From the Senator's Desk . . .
June 26, 2008
As El Paso adjusts to the incredible growth at Fort Bliss, area leaders have made a concerted effort to determine how to improve United States Department of Veterans Affairs (VA) facilities in our region. The information below outlines the current veterans healthcare system in El Paso.
Written by Senator Eliot Shapleigh, www.shapleigh.org
"Veterans Healthcare in El Paso"
As El Paso adjusts to the incredible growth at Fort Bliss, area leaders have made a concerted effort to determine how to improve United States Department of Veterans Affairs (VA) facilities in our region. The information below outlines the current veterans healthcare system in El Paso, the type of facility most appropriate for El Paso, and the VA medical facility selection process.
Overview of VA medical facilities
There are several types of medical facilities operated by VA. VA Medical Centers are hospitals where surgery and overnight admissions would occur. There are also Outpatient Clinics and Community Based Outpatient Clinics (CBOC). A CBOC is usually a satellite of either a hospital or another clinic and is the smallest type of healthcare facility operated by VA. Vet Centers principally assist veterans with readjustment issues through group therapy and counseling. Finally, State Veterans Homes provide assisted-living and day health care.
VA Health Care Systems (VAHCS) are a system of any of the above, while a Veterans Integrated Service Network (VISN) is the umbrella organization for all healthcare facilities and systems in a geographic area. Each VISN organizes the funding for the 5 to 10 VA Medical Centers it includes. Within the VISN there is a full range of care for the veteran, acute care to long term care. El Paso is part of VISN 18, which includes Arizona, New Mexico, the western portion of Texas, and bordering counties in Colorado, Kansas, and Oklahoma.
Current VA healthcare system in El Paso
There are six VA Health Care Systems in Texas, including El Paso. Each includes a variety of facilities, although most include a parent facility that is a VA hospital. In the El Paso VAHCS, however, the parent facility is a large Outpatient Clinic. There is one satellite clinic associated with it, the CBOC in Las Cruces. (Note that, although the El Paso Clinic is labeled a Medical Center, it is not a full hospital.) There is also a Vet Center in El Paso.
The El Paso clinic has 20 primary care doctors and 30 specialists to handle about 23,000 patients. Each primary doctor currently works about eight hours a day and has a panel size of 1,200 patients. Its services include dental work, primary care and dermatology. (For a complete list of services, click here.) It has eight operating rooms, two procedure rooms and sixteen recovery beds.
The El Paso system offers inpatient care for acute emergencies through a bed sharing agreement with William Beaumont Army Medical Center. Through the joint venture, VA purchases emergency room service and inpatient care for acute medical, psychiatric and surgical emergencies and through referrals to community and other VA medical facilities.
Need for a VA medical center in El Paso
There are two primary reasons why a VA medical center is needed in El Paso: the unavailability of certain services and expected growth in the area's veteran population.
A number of services are not currently available at the El Paso clinic. The nearest VA Hospital is the New Mexico VA Health Care System in Albuquerque, about 230 miles away. Some of the services veterans might travel to Albuquerque for include chiropractic care, mental health/substance abuse, stroke and rehabilitation, and emergency care. (For a list of services available in New Mexico, click here.) In 2007, a total of 915 veterans were referred to other VA facilities in Tucson, Iowa, Big Spring, Houston, Phoenix, Dallas, Los Angeles and San Antonio.
Nearest VA Hospitals to El Paso
Additionally, the veteran population is El Paso is large and likely to continue growing. The 2000 Census shows that about 52,000 veterans live in El Paso County, with another 15,000 in nearby Doña Ana County. According to 2007 data from the VA, the catchment area (the area supposed to be served by the clinic) has more than 76,300 veterans.
In addition to the current population of veterans in El Paso, BRAC-planned growth for Fort Bliss will bring 28,000 additional soldiers to El Paso by 2012. Many of these people are likely to stay in El Paso beyond the soldier's active duty, increasing the veteran population further.
