Wednesday, February 8, 2012

Position Paper on Justification for VA hospital


Committee name         Veterans Alliance of the Rio Grande Valley ad hoc
Topic                           To build a hospital to meet the healthcare needs of veterans in the lower                                         RGV and Coastal Bend area
Counties                      Duval, Kleberg, Nueces, San Patricio, Refugio, Kenedy, Jim Hogg,
                                    Webb, Zapata, Brooks, Cameron, Hidalgo, Starr, & Willacy
State                            Texas              

Background Information
The lower Rio Grande Valley region is made up of 8 counties: Kenedy, Jim Hogg, Zapata, Brooks, Cameron, Hidalgo, Starr, & Willacy. Added to the region of need is Webb County, located west of the Zapata County. The Coastal Bend includes the counties of Duval, Kleberg, Nueces, San Patricio, and Refugio.

The firm Booz Allen Hamilton conducted a study in 2007 entitled, VA Health Care Study for Inpatient and Specialty Outpatient Services in the South Texas Valley-Coastal Bend Market. In the study they identified the counties into sectors. Specifically, Sector 1 was identified to be the Coastal Bend counties and Sector 2 was recognized as the Lower Rio Grande Valley.

Group’s Position
The Veterans Alliance of the Rio Grande Valley (RGV) was created to support the construction of a hospital that would meet the healthcare needs of veterans in the lower RGV and coastal bend area. It is the purpose of the Veterans Alliance to address the lack of services offered in clinics versus what can be made available in a hospital, like:
  • Primary Care
  • Medical & Surgical Specialty Care
  • Mental Health
  • Inpatient Care
Moreover, it is the purpose of the Veterans Alliance to address the travel burdens that have arisen as a result of traveling to San Antonio to obtain care in the areas, such as:
  • Transportation & Lodging
  • Van Service
  • Ambulance Service

While the Booz Allen Hamilton study (2007, p. 31) concluded that “the demand for beds is projected to fluctuate, rising and then declining, compared to the baseline through FY 2025,” the study also added:
      “In both sectors, the demand for outpatient specialty care is expected to approximately           double and the demand for mental health services is expected to increase by approximately            55 percent between 2005 and 2025. In both sectors, the top four utilized specialties are     projected to be podiatry, cardiology, orthopedics, and urology” (2007, p. 32).

Booz Allen Hamilton (2007, p. 34)  showed “the gaps between the health care needs of veterans living in the Valley-Coastal Bend market, and the supply of VA health care services available to them. The local clinics meet the primary care needs of Sector One and Sector Two enrollees; however, VA inpatient and outpatient specialty services are not available locally. Sector Two veterans face especially heavy travel burdens traveling approximately ten hours round trip to access inpatient and outpatient specialty care in San Antonio.”

The Department of Veterans Affairs (VA) has declared that “veterans’ health care services in far South Texas were not adequate to meet standards for access to care and the needs and expectations of Valley veterans” (Draft-Statement of Objectives, 2008, p. 1). Additionally, the draft (2008, p. 1) stated, “VA supply does not currently meet the veteran demand for acute inpatient and specialty outpatient care in the Valley.”

In an interview by an Associated Press reporter in 1987, when then U.S. Senator Lloyd Bentsen and Congressman Eligio Kika de la Garza “expressed frustration and even dismay at the VA’s insistence that a Valley VA hospital has little or no merit.” 

Justification Summary
“The Booz Allen study team does not recommend building a small hospital in the Lower Rio Grande Valley. This is notable since there has been considerable advocacy to construct such a facility. The projections suggest that by 2015 there will be a need for 15 acute medical and surgical beds and 4 psychiatric beds, and by 2025 this will decline to 14 and 4 beds, respectively” (2007, pp. xi-xii). According to presentation made to the Veterans Alliance of the Rio Grande Valley, regarding the “VA Texas Valley Coastal Bend Health Care System” as shared by Jeff Milligan, the following numbers reflect the number of patients admitted to the South Texas Health System (STHS) and Valley Baptist Health System (VBHS) from April-November 2009: 
  • Patients Admitted =   1207
o   STHS:       696                             
o   VBHS:      511                             
  • Patients Visited ER = 989
o   STHS:       522                             
o   VBHS:      467                             
  • Average Daily Census = 25.39
o   STHS:       15.17                          
o   VBHS:      10.22

Valley Veteran Inpatient Contracts FY10-April 2010 STHS/VBHS:
      o    Patients Admitted = 820
  • Patients Visited ER = (Oct-April) = 1,276
  • Average Daily Census = 37.90



New up to date statistics:
       o    Patients Admitted=


The Booz Allen study team was unable to offer a final number to truly confirm how many veterans would come to Harlingen if the flagship hospital for the new district would be established in that city. Even more importantly, there are other qualifying veterans that have not been taken into account. Plus, within the next two months the veteran population will increase dramatically with the arrival of the “winter Texan” veterans. Another sector of veterans that are anticipated to seek VA health care for those veterans that qualify for health services but have not applied for them. This is conjecture based on the recession fueling the surge on new veterans especially the older veterans. Vietnam veterans are coming forward an applying for benefits. “Aging bodies and changing rules have made more Vietnam veterans eligible than ever before” says John Rowan, president of the Vietnam Veterans of America. The Veterans Affairs is proceeding with plans to split the Valley, Corpus Christi and Laredo off from its San Antonio-based hospital system by 2011 and give the region its own director, its own budget and its own office in Harlingen.

Conclusion;
There are no confirmed figures as to veteran population in Deep South Texas, we are basing our findings on the Booz Allen Hamilton Study and its recommendations.  Mindful, they will eventually become Veterans Affairs statistics.  Since ADC statistics are proving that there are enough veterans to sustain a hospital, the Veterans Alliance suggests that the present expansion in Harlingen include emergency and inpatient care.  We urge your support for adding emergency and inpatient services to the medical facility in Harlingen so that the veterans of Deep South Texas will finally have the full hospital that they have been pleading for over the past 40 years. This is the most cost effective way.  Since the VA has already invested over 40 million dollars on the proposed new building, it can easily be adapted to provide the new services recommended.  The State of Texas stands ready to assist the VA in whatever way the VA suggests and is allowed by the new law. The VA can partner with Texas in this expansion if VA so wishes.
Our elected officials and veterans call this approach the “common sense solution”.  Our regional and local elected officials support our efforts.  Please consider our pleas for a VA hospital.  It has been a long drawn out battle that needs closure for our Veterans.  Veterans are passing away each day with their dream of a VA hospital unfulfilled.
On behalf of the Veterans Alliance of the Rio Grande Valley and veterans and their supporters thank you. Should you have any questions, please call us.  God Bless.
Sincerely,

Homer Gallegos
Chair

Arturo Treto Garza
Co Chair