North Chicago VAMC and Naval Health Clinic Great Lakes 2010 Integration

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North Chicago VAMC and Naval Health Clinic Great Lakes 2010 Integration Heather E. Rudisill, Au.D. Audiologist, North Chicago VAMC March 4, 2009 Mr. Patrick Sullivan, FACHE, Director NCVAMC CAPT T. E. McGue, MC, USN, CO NHCGL

VA-DoD Joint Ventures There are numerous medical sharing and joint venture sites where VA and DoD are already partnering *Las Vegas-So Nevada VAMC/ Nellis AFB / UNLV Med *Denver VAMC/ Fitzsimmons AMC/ USAFA/U of CO Med/ Ft Carson AMC North Chicago VAMC+ Great Lakes Naval Health Clinic = FHCC *Honolulu VAMC/ Tripler AMC / Hickam AFB/ Pearl Harbor Naval/Univ of HI Med *Biloxi VAMC/ Keesler AFB/ Pensacola NAS The North Chicago FHCC should be viewed as the premier model for joint partnerships. They (JEC) have selected 4 locations for integration advancement

CAPTAIN JAMES A. LOVELL FEDERAL HEALTH CARE CENTER 2010

Construction of the new ambulatory clinic for the Captain James A. Lovell Federal Health Care Center 12/23/08 2

Factors Driving Integration Base Realignment and Closure (BRAC) Navy consolidated recruit training into one location Presidential Priority Executive Order 13214 President s Task Force mandated an increase in VA/DoD collaborative efforts. Capital Asset Realignment for Enhanced Services (CARES) study 2001/SRA study 2001 Center for Naval Analysis recommendations 2002 Direction and leadership from the Health Executive Council and Joint Executive Council Congressional interest - ongoing

Phase I Phase II Phase III Sharing Relationship October 2003 Inpatient Mental Health transferred Reimbursement methodology: As TRICARE Network Provider Status Local VA/DoD Working group chartered Multi-disciplinary December 2004 DoD Blood Donor Processing Center transferred Reimbursement methodology: Navy leases VA laboratory space VA purchases blood products Avoids $3M construction cost to Taxpayer Network Relationship January 2005 $13M NCVAMC Project Construction of 4 new Operating Rooms Renovated 4 existing Operating Rooms Expansion of existing Emergency Department June 2006 Transfer of inpatient med/surg/pediatric Professional services by Navy Physicians for Surgery and Pediatrics Transfer of operating room Transfer of ICU Transfer of ER service Reimbursement methodology: Facility charges at TRICARE Network negotiated rate. Federal Health Care Center FY2007 Navy construction project began 2 JUL 2007: Surface parking (staff) completed December 2007 FY2008 Begin parking structure supporting facilities (electricity, water, sewer, etc.) Renovate 45,000 square foot existing NCVAMC spaces Begin 201,000 square foot ambulatory care center Fall 2010 Construction project completed FHCC opens

FHCC Governance Joint Executive Council (JEC) Health Executive Council (HEC) Joint Facilities Steering Group (JFSG) VHA Advisory Board BUMED Stakeholders Advisory Council VISN 12 FHCC SES VA Director Navy 06 Deputy NME Patient Services Patient Care Facility Support Dental Services Resources Branch Clinics = Management authority through Resource Sharing Agreement (RSA) = Operational Line of Authority = Communication and RSA Compliance = Military Reporting Relationship & Accountability Revised on 9/03/08 to reflect Branch Clinics

NCVAMC Organizational Chart

FHCC Great Lakes/North Chicago Milestones Timeline Jan 08 All Critical EDMs Ready for HEC/JEC Mar 08 All Policy EDMs Completed Oct 08 All Outstanding EDMs Completed Jul 08 All Critical EDMs Signed Mar 09 All Outstanding EDMs Signed April 08 FHCC CONOPS Oct 08 Other Policy Solutions added into CONOPS Mar 09 Other Policy Solutions added into CONOPS May 09 FHCC Advisory Board (Assembled) Jun 09 Major Business Processes Developed Nov 09 Executive Sharing Agreement Signed Jan 2010 FHCC Business Plan Completed Locally Jan 2010 Clinic level SOPs (detailed level) Jan 2010 FHCC Implementation Plan 1 October 2010 FHCC activated 12/11/08 9

Joint Incentive Fund Projects JIF projects Women s Health - $852K Mammography - $470K MRI - $3,426K Oncology - $685K Dedicated fiber optic connectivity - $248K Hospitalist - $403K Digital Radiography (PACS) $638K Project Management Support - $1,770K *Enterprise IM/IT Requirements - $11.3M

Captain James A. Lovell Federal Health Care Center Commissioning June 2010 Projected catchment: 135,000 beneficiaries (veterans, active duty, dependents, and recruits in northeastern Illinois and southeastern Wisconsin). 400 hospital beds (150 Acute Care) 900,000 projected annual outpatient medical 187,000 dental visits. Approximately 2800 FTEE Currently 1300 NCVAMC employees Currently 400 civilian and 1100 uniformed employees at NHCGL Staffing model under review FTE savings will occur with integration FY 07 budget for the NHCGL and NCVAMC is $350,000,000 which includes military personnel.

Captain James A. Lovell Federal Health Care Center 2010 12

Challenges/Change for Audiology Pediatrics Provision of Hearing Aid Services No reduction or expansion of services Test Protocols Audiologist/ENT Changes Additional audiologists ENTs currently contractors. Will have full-time ENTs.

Summary Progress accomplished to date can be attributed to extensive cooperation at all levels between VA and DoD. We have been given this opportunity to influence the future of federal health care. The goal is to establish processes which can be exported.

Questions?

Resources Naval Health Clinic, Great Lakes. VA/DoD Partnership Information http://greatlakes.med.navy.mil/default.htm http://greatlakes.med.navy.mil/va%20dod/va%20dod.html DoD VA Program Coordination Office (703-681-4258) www.tricare.mil/dvpco/default.cfm Heather.rudisill@va.gov