Director's Message December 22, 2023

These core values are Integrity, Commitment, Advocacy, Respect, and Excellence. This ethos governs our interaction with our patients, and ourselves.

You’ve probably heard me share my model for the VA Pacific Islands Health Care System which consists of a three-legged stool. In this model, we recognize the key participants in our work, which are employees, Veterans, and our Veteran’s family. To maintain balance in the three-legged stool, our employees, Veterans, and the families (and caregivers) of those Veterans need to work in partnership to be successful in providing safe, compassionate, and quality care.

As part of my three-legged stool model, ICARE has expanded to become “ICARE squared”, which includes the core values of Innovation, Compassion, Accountability, Research, and Education – values that each of you embody when you care for our Veterans every day. This year we have put these values in action in all our departments and with improvements across all our sites of care.

At VA Pacific Islands Health Care System (VAPIHCS), we have worked hard towards meaningful improvements to ensure that we can continue to provide the same level of safe, compassionate, and quality care we have always provided our Veteran population as we continue to expand and grow along with it. The Kona Community Based Outpatient Clinic (CBOC) will move to a new location in 2024. In Guam, a new CBOC Annex will open, doubling our patient care space. The Daniel K. Akaka VA Clinic will open on Oahu in the spring of 2024, while the Leeward CBOC will remain open which will greatly expand capacity on the Leeward side of the island.

We have remodeled or made improvements to facilities in all the islands in our coverage area.

The Promise to Address Compressive Toxins (PACT) Act was passed in August of 2022, and we held PACT Act enrollment events on every island throughout 2023, helping Veterans to learn about this legislation and the expansion of VA care that it allows. We identified over 7,000 Veterans as eligible for PACT Act benefits and assisted them in registering and expanding their access to our health care system. Additionally, we enrolled 2,361 new Veterans for VAPIHCS care.  As the numbers show, we have been very successful so far. We will continue to engage with Veteran populations across our islands and enroll eligible Veterans.

We have strived to integrate Whole Health into all that we do.  Primary Care doctors regularly recommend Whole Health options to Veterans who are struggling with finding the right exercise, making changes to diet, quitting smoking, and so much more. Within VAPIHCS, many employees have worked to bring Whole Health principles into their departments. Home Based Primary Care (HBPC) is a wonderful example of this. They have brought HBPC nurses from all our islands together for virtual meetings where they participated in relaxation activities and other practices that can help reduce stress and burnout and improve employee retention.

Mental Health is so important, and we at VAPIHCS are proud of our psychologists and all that they have accomplished in the last year. Dr. Michael Mahoney coordinated the mental health disaster relief efforts in Maui, and I know that staff and Veterans there were grateful for the support. Disaster Response Training was provided to 50 VAPIHCS Mental Health Providers. 

We hope it is not needed, but it’s important that staff be prepared for anything. Dr. Mary Harlinger proposed, developed, and recruited a psychologist who is now onboard and serving as the LGBTQ+ Care Coordinator. Dr. Lisa Lee helped coordinate a VAPIHCS presence at Honolulu Pride events, because outreach to our LGBTQ+ Veterans is important. VAPIHCS psychologists published several notable studies and brought important research to the islands as well. Thank you to all the providers on the front lines caring for Veterans’ mental health, and working to improve their access to the care they need to feel well.

We hope it is not needed, but it’s important that staff be prepared for anything. Dr. Mary Harlinger proposed, developed, and recruited a psychologist who is now onboard and serving as the LGBTQ+ Care Coordinator. Dr. Lisa Lee helped coordinate a VAPIHCS presence at Honolulu Pride events, because outreach to our LGBTQ+ Veterans is important. VAPIHCS psychologists published several notable studies and brought important research to the islands as well. Thank you to all the providers on the front lines caring for Veterans’ mental health, and working to improve their access to the care they need to feel well.

We have made a big push for a return to in-person appointments for Veterans who want them. However, we are also working to improve care for our Veterans who prefer telehealth modalities. We have installed Access to Telehealth Through Local Area Stations (ATLAS) booths in Saipan, Tinian, Rota, and the Big Island. These booths allow Veterans to access services like medication reconciliation or mental health appointments using the internet and video chat inside the booths. They are currently operational, and we look forward to seeing Veterans take advantage of them in 2024. It’s very important to me that we deliver the benefits that Veterans have earned and deserve at the highest standard of care possible - as close to home as possible.

In 2023, we hired a full-time Audiologist for our Hilo CBOC, as well as a tech for the Maui CBOC. An audiology booth was installed at the Windward CBOC where we will begin full-time audiology services in the new year, and four audiology booths were installed in the new Daniel K. Akaka Clinic, which will open in the spring of 2024. Remember – Veterans can self-refer to Audiology if they are having difficulties with their hearing. 