Click here to view larger image.
Proposal for El Paso
The El Paso hospital should be a research hospital. Research hospitals provide the same care as service hospitals, but also conduct medical research and teach medical students. For example, the Atlanta VAMC is a teaching hospital and it conducts medical research. Medical research includes gene therapy for bone diseases, rehabilitation medical engineering, and health service research.
Research hospitals are often affiliated with a local university. The El Paso Hospital should be connected to the Texas Tech University Health Science Center-El Paso (TTUHSC-EP) medical school and campus hospital. The VA has established 5,000 affiliations with over 1,200 educational institutions. Other university-based VA hospitals include Houston (Baylor), Los Angeles (UCLA), and West Roxbury/Boston (Harvard). Each year, over 100,000 trainees nationwide receive clinical training in VA facilities. Clinical trainees at VA facilities include future physicians, dentists, nurses, pharmacists, and social workers.
A number of benefits that come with this type of affiliation. According to the VA, working with universities and medical schools has a substantial impact on the current and future health workforce of the VA healthcare system and the nation. Involvement with these institutions contributes to excellence in patient care, recruitment and retention of VA healthcare staff and the enhancement of the learning environment. The research these hospitals conduct with the universities provide cutting edge advancements in care for veterans and the nation.
VA medical facility selection process
Currently, states do not play a role in deciding where a VA medical facility is located, but they do provide information and statistics to support the claim that such a facility is needed.
The normal process for selecting a VA medical facility is for the VA to conduct a study of an area regarding whether such a facility is needed. Those studies are initiated by the secretary of the VA or a member of Congress. Generally, a member of the veterans affairs committees of either branch of Congress may make a formal request to the VA secretary to conduct a study of a certain area for a future VA medical facility site. The study may take into account various factors, including veteran populations and the amount of resources that are needed and that are currently available for that area.
For example, the Booze Allen Hamilton Inc. study, The VA Health Care Study for Inpatient and Specialty Outpatient Services in the South Texas Valley-Coastal Bend Market, used the following methods for developing recommendations for the possible selection of a Health Care Center in Harlingen:
- Conducted a market-based analysis that considered current and future demand for inpatient and specialty outpatient care based on a 30-year planning horizon;
- Determined the currently supply of VA and non-VA health care resources available to address future demand requirements;
- Developed a broad array of service delivery options, including both inpatient and specialty outpatient solutions, based on future demand projections, available health care resources, and veteran and stakeholder input; and
- Recommended the best options for the VA to consider based on quantitative and qualitative assessments.
The study may be viewed in its entirety by clicking here.
A study will provide the basis for recommendations to the VA secretary. The VA secretary or the President has the authority to make a formal request to Congress to construct a new facility. The decision to pursue construction of a new VA medical facility resides with Congress's house and senate veterans affairs committees and with the full Congress which has to approve and enact such a legislative measure. The VA medical facility acquisition legislation then must receive appropriated funds in the VA's budget.
The County of El Paso Commissioners Court recently wrote the region's federal legislators to request an independent study on the needs of El Paso, citing the fact that the previous study is now outdated when the growth associated with BRAC and Grow the Army are considered. Click here to review the County's letter to Congressman Reyes; here for the letter to Congressman Rodriguez; here for the letter to Senator Hutchison; and here for the letter to Senator Cornyn.
Conclusion
By 2013, El Paso and Fort Bliss will be host to an estimated 37,000 active military and 47,000 veterans, with an additional 13,000 veterans living in nearby Doña Ana County, New Mexico. As one of the largest gainers of servicemembers in the 2005 round of BRAC, El Paso and Fort Bliss deserve the top level of medical care available. As America’s leading Future Combat System base, it’s time for the El Paso-Fort Bliss-Southern New Mexico area to have a full VA hospital.
Very truly yours,
Senator Eliot Shapleigh
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