MICHAEL W. MURPHY, PH.D.
DIRECTOR, VA NORTHERN INDIANA HEALTH CARE SYSTEM (NIHCS)
VETERAN INTEGRATED SERVICE NETWORK (VISN) 11
VETERANS HEALTH ADMINISTRATION
DEPARTMENT OF VETERANS AFFAIRS
SUBCOMMITTEE ON OVERSIGHT AND INVESTIGATIONS
COMMITTEE ON VETERANS' AFFAIRS
U.S. HOUSE OF REPRESENTATIVES
June 1, 2000
Mr. Chairman and members of the Committee I have been invited to discuss the VA Northern Indiana Health Care System (NIHCS). NIHCS is dedicated to serving America’s veterans and ensuring that they receive the medical care benefits they deserve.
The integration of the VA Medical Centers in Fort Wayne and Marion IN into the VA Northern Indiana Health Care System was announced in March 1995. VAMC Fort Wayne was a primary and secondary medical and surgical facility, with an outpatient clinic and nursing home, located in the second largest city in Indiana. The primary service area (PSA) served 19 counties in the northern third of Indiana along with 7 counties in northwest Ohio, with an estimated veteran population of 150,224 (1994 data). VAMC Marion was a psychiatric and long term care facility with primary medical services and an outpatient clinic, and served as the neuropsychiatric referral facility for the entire state of Indiana. The computer databases were merged and NIHCS commenced operations as an integrated facility on October 1, 1995.
Upon integration the veteran catchment area for NIHCS was redefined to include 28 counties in Indiana and 7 counties in Ohio. The Marion campus serves as the neuropsychiatric referral facility for Indiana. The two campuses are separated by 60 miles and provide complementary services. Medical and surgical services are available at the Fort Wayne campus, psychiatry and extended care are provided at the Marion campus. Primary care clinics and nursing home care units are available at both campuses. Inpatient services are provided in the 243 authorized hospital beds and 180 nursing home care beds. A Community-Based Outpatient Clinic (CBOC) was opened in the South Bend-Elkhart area in April 1998, extending care to the state’s largest population of under served veterans. In August 1999 a second NIHCS CBOC was opened in Muncie, providing area veterans convenient access to primary care services.
NIHCS also provides administrative support to a veteran’s readjustment counseling center (Vet Center) in Fort Wayne and to the Marion National Cemetery.
Although the Marion campus is well over 100 years old and the Fort Wayne campus was constructed in the 1950’s, recently completed renovation and construction, in addition to projects currently under way, ensure a modern and attractive state-of-the art healthcare environment. A 240 bed geropsychiatry building was occupied at the Marion campus in July of 1997 and a 100 bed general psychiatry building is scheduled to be activated in the fall of 2000. A new ambulatory care addition was opened in November of 1998 at the Fort Wayne campus.
NIHCS is fully accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) in the Hospital Accreditation Program (HAP), Home Health Care, Long Term Care Program, and Behavioral Health Care. Our most recent cyclic survey in 1997 resulted in scores of 89, 90, 91, and 98 respectively, Two random unannounced JCAHO surveys in the spring of 1999 resulted in our scores being raised to 94, 94, 94, and 98. We are also fully accredited by the College of American Pathologists (CAP), the Commission on Accreditation of Rehabilitation Facilities (CARF), and the Nuclear Regulatory Commission (NRC).
A Combined Assessment Program (CAP) Review by the Office of Inspector General (OIG), Department of Veterans Affairs was conducted at NIHCS March 6-10, 2000. During the exit interview and subsequent conference calls, the IG made a number of recommendations for improvement, including the need to review staffing levels; review specific patient care programs in terms of reprogramming or relocation of current programs and development of new programs, e.g. dementia unit; improve safety features; and, improve medication management and security. We have concurred with all recommendations and some corrective actions have been completed, with implementation plans being developed for all others. We have discussed these actions and plans with two members of the review team.
Our emphasis continues to be on providing high quality health care services for all veterans in the appropriate clinical setting. We have expanded our efforts in serving homeless veterans by partnering with a provider in the Anderson area, through the Homeless Provider Grant and Per Diem Program. Additionally we work closely with the Homeless Task Force of Fort Wayne in supporting "stand downs" and other essential homeless services. Our Home Based Primary Care (HBPC) program provides in-home primary medical care services to home-bound veterans with chronic diseases and terminal illnesses. Our Adult Day Health Care program provides maintenance and rehabilitation services to veterans in an outpatient setting. Our Respite Care program provides care givers brief periods of needed relief from the responsibility of providing 24 hour care to their loved ones.
The shift in emphasis at NIHCS, from a hospital-based healthcare system to an ambulatory care, outpatient focused system, has resulted in many changes in the delivery of quality health care for our veterans. This shift is consistent with the current delivery paradigm in the private sector and more specifically within the VA in medical, surgical, psychiatric and mental health care.
NIHCS supports the Veterans Health Administration, and VISN 11 in developing programs for veterans consistent with the six nationally adopted domains of value: Quality, Cost, Access, Satisfaction, Functional Outcomes and Community Health. We are committed to providing America’s veterans the highest quality health care in the most cost effective manner and in the least restrictive setting. We have an equivalent commitment to our employees to improve communication and participation in implementing new programs. The many changes that have taken place at NIHCS and that will be necessary in the future have a significant impact on employees in terms of how they do their jobs, the settings where care is provided, the skills sets necessary to do the quality work we all strive for, and overall job satisfaction.