Director's Message November 10, 2022

I served for 36 years in the United States Navy. I was also the 36th Surgeon General of the Navy. And, I have continued to serve within VA, always with the mission of doing my part to devote as much of myself as I can to building up the country that I love.

But, what does service to your country mean?

Sometimes it can mean leaving your friends and family at a moments’ notice to tend to the injured or sick in a war zone. Sometimes it can mean spending holidays away from those you love because of a higher purpose. Sometimes it can mean missing the birth of a child, the death of a parent, or your wedding anniversary.

Service involves sacrifice, and those sacrifices are made willingly, with the goal in mind to give of yourself so that others may enjoy peace and freedom back home.

I don’t regret any of the moments that I sacrificed, and I know that my fellow Veterans would say the same. To serve your country is to be part of something larger than yourself; to stand with your brothers-and-sisters-in-arms and to know that you are doing good for your country and your community.

Martin Luther King, Jr said: “Life’s most persistent and urgent question is: What are you doing for others?”

It’s interesting to me that many people who leave the military go on to serve in other ways, such as being police officers, or as VA employees.

I think this is because working in service to your community and your country changes you. There’s a responsibility to others that you learn to recognize and respect. So many Veterans continue their service after they leave the military, and I want to honor that today. That devotion is one of the many things that makes Veterans unique.

At VAPIHCS, our mission is to serve the men and women who have worn the cloth of our nation. We don’t just do this on Veteran’s Day; we do it every day of the year.

I’d like to tell you about some of the things that’s we’ve done in the last year to work in service of our Veterans in the Pacific Islands.

The PACT Act was passed by Congress, and every day since, VAPIHCS employees have been working tirelessly to enroll Veterans who were not previously eligible for care. We’ve sent teams to Saipan, Guam, American Samoa, and the Hawaiian Islands to enroll as many Veterans who now qualify.

Additionally, we are working to expand services for Veterans in all parts of our coverage area. We’ve made partnerships with medical facilities in the community to give Veterans more access to a variety of sites of care, but we’re also building new sites of care of our own. The Windward Community Based Outpatient Clinic (CBOC) is open for business now, and you can go and transfer your care there. We opened a new Accessing Telehealth through Local Area Stations (ATLAS) care site in Oceanview on the big island, and we have more ATLAS sites opening now in Guam, Saipan, Tinian, and Rota. And of course, the Akaka VA Super CBOC named to honor the late Senator Daniel K. Akaka and will open in 2024.  Two weeks ago, we led an VAPIHCS large event in Guam which included a job fair, health care outreach, and VHA enrollment. There’s more to come, but suffice it to say, we’re doing everything we can to plan for future growth and to ensure the highest quality of care for Veterans in the coming years.

VAPIHCS has also made a renewed commitment to women’s health, including abortion services when necessary. Women Veterans may need support for birth control, infertility, In- Vitro Fertilization (IVF) treatment, disorders and diseases more common in or specific to women, maternity, menopause, and pain management. VA provides women health services within each CBOC to address these needs.  From Maternity Care Coordination services to installing breastfeeding stations in locations across VAPIHCS, services are being added or improved continuously. Dieticians can consult with Veterans and create an individual diet plan based on their needs and health concerns. VAPIHCS’s OBGYN Doctors and Primary Care Providers can review a woman’s file and give advice on risk factors they might face if they choose to become pregnant, as well as giving guidance on abnormal PAP smears, and other gender-specific needs. Veterans can consult with prosthetics for a lactation package, blood pressure cuffs, and more. The goal is to provide gender-specific primary care for all aspects of women’s health. That includes preventative services, mental health, osteoporosis prevention and treatment, breast health, pain management, and a holistic approach to care that is all-inclusive. 

