Rio Grande Valley VA Town Hall Meeting. Mr. Robert M. Walton Director

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1 Rio Grande Valley VA Town Hall Meeting Mr. Robert M. Walton Director

2 This Is Your VA - Where We Were - Where We Are - Accelerating Care Initiatives - How Are We Doing? - How Can We Do Better? 2

3 VCB Counties We Serve Veteran Population, Enrollees, and Uniques 3

4 VA Texas Valley Coastal Bend Health Care System The Valley Coastal Bend is comprised of 20 counties in deep South Texas and encompasses the Laredo, McAllen, Harlingen, and Corpus Christi Outpatient Clinic service areas. Corpus Christi VA Outpatient Clinic McAllen VA Outpatient Clinic VA Health Care Center at Harlingen Laredo VA Outpatient Clinic Harlingen VA Outpatient Clinic Corpus Christi VA Specialty Clinic 4

5 Harlingen VA Outpatient Clinic Active Patients: 10,595 (August 2014)

6 McAllen VA Outpatient Clinic Active Patients: 11,177 (August 2014) New Services include Optometry, Prosthetics, and Physical Therapy 6

7 VA Health Care Center (HCC) at Harlingen This facility was activated on January 18, 2011

8 Laredo VA Outpatient Clinic Active Patients: 2,720 (August 2014) 8

9 Corpus Christi VA Outpatient Clinic and Specialty Clinic Active Patients: 10,814 (August 2014) 9

10 Current Services in VATVCBHCS Active Services Primary Care Pathology and Laboratory Mental Health Prosthetics Amputee Clinic Dermatology Minor Procedures Rheumatology Infectious Disease Pulmonary Orthopedics Neurology Gastroenterology Urology Dental Physical Therapy Oncology Optometry Ophthalmology Podiatry Physical Medicine & Rehabilitation Geriatrics and Extended Care Home and Community Based Care Cardiology ENT Audiology Nutrition Social Work Women s health Pharmacy Radiology/MRI/CT Services Telemedicine

11 Rio Grande Valley Inpatient Contracts Fiscal Year Vendor Authorized BDOC ADC Unique Patients Payment Amount FY11 South Texas Health System 7, $14,323,198 FY11 Valley Baptist Health System 4, $10,099,086 Total 11, ,441 $24,422,284 FY12 South Texas Health System 6, $13,876, FY12 Valley Baptist Health System 5, $11,424, Total 12, ,696 $25,301, FY13 South Texas Health System 7, ,276 $11,789, FY13 Valley Baptist Health System 4, $9,098, Total 12, ,270 $20,888, FY14 thru June South Texas Health System 6, ,071 $8,165, FY14 thru June Valley Baptist Health System 4, $7,648, FY14 thru June Total 11, ,986 $15,814, Note: Numbers are based on paid claims from VSSC Non-VA Care Cube thru 07/01/14. Unpaid or pending claims are not included in the data counts. From Strategic Analysis Service ADUSH for Policy & Planning.

12 Number of Rio Grande Valley Market Veterans Seeking Care at the San Antonio VA Cameron Co Hidalgo Co Jim Hogg Co Starr Co Willacy Co Zapata Co VCB Total SOURCE: VSSC Enrollment Cube Date Pulled: 9/4/14

13 Rio Grande Valley Market Veterans Seeking Care at the San Antonio VA Year Cameron Co Hidalgo Co Jim Hogg Co Starr Co Willacy Co Zapata Co VCB Total ,304 2, , , , YTD

14 Non-VA Care (Fee) Update FY-14 (Thru August) Total Fee Authorizations for the entire VATVCBHCS: FY10 for VCB: 19,936 Authorizations FY11 for VCB: 29,762 Authorizations FY 12 for VCB: 26,579 Authorizations FY13 for VCB: 24,938 Authorizations FY14 for VCB (Thru July): 34,921 Authorizations Source: VSSC Non-VA Medical Care Program Performance 14

