September 16, 2014

A meeting of the Texas Hill Country Veterans Council was held on September 16, 2014 at the Kerrville Chamber of Commerce. Attending the meeting were:

Vicki Marsh, President
Bill Bacon, First Vice President
David Rittenhouse, Second Vice President
Members Bill Cantrell, Emilio Rendon, Maggie Baker
Paul Gregory, Chief Administrative Officer Kerrville VA
Guests Susan Junker and Gary Powers

The meeting was called to order at 0905 by President Marsh.

The first issue on the agenda was the status of the Green Team Pact Doctor. Paul Gregory said they had had no success to date in finding a new MD but they did have approval to do an overhire for the position which means that he can go over budget in his attempts to find someone.

Emilio Rendon told Paul Gregory that some veterans involved with his KVA group have complained that services ordered or referred by an MD are being rejected by non-medical personnel. Paul Gregory said they are doing extensive peer reviews to check records. Vicki Marsh said that if the referral or medical order are not input into the patientís record, the administrative personnel can do nothing about it. Since personal records are readily available it is up to the veteran to review the notes of his visit and make sure everything is complete.

Vicki Marsh said she was very disappointed in the amount of publicity for the Mental Health outreach program. She said that some veterans are uncomfortable with doing outreach for mental health. Paul Gregory said he would take the responsibility for the lack of publicity. Bill Bacon suggested that for the next outreach program, if the VA will print adequate flyers, the veterans can take them around the area and have them put up in windows of businesses.

Paul Gregory said that the 1st floor construction was complete. The VA will submit a PSA to local media detailing the changes. Emilio Rendon asked about empty offices on the 1st floor. Paul Gregory said there were only three empty offices as of that day and that they were being filled on the next day.

Vicki Marsh brought up telehealth in Dermatology. Paul Gregory said that tele-Health in this instance is where a technician takes photos of the patient and sends them to the Dermatologist. Further Vicki Marsh asked which services were being conducted by tele-Health. Paul Gregory replied amputee support, audiology, poly trauma, ekg and retinal exams. Sleep clinic is in the near future.

Vicki Marsh asked about dental hygiene. Paul Gregory replied that the new hire wanted a full time position, and KVA was not yet prepared to offer full time employment. He said we are in no danger of losing the position and they are actively pursuing new applicants.

Vicki Marsh said that service connected dental requirements are growing. Paul Gregory said that the STVHCS has a residency program that is largest in the VA nationally.

Vicki Marsh said the Mental Health Clinic appeared to have good staffing. Paul Gregory replied that the guide is 6.6 to 7.5 clinicians to 1,000 patients. This means we should have 7 personnel in the clinic. Of these 3 are Licensed Individuals, 2 are non-licensed and 2 are administrative of which we have one vacancy. We also currently have 1,380 unique encounters. This counts the specific problems not the encounters. For example, an individual patient may have 2 separate problems he is dealing with. At the same time, he may be seen for these problems on multiple occasions. The 2 problems are counted in the unique encounters. The multiple sessions do not count. Paul Gregory said that Dr. Costello is the mental health representative for the PACTs. A psychologist is coming on board to assist in the GEM clinic. Dr. Mary K Johnson (AMVAMC) is the local recovery coordinator. Dr. Senter is checking current unique encounters vs last yearís numbers.

In neurology, Paul Gregory said that no qualified applicants have come forward. Some patients are getting non-VA referrals and they are notified on their reminder cards.

Fay Mencey has come to KVA in Occupational Therapy.

Paul Gregory said that they are still trying to understand the workload for the Patient Advocateís position.

Dr. Kimberly Addis is the new Imaging Manager and Charles Stamper is the new imaging business manager.

Vicki Marsh asked about the wiring that caused the black out last month. Paul Gregory said that the faulty switch was replaced as well as water tight fittings that leaked.

Dr. Rockwood will be coming to KVA on Wednesdays to perform cystoscopy.

Vicki Marsh asked about the swallowing clinic to which Paul Gregory replied that they were unable to man the clinic but a permanent position was coming.

Vicki March asked about the status of the call center. Paul Gregory said that it is now called the Consolidated Out Patient Appointment Center and they are in the process of expanding their staff.

Paul Gregory said he had no answers for pregnant females requiring colonoscopies.

A Stakeholders (MAC) meeting is scheduled for Wednesday 24 September at 1000 hours.

Emilio Rendon asked if it was possible to have first aid training for the visit vet group.

Paul Gregory said that they had no plans yet for the 5th floor.

Paul Gregory exited the meeting.

The Council then discussed the issues relating to hiring practices for the VA and what possible solutions may be available.

The council also mentioned the issue of Council members who no longer are active and do not attend meetings. It was decided that Bill Bacon would contact Ashmore, Ledford and Dr. Dan Bacon. Vicki Marsh would speak with Jackson, Barker and Kinley.

The meeting adjourned at 1030 hours.

Taken by Bill Bacon

Comments to us or the V. A. would be greatly appreciated.