HILL COUNTRY (TEXAS) VETERANS
The Hill Country Veterans Council (HCVC) met with management of the
South Texas Veterans Health Care System (STVHCS) in Room 147 of the
Kerrville VAMC on February 18, 2015. The meeting began at 1100
The senior spokesman for the STVHCS was Mr. Joe Perez, Assistant
Director, and principal staff including Mr. Paul Gregory, Senior
Administration Officer of the Kerrville VAMC.
Representing the HCVC were President
Vicki Marsh, Vice President Bill Bacon, Members Maggie Baker and
Gary Noller. Other VSOs represented were VFW Kerrville, American
Legion Bandera, Fredericksburg and Kerrville, Military Order of the
Purple Heart Kerrville. Others attending were Gillespie County VCSO,
and Veteran Outreach. A total of 15 veteran representatives were
Mr. Perez began the meeting saying that the 2014 STVHCS budget was
$627m but ended at $645m. The FY 2015 budget is set for $609m. The
decrease is due primarily to the impact of the Choice Act diverting
some expenses to other budgets.
Construction at KVA continues with the canteen canopy which is now
completed. The VA Police will be moving to the Education BLDG to
allow for more space for the mail- out pharmacy program. When asked
how many new employees the new pharmacy would employee, no one from
STVHCS had the answer. Landscaping will be completed by the end of
February 15. It is not only a beautification project but is meant to
replace old, worn out plumbing and improve drainage away from the
building. Five new construction projects are beginning that focus on
infrastructure such as HVAC. Paul Gregory will provide more details
at the next meeting ot the HCVC.
Secretary MacDonald visited the STVHCS Audie Murphy. According to
Mr. Perez, the meeting went well. The Secretary has reorganized the
reporting system of the VA into 5 regions defined by state lines.
Mr. Perez did not have any answers as to how the system will work
considering some VISNs (16 and 18 for example) cross state lines.
They don't know all the specifics and but have a June date for
The Veterans Choice Card has been mailed to most veterans in the
area. There are not a lot of answers yet, but the program goes
through a third party administrator, in our case Tri West. One issue
related to this program is that the VA loses control of the
information learned by the providers so that the veterans' records
lose continuity and become incomplete. There is a portal that can be
used but it is limited to 350 patients. There are currently 92
providers under contract in the western and northwestern areas of
STVHCS including 19 in Kerr County. They did not have that
information for Gillespie Co or Medina Co. The information seemed to
be incorrect in that 42 providers were in Crockett County (The
County Seat is Ozona, and it is one of the lesser populated counties
in Texas) In addition there was only one provider in Real Co which
was a marriage counselor. Enrollment in Care must be "clinically
indicated" by the veteran's Patient Aligned Care Team (PACT) doctor.
Specialists in Choice Care are called Choice Champions. For
Kerrville VA, they are Paul Gregory and Terry Garza.
Dr. Calvin Leuschen brought up that
the Providers in the PACTís may see a patient for only about 5
minutes. Then the Doctor must input the information he learned from
that visit into the computer to insure that no information is lost.
This may take up to fifteen minutes. The Choice program allows for
only one visit that is clinically indicated. This means the Veteran
is allowed to see a contract provider who then must relay the
information to the PACT Team so the Doctor on the team can input the
information into the veteran's file and make such action as deemed
necessary such as referrals for diagnostic tests. Therefore, the
Doctor saves the 5 minutes of patient visit time, but is required to
double his/her administration time.
Several veterans mentioned that the information being sent by the VA
is too detailed and complicated to be understood by many of the
veterans. Simplification was requested. In addition a suggestion was
made to create an advisory committee comprised of Veteran Service
Officers from the San Antonio area to review information before it
is mailed out. Mr. Perez said that seemed like a very good idea.
The issue of large panels was broached due to the lack of Providers
in the PACTS. Mr. Gregory said that the holes in care were being
filled by mid-level providers and contract/ providers.
President Marsh asked about a full-time patient advocate, but was
told that this medical facility and others in San Antonio do not
have them. Rather all patient advocates are located at Audie. Paul
Gregory does keep track of complaints that he and Terry Garza handle
The authorized overhire facilitates replacement for the Blue Teamís
Dr. Chatham who retires soon. The special recruiter Mr. Youngblood
promised to have a name for the Green Team doctorís replacement in
March. The neurologist position is still being advertised because
VAís salary for one is not competitive with the private sector.
A replacement for the Executive Manager will be on board in May and
a replacement has been identified for the Dental Hygienist. STVHCS
is working on a start date for the audiology technician. An
optometrist from Data Point comes 2 days a week. Mr. Gregory will
clarify if another one is also coming on those days.
Regarding optician services available every Tues., Mr. Gregory will
find out if the same access applies to the Kerrville Campus as it
does to the Data Point Clinic.
Hours for the Release of Informationís office are temporarily
mornings only while the position is under review.
A speech pathologist has been identified and VA is awaiting
acceptance on its offer.
The census remains about 75. That includes the 20-bed transitional
care unit. Once the new Executive Manager is on board, then more
nursing staff can be added and trained. Current staffing levels
limit the census.
The next MAC meeting is scheduled for April 29, 2015.
Comments to us or the V. A. would be greatly appreciated.