15 Non-VA Claims Processing Update % of Claims over 30 days 15

16 VCB Staffing Growth Site Oct 2010 Oct 2011 Oct 2012 Oct YTD Harlingen Corpus Christi McAllen Laredo VCB Totals

17 VCB Staffing Growth Laredo McAllen Corpus Harlingen /1/10 10/1/11 10/1/12 10/1/ YTD 17

18 VA National Audit Findings The National Access Audit results show that as of May 15, 2014, wait times were: New Patient Primary Care average wait time was days New Patient Specialty Care average wait time was days New Patient Mental Health average wait time was 55.4 days Established Patient Primary Care average wait time was days Established Patient Specialty Care average wait time was 1.22 days Established Patient Mental Health average wait time 1.77 days We had 853 Veterans who had been waiting for 90 days or longer for a Specialty Appointment: 87 for Audiology, 56 for Ophthalmology, 484 for Optometry, 66 for Podiatry, 42 for Poly-trauma, and 118 for Physical Therapy We had 215 Veterans who had been waiting for 90 days or longer for a Primary Care Appointment There were inconsistencies throughout VATVCBHCS in the determination and use of the Desired Date for established patients 18

19 VCB Response to Findings In response to the Accelerated Access to Care Initiative, on May 23 we began calling all these Veterans and offered the opportunity to move their appointment up, send to Non-VA Care, or keep the scheduled appointment. We administered additional training for all scheduling staff. New Scheduling Review Process. Added Mid Level Provider and their teams to McAllen (MOPC), Harlingen (HOPC),Corpus Christi (CCOPC), and Laredo (LOPC) Outpatient clinics to assist with walk-in patients. 19

20 VCB Response to Findings We are adding one Primary Care Team (Physician, RN, LVN, MSA) to each McAllen (MOPC) and Harlingen Outpatient Clinic (HOPC). One Audiologist to each HOPC and Corpus Christi Naval Air Station (CCNAS). Optometrist and Ophthalmologist to Corpus Christi Specialty Clinic (CCSC). Two Eye Techs, one at CCSC and one at Harlingen Health Care Center (HCC). Neurologist, Respiratory Therapist, and Nurse Practitioner for Poly-Trauma and sleep clinics at HCC We have 20 Recruitments for vacant Mental Health positions, and we will be adding a Professional Counselor and a Behavioral Health Physician Assistant for CCOPC, and a Psychologist for MOPC. We are adding a Nurse and a Management Analyst to assist with scheduling reviews to ensure that appropriate scheduling practices are being followed. We are adding additional RN & MSA to the Non-VA Care staff to improve the timeliness of processing and coordination of acre 20

21 VATVCBHCS Wait Times Update (Does not count Non-VA Care Appointments) VATVCBHCS 16-May 1-Jun 15-Jun 1-Jul 15-July 1- Aug 15-Aug 1-Sep Appointments Scheduled 16,789 18,709 19,728 19,735 19,023 18,674 18,335 18,719 New Pt Ave W/T PC New Pt Ave W/T SC New Pt Ave W/T MH Est Pt Ave W/T PC Est Pt Ave W/TSC Est Pt Ave W/T MH

22 What is PC3 (TriWest) Contract? VHA has awarded national contracts for surgical and medical specialty providers under a VHA program called Patient-Centered Community Care (PC3). The PC3 contractor for Valley Coastal Bend is TriWest. As TriWest continues to build a larger and more diverse provider network, VCB will send more Veterans to PC3 contracts instead of using the traditional fee voucher. The contracts include: Inpatient Specialty care Outpatient Care Including Skilled Home Health and Home Infusion Therapy Mental Health Care Limited Emergency Care Limited Newborn Care for enrolled Female Veterans after delivery The contracts do not include: Dental Care Nursing Home Care Long Term Acute Care Hospitals (LTAC) Homemaker and Home Health Aide Services Chronic Dialysis Treatments Compensation and Pension Examinations 22

23 Self Check-in Kiosks are here - Successfully deployed 38 kiosks at 7 VCB sites. - Week of August 4 th Harlingen & McAllen - Week of August 26 th - Corpus Christi & Laredo - From August 4, 2014 through September 3, 2014, we had: - Number of Kiosk Successful Check-In; 1,597 23

24 How do I Stay up to date with the New Health Care System? Stay connected: Like us: Follow Us: 24

25 This Is Your VA - What are we doing? - How can we do better? 25