CHARLEEN R. SZABO, FACHE
ACTING NETWORK DIRECTOR
VA STARS & STRIPES HEALTHCARE NETWORK,
VETERANS HEALTH ADMINISTRATION
DEPARTMENT OF VETERANS AFFAIRS
COMMITTEE ON VETERANS AFFAIRS
March 16, 2004
Mr. Chairman and Members of the Committee:
I am pleased to appear before the Committee to discuss VISN 4’s ongoing efforts with regard to CARES.
The CARES process has involved one of the most comprehensive evaluations of the VA health care system ever conducted. It is a data-driven planning process designed to project future demand for health care services in 2012 and 2022, compare them against the current supply, and identify the capital requirements and the asset realignments VA needs to improve access, quality, and the cost effectiveness of the VA health care system.
My testimony will be in two parts – the first part will address
The VA Pittsburgh Healthcare System consists of three divisions,
As part of the VA Stars & Stripes Healthcare Network, VA Pittsburgh serves as the tertiary hub for the other western VISN 4 facilities, providing specialty care for patients from the VA medical centers in
With an annual operating budget approaching $300 million, VA Pittsburgh treats over 52,000 veterans per year. While the average daily census has been around 550 over the last 3 years, outpatient visits have increased to over 430,000. Service enhancements made in recent months include the addition of bariatric surgery and renal transplantation, along with the establishment of an independent liver transplant program. Oxygen capacity was added to more nursing home units and additional cardiac telemetry beds were added in acute care to meet the growing demand for higher acuity services. Other programs were expanded to support veterans in the community including mental health intensive case management, homemaker and home health aide services, and opioid substitution. When clinic wait times became lengthy, providers were added to primary and many specialty clinics. These clinics can now schedule veterans within 30 days. Numerous renovations have been made including the operating rooms, laboratory, specialty clinics, an inpatient psychiatry unit and renal dialysis. With these improvements, reported veteran satisfaction with care has increased from 59% to over 70% in the last four years.
The plan proposed under CARES calls for substantial construction of new space in
All of the excellent behavioral care and other services provided at the
Care will be improved through co-location of behavioral health care with other tertiary services. Patient safety and care outcomes will improve as veterans no longer require transport across town when they become medically ill. As aesthetically pleasing facilities, which meet modern privacy standards, are provided veteran satisfaction will continue to improve. The environment can positively impact care outcomes, as patient comfort and confidence increases. Researchers currently situated at
And now, turning to the VA Medical Center in
The VA medical center in
A majority of veterans requiring outpatient sub-specialty care, as well as secondary and tertiary care, are referred to the VA Pittsburgh Healthcare System, which is located about 35 miles from Butler, PA. Approximately 80 veterans per year are referred to community hospitals, with
The medical center has been very successful in partnering with similar community organizations that have been located in underutilized space on the VA campus and provide expanded services for veterans. One of these partnerships is the
Another significant project is the recently approved enhanced use lease with
The draft national CARES plan endorses continued exploration of potential enhanced use proposals for the VA medical center. It specifically cites an enhanced use opportunity with Butler Memorial to expand specialty care on the VA campus. Since the draft plan has been published, discussions on an enhanced use lease have been expanded to include the construction of Butler Memorial’s replacement hospital, an ambulatory surgical center, cancer center, and medical office building on 30 acres of the VA campus. A concept paper to pursue this enhanced use lease potential has been submitted to VACO for review and approval.
The draft national CARES plan also calls for the closure of the VA medical center’s seven acute medicine beds. Nursing home care and outpatient services are recommended to continue operation.
The potential enhanced use proposal with Butler Memorial for its replacement hospital is an innovative project that will enhance services to veterans in the
In summary, this plan provides for continued delivery of excellent health care to veterans and potential savings in building maintenance that will support the VA Pittsburgh Healthcare System and VAMC Butler in expanding and enhancing the services provided to our nation’s veterans.