The Center for Development and Civic Engagement (CDCE) held birthday parties for each of the military services this year. These events provided an opportunity for staff to set up tables and showcase our services for Veterans in the lobby of our Spark Matsunaga Ambulatory Care Center (ACC) and celebrate our United States military branches. The CDCE also planned and executed the first annual Koa Challenge Veteran Games, which were held at the American Veterans (AMVETS) West Oahu Vet Center. The games were very successful, and I look forward to seeing them continue in the years to come. Additionally, the CDCE hosted a Thanksgiving event at Cloudbreak housing in Barber’s Point. We will continue to look for opportunities to engage Veterans on all our islands in the new year.

During the COVID-19 pandemic, we had to suspend outreach. In 2023 we began to hold community events again, and we brought on board a new Outreach Coordinator, Maurice Martin, who will work to ensure that we continue reaching out to Veterans in the communities where they live in 2024. Our Outreach Coordinator is part of our Public Affairs staff, who have also implemented many notable changes in the last year. We now have a new podcast called VAPIHCS Talk Story, which will help inform and educate Veterans and staff about all that we have to offer. Digital boards have been installed in E-wing to help communicate important messages. I’ve chaired, along with Dr. John Henry Felix, the Veterans and Community Task Force, which has allowed Veterans to have a real say in the administration of their care. We have accomplished so much working together for the good of our Veterans in 2023.

On a national research level, the Million Veteran Program (MVP) reached its goal of enrolling one million Veterans in the program. Thank you to all the Veterans who have participated! Locally, we are dedicated to research that will help us serve our Veterans with technology, evidenced-based practices, and innovation. We currently have 17 active studies addressing diabetes, cancer prevention, COVID-19, Traumatic Brain Injury (TBI), the epidemiology of neurodegenerative diseases, Parkinson’s disease, mental health, and genetics. This year we saw multiple successes across our station, and I know we will see many more in 2024. 

I’m so proud of all that we’ve done and all that we are working to do!

From our Ohana to yours, Happy Holidays!

Closed for Christmas

Clinics will be closed on Monday, December 25, 2023, in observance of Christmas. We will reopen for normal operations on Tuesday, December 26, 2023. Blessings to you and your family in this joyful season! 

Navigating Holidays

The holidays can be difficult for people with physical disabilities, mental health challenges, a sexual orientation or gender identity that your family does not respect, and other limitations. It doesn’t matter if you’re trying to avoid large gatherings that may trigger your PTSD, or if you’re struggling to say no to your grandma’s cheesecake because you are lactose intolerant; the key is setting boundaries. VAPIHCS would like to help you do this. 

Gently remind your family of the things that you are unable to do prior to attending any gatherings. Make a plan for how to keep yourself safe. If you need help with planning a holiday that won’t trigger your PTSD, you can use out PTSD Coach app or PTSD Coach Online tool. If you need help asking your friends and family to respect your boundaries, talk to our Whole Health team for tools that can help you. We also have an excellent mental health team, and you can always ask for a referral to speak with someone. Remember our Chaplains are also available to talk with you any time you’re struggling, and you can call them at 808-433-0271.

Thoughts from Chaplain Richie Charles

A story is told of a carpenter who was so skillful in building homes that he developed a reputation for being the best home builder in his area. But coming into his golden years, he felt it was time to spend more time with his grandchildren. So, he informed the general contractor of his plans, and his boss was sorry to hear the news. But then his boss got an idea. The general contractor asked the carpenter to build just one more house and offered him an almost unlimited budget for this last project.  

The carpenter reluctantly agreed and out of spite, used the cheapest materials. He chose the worst flooring and selected the least favorable location to build the home. In the end, it would be the worst home he had ever built.  

After the carpenter completed the home, the general contractor came with keys to the front door, and with a smile, handed the keys over to the carpenter. Surprised and confused, the carpenter wondered why the keys?

The general contractor replied, “these keys are for you. I asked you to build this last home because it was my parting gift to you. I have also chosen to cover all the expenses for the build.”

If only the carpenter realized that the house he was building was really a gift to himself, how differently would he have built it!

Service is much the same way. It can feel like it’s something we’re only rendering unto someone else, but in reality it’s also the greatest gift we can give to ourselves. The ability to touch lives and meet the needs of Veterans is a priceless gift, as there are few things more satisfying than knowing that one’s life has become a conduit of relief and goodness for another.  

In this holiday season, let’s not forget the blessing that comes from giving.

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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