Additionally, VAPIHCS is working hard to correct the DD214s of service members who were dishonorably discharged for their sexuality prior to the repeal of “Don’t Ask, Don’t Tell.” This is all part of our leadership’s plan towards building an inclusive VA where any Veterans can come and feel welcome. That’s not just an organizational priority; it’s important to me personally. I want to make sure that no one who walks through our doors ever feels like they don’t belong. I know that inclusion takes time and effort, and I’m committing to ensuring that my staff is taking the time and making the effort to learn how to be inclusive to all Veterans; regardless of race, gender, sexuality, or anything else.

Another thing that we spend our days mindful of is the wounds that Veterans carry. Some of those wounds are things that you can see. However, there are the unseen wounds of war, spiritual, psychological, and moral injuries and those wounds cannot be seen by the naked eye. They are invisible, and yet they are just as heavy as any wound that you can see. We place a high priority on mental health and suicide prevention, and we work every day to find the best ways to care for each Veteran. Everyone who walks through our door is unique, and they have needs that are different from anyone else. We determine what services they need, and then we offer every service we can to help. I believe that even one Veteran taking his or her life is too many, and we work every day to reach out to Veterans to prevent tragedies.

Unfortunately, a lot of Veterans who do take their lives aren’t enrolled with VA, and that is part of the problem. I’d like to speak to everyone listening and say this, if you know a Veteran who is not enrolled for VA services, please speak to them about it. Get them to come and talk to us. I know that some Veterans don’t think that VA is for them. They think they don’t need it, or that it’s only for people who were physically injured in a war. Look, VA is for everyone. It’s for every Veteran. We want them all to enroll, and to find out what they qualify for. These benefits aren’t gifts; they’re things the Veteran earned through their time in service. So, tell the Veterans in your life to come talk with us and find out what they’re owed. There’s no shame in claiming what you earned.

Honoring Veterans should be about a lot more than waving flags one day a year. That’s why VA is here. It’s our job to spend every day working in service of our Veterans, and to remember to thank them for their service to our country. So today I want to say to all the Veterans out there: Thank you. Your service is recognized, and your sacrifices have been noticed and appreciated. Today and every day, we at VAPIHCS are grateful for all that you did, and all that you continue to do. Don’t forget: Come and see us. Even if you didn’t qualify for VA services before, you may qualify now under the PACT Act.

Thank you to all our Veterans, and to all those who work every day in service of them. Happy Veterans Day.

VA Hiring Initiative

In order to meet VHA’s top priority of hiring faster and more competitively, VA Pacific Islands will be participating in a nationwide Onboard Surge Event from November 15, 2022, to November 17, 2022. The event is focused on fast-tracking a selectee’s onboarding experience by coordinating all (or as many) required pre-employment actions as possible into this three-day event. There will be Veteran Integrated Service Network (VISN) team members arriving on site next week to help with this event and they will work collaboratively with the different teams here to facilitate the onboarding process for these selectees.

The PACT Act expanded eligibility, and Veterans who were not eligible for VA care before may be eligible now. As VA expands care, we must also expand our employee pool to meet the new demand. I encourage you to think about working for VA. It’s a great way to do what you love while helping Veterans. Please take a moment to look through our job postings and see if anything is right for you. What better way to celebrate Veteran’s Day than to join our Ohana?

Whole Health

Here at VAPIHCS, we like to treat the whole person, not just individual diseases, or problems. Part of this is thinking about things that doctors might not usually talk to you about, like how much sleep you get. You need good sleep for your body and brain to function well. Getting 7 to 8 hours of good quality sleep each night is the best way to rejuvenate physically and mentally. If your nightly sleep doesn’t leave you feeling recharged in the morning, you can take simple steps to improve it. One way is to limit caffeine and screen time in the evening, but there are many other things you can do. Learn more about good slumber habits to live according to Whole Health.

