Director's Message August 19, 2022

Key Components of the PACT Act include:

• Expands VA health care eligibility for toxic-exposed Veterans and extends enhanced eligibility for Vietnam era, Gulf War era, and Post-9/11 combat Veterans
• Adds more than 20 burn pit and toxic-exposure-related conditions to VA’s service presumption list
• Improves VA’s decision-making process for determining what medical conditions will be considered for presumptive status
• Every enrolled Veteran will receive an initial toxic exposure screening and a follow-up screening at least every 5 years. Veterans who are not enrolled, but who meet eligibility requirements, will have an opportunity to enroll and receive the screening
• VA health care and benefits personnel will receive toxic exposure-related education and training
• Requires research studies on mortality of Veterans who served in Southwest Asia during the Gulf War, Post-9/11 Veteran health trends, and Veteran cancer rates
• Helps VA build a stronger, more skilled workforce to meet the growing demand for benefits and services
• Authorizes 31 new medical facilities across the country, providing greater access to VA health care

VA Pacific Islands Health Care System (VAPIHCS) Member Services Chief James Sewell and the Health Administration Services (HAS) member services team have been personally traveling to help enroll new Veterans with the assistance of the Vet Centers.
“Now that so many more Veterans are eligible for VA care, we have to get out there and get everyone enrolled,” said Sewell.
The team already went to:

• Moloka’i CBOC: August 15, 2022, and August 16, 2022

They will be in:

• Kona Vet Center: August 24, 2022, and August 25, 2022
• Maui Vet Center: August 29, 2022, and August 31, 2022
• Kauai Vet Center: August 31, 2022, and September 1, 2022
• After that, the team heads to Guam for enrollment outreach:
• Guam Vet Center: September 5, 2022, to September 9, 2022
• They will also visit Saipan:
• Saipan CBOC: September 7, 2022, and September 8, 2022
• Finally, the last stop is American Samoa:
• American Samoa Vet Center: September 5, 2022, to September 12, 2022.

The team will be going to Hilo as well, but those dates will be announced in the future. However, Veterans do not have to meet with the enrollment team in person. They can call 1-877-222-8387 to talk to the National Health and Eligibility Center. They can also enroll with VA or apply for expanded care online. Even if you have been denied VA benefits in the past, you are still encouraged to speak with someone about your eligibility now. What the VA can cover has been expanded substantially, and many Veterans who have been denied care in the past will now be eligible.

Please reach out if you have any questions about applying for expanded coverage. To learn more about the PACT Act and to apply for your expanded coverage, please visit our website at https://www.va.gov/PACT.

Defense Health Agency Partnership

Our concept of care at VAPIHCS is patient and family centered. I’ve said many times, how important it is to use principle-based decision-making – if there’s a rule that fits, use it. But the key is to do what’s right and always do the right thing for our Veterans and our staff. During last month’s Employee Town Hall, we received a question asking whether we’d get a VA hospital – and my answer was, that we already have one. Tripler Army Medical Center (TAMC) is a major hospital and army facility. With the Defense Health Agency (DHA) taking over Garrison care (retirees and dependents) and taking over day-to-day health care operations in TAMC and in Guam Naval Hospital, VA can be an integral partner with them. DHA is very interested in increasing our partnership, building upon the foundation we currently have to truly integrate. Our partnership could create a seamless care model where VA employees are working in TAMC, and VA patients are being seen there. Partnership is a major activity. The vision I have for a VA hospital is true integration with TAMC, where we can serve not only our Veterans in the Hawaiian Islands and throughout the entire Indo-Pacific region, but also aid in the care of our active duty, retired, and eligible family members as a unified federal health entity.

VA Leadership Visit

VAPIHCS had the pleasure of hosting the Under Secretary for Health, Dr. Shereef Elnahal on Tuesday, and the Deputy Secretary, The Honorable Donald Remy, Ms. Vivian Hutson, Special Advisor to the Secretary on Indo-Pacific Affairs, and Ms. RimaAnn Nelson, the Assistant Under Secretary for Health for Operations on Wednesday this week in Honolulu, and Thursday at our Hilo Community Based Outpatient Clinic (CBOC.) The DEPSEC and his team will continue their journey, visiting several VA and VAPIHCS facilities in Guam, Saipan, and the Philippines next week, before returning to Honolulu.

I’d like to take a moment to thank everyone who was involved in coordinating and everyone who participated this week. To the staff who highlighted services during his facility tour, to Employee Health, lab, and Geriatric Rehab and Extended Care (GREC) staff who supported COVID testing, and to the staff who participated in meetings and informal discussions with the DEPSEC, everyone who contributed – thank you all for being here, and showcasing the amount of talent, professionalism, and aloha spirit we have here at VAPIHCS. We look forward to hosting future special guests and sharing what makes our VAPIHCS Ohana unique; and how we all work together to care for our Veterans.

VA Commitment to Research

One of the original pillars of the Veterans Health Administration is a commitment to Research. With the unfortunate recent closure of the Pacific division of the National Center for Post-Traumatic Stress Disorder (NCPTSD), our leadership, along with Associate Chief of Staff (ACOS) for Research Dr. Curtis Lowery, advocated for support and resources to continue research activities. In partnership with the Office of Mental Health & Suicide Prevention, we will receive funding starting in Fiscal Year 2023 for four Full-time Employee research positions over five years. This is a great success for our research program at VAPIHCS. With these positions, we can continue exploring innovative and evidence-based practices to provide the best care for our Veterans.

Thoughts from Chaplain Richie Charles

Does it ever feel like your well has run dry? In a dry well experience, a person can come to the point of feeling less optimistic for the work that one does. It can lead to having moments of cynicism about their impact, rather than the passion they once felt. One can have a reduced sense of motivation, and instead have an abiding sense of inner exhaustion. A dry well experience can impact a person’s enthusiasm and sense of creativity.

When well contractors work on literal wells, one of their recommendations is to be careful not to draw water faster than what the well can produce.

Wells are holes drilled into the ground that often draw water from an underground water source called an aquifer. But not all wells yield the same amount of water, nor do they yield water at the same rate. While some wells yield one gallon per minute, others yield. A person must be mindful not to draw water at a faster rate than the aquifer below can replenish itself.

When we think of self-care, some helpful questions to ask ourselves might include: is my output greater than my input? Have my withdrawals exceeded my supply? Am I giving out more than I am investing into myself? Like any well, if we want to keep supplying “water” to refresh others, we must learn to first refresh ourselves. We simply cannot give what we do not have. None of us have an infinite reservoir of “water”. Replenishing one’s supply is about caring for oneself so that one can be better suited to care for someone else. It doesn’t mean that we stop giving, but that we remain mindful to regularly monitor our own supply to never forget to make deposits first.

One Team, One Ohana!
Adam M. Robinson, Jr., MD, MBA, CPE 
Director, VA Pacific Islands Health Care System
VADM, MC, USN, (RET)
36th Surgeon General, USN

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