to make the trip to Phoenix for specialty outpatient care.

In her testimony to the five national CARES commissioners, Patricia McKlem, former director of the Prescott VA hospital and now director of VISN 18 – the Southwest VA Healthcare Network, told commissioners that 126,000 veterans are enrolled in the VA health care system in Arizona. In the year 2014, the VA expects that about 146,000 veterans will be enrolled in the system.

In Prescott, she said the number of veterans who receive care has doubled in 10 years, from about 10,000 to more than 20,000. The city of Prescott and other communities in northern Arizona have had some of the highest growth rates in the nation for the past 10 years.

McKlem said that "pulling most of the specialty workload" back to Prescott from Phoenix would help veterans avoid traveling the 100 miles to Phoenix and reduce the workload in the already overloaded Phoenix market. The VISN 18 proposal includes a construction project to provide for outpatient specialty care space at the Prescott VA hospital.

McKlem also talked about mental health care, inpatient psychiatry and research facilities in Prescott, Phoenix and Tucson.

Commissioners asked McKlem and other Arizona panel members about the Community Based Outpatient Clinics that offer primary care to veterans closer to their homes, and plans to increase the number of clinics. They expressed concern about serving Arizona's rural and Native American populations.

Commissioners complimented Arizona representatives about their mental health systems and their use of "tele-medicine." They asked about special programs that take into consideration the Native American culture and about a rehabilitation program for the blind in Tucson.

Commissioners complimented Arizona leaders about the use of "tele-psychiatry" to serve veterans at the Community Based Outpatient Clinics and about programs for female veterans in the state.

They also asked Arizona officials about long-term care for veterans and the possibility of an Arizona State Veterans Home.

The five national CARES commissioners also heard testimony about health care for veterans from representatives from the Paralyzed Veterans of America, the Navajo Veterans Service Organization, the Disabled American Veterans, the National Nurses Organization of Veterans Affairs and the American Federation of Government Employees.

The CARES commission chairman, Bob Ray, said that "VISN 18 has an excellent plan. If Congress accepts the plan, your veterans will be taken care of," and "I hope they will support it."

The commissioners will submit their final report to Principi in mid-December, Ray said.

Contact the reporter at dgoss@prescottaz.com.