COVID-19 Response

VA’s priority remains vaccinating and boosting as many employees, Veterans, their families, and caregivers as possible because it is the best way for us to end this pandemic and reduce the number of hospitalizations across the country. As of November 2, 2022, VA has documented that over 4.3M Veterans received at least one dose of vaccine. And more than 4.3M Veterans have completed a vaccination series (two-dose or one J and J vaccine). Additionally, more than 2.2 million Veterans have received an initial booster dose. That represents about 52% of the more than 4.2 million individuals we have a record of being fully vaccinated.  Over 457,000 Veterans have received an additional booster dose, and over 396,000 have received a bivalent dose. Remember that it’s also flu season, and you can get your COVID-19 booster and your flu shot at the same time. Call us to make an appointment at 1-800-214-1306.

The Great American Smokeout is Coming on November 17, 2022

Smoking has a way of clouding nearly everything in a person’s life. The U.S. Department of Veterans Affairs can help Veterans clear the air with text, phone and in-person support and counseling, as well as prescription medications and nicotine replacement therapy (NRT) products to help them stop smoking. VA has more ways than ever to help Veterans make smoking a thing of the past and improve their health and quality of life.  

Many people who smoke say they do so to cope with stress. And they might not stop smoking because they worry that quitting will only add to that stress and harm their mental health. However, research has found the opposite to be true: Stopping tobacco use can improve your mood and decrease your feelings of depression and anxiety. It also can make certain medications for depression, anxiety and psychotic disorders work better. 

If you smoke, you likely know that it can harm almost every organ in the body, including the brain. You may not know that it can also harm the health of the nonsmoking people — and even the pets — around you. Secondhand smoke causes more than 41,000 deaths in the United States each year and many serious health problems. When you stop smoking, the people around you are likely to have better lung function and a lower risk for heart and respiratory diseases. 

After you stop smoking, better mental and physical health — for you and the people around you — are the foundations of an improved quality of life, but you’ll also experience many direct lifestyle benefits. For example, when you stop smoking, you’ll sleep better and feel an energy boost that will enable you to spend more time doing the things you enjoy. And you won’t miss important events or special moments when you must go outside to smoke. You’ll also have more time and money to devote to the people, causes and activities that are meaningful to you. 

VA has many treatment options to make it easier to stop smoking. Because each method addresses a different aspect of smoking, a combination of more than one method can be very effective. The best treatment is the one that works for you, but research has shown that combining counseling with medication (such as NRT gum, patches, lozenges and other products) is the most effective for remaining tobacco-free over the long term.: 

• Counseling: VA offers group and individual counseling to talk about everyday tobacco use, triggers for smoking, and lifestyle changes that can help Veterans quit smoking. Counseling is available in person or through the VA Video Connect secure videoconferencing app. You may use My HealtheVet, VA’s online patient portal, to send VAPIHC “Quit Tobacco” group a secure message to learn more about your options. 
• Medications and NRT: VA offers prescription medications approved by the Food and Drug Administration as well as NRT gum, patches, and lozenges to help relieve nicotine withdrawal symptoms and cravings that come with stopping tobacco use. Your provider can guide you through the available options and help you decide which one (or combination) is likely to work best for you. 
• Quit VET: Veterans can call 1-855-QUIT-VET (1-855-784-8838) for counseling and help in developing a plan to stop smoking. Quitline counselors are available Monday through Friday, between 9 a.m. and 9 p.m. Eastern time, to help you prepare for potential challenges and avoid relapse. Counselors offer continued support in English or Spanish through follow-up calls and counseling sessions. 
• SmokefreeVET: For tools and tips you can use to quit smoking, sign up for SmokefreeVET by texting VET to 47848. SmokefreeVET provides regular text messages as well as extra support for Veterans who text the keywords URGE, STRESS or SMOKED to 47848. Para inscribirse en SmokefreeVET en español, manda el texto VETesp al 47848. Learn more at the SmokefreeVET website. 

It’s not easy to stop smoking, but VA has a range of evidence-based treatments that have led countless Veterans to long-term success. When you’re ready to clear the air, contact the VAPIHCS Tobacco Program at 808-835-9669 or the Call Center at 1-800-214-1306.

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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