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Witness Testimony of Ms. Rica Lewis-Payton, FACHE, Veterans Integrated Service Network 16, Deputy Director, Veterans Health Administration, U.S. Department of Veterans Affairs

Mr. Chairman, Members of the Committee, and Members of the Louisiana delegation, thank you for the continued support the Congress has given the Department of Veterans Affairs (VA) in our rebuilding and recovery efforts not only in southeastern Louisiana but also the entire Gulf Coast region.  Thanks to your support, veterans and VA employees living along the Gulf Coast continue to make great strides along the road to recovery from the devastation caused by Hurricane Katrina.

Hurricane Katrina was one of the greatest natural disasters our Nation has ever faced.  Our medical centers, the communities we serve, and the homes of veterans and employees sustained destruction on a monumental scale.  Today, I will describe our ongoing health care restoration efforts in New Orleans, and the current status of plans to rebuild our VA medical center.  

The Southeast Louisiana Veterans Health Care System (SLVHCS) has made significant progress in the last year in meeting the health care needs of veterans in the greater New Orleans area.  With the support of Congress, VA accelerated the activation of Community Based Outpatient Clinics (CBOCs) in the areas proposed under the Capital Asset Realignment for Enhanced Services (CARES) program.  New CBOCs are now open in Slidell, Hammond, and St. John’s Parish, Louisiana.  Currently,

SE Louisiana is served by six permanent CBOCs.  Primary Care and general mental health services are offered at each of these locations.  Specialized mental health programs (including PTSD and substance abuse treatment) are currently provided and we are acquiring additional space to significantly expand these services.  Inpatient mental health care is coordinated with the Alexandria and Shreveport VA Medical Centers. 

Plans are progressing to lease space for additional specialty care and ambulatory procedures.  Patients requiring highly complex care are referred to other VISN 16 facilities or care is obtained within the community.   Pathology and laboratory services have been enhanced in the past year.  They are centralized at the Baton Rouge CBOC, Foster Avenue Division.  Outpatient pharmacy services currently exist at all our CBOCs and a $3.5M project to establish a new and enhanced pharmacy in New Orleans will be completed in November 2007.  A newly constructed Diagnostic Imaging Center will open on the New Orleans campus in September 2007, providing the full range of general radiology, CT and MRI capability.  Dental services are provided at the Baton Rouge clinic and were expanded in April 2006 by leasing space in Mandeville, Louisiana.  Currently there are no patients on the wait list for dental care.

In keeping with the national initiative to provide patient care in the least restrictive environment, SE Louisiana has tripled the size of its Community and Home-Based care programs.  This includes Home Based Primary Care (HBPC), telemedicine, contract community nursing homes and a unique “Hospital in the Home” program whereby teams of clinicians visit the patient in the home in order to shorten hospital stays or, if possible, avoid the need for hospital admission altogether.  This is just one example of how VA is reinventing care to meet the specialized needs of veterans post-Katrina. 

In June 2007, VA entered into an agreement with its affiliate, the Tulane University Hospital and Clinic to allow VA physicians to admit and manage the care of veteran patients in the Tulane hospital.  Veterans have responded very favorably to this “virtual VA inpatient” program because it allows them to remain near their families and support systems while being treated by their own familiar team of VA physicians and social workers.  To the best of our knowledge, this has not been done elsewhere in the country.

VA is using adaptability and flexibility to meet the needs of veterans during the recovery period from Hurricane Katrina.  Patients are grateful for the response by their government and are seeking care within the SLVHCS in record numbers.  SLVHCS has served almost 30,000 unique veterans through May 2007.  On average, 1,000 outpatients are seen in the CBOCs per day.  It is projected that by year end, more than 35,000 unique veterans will have been treated.  This is nearly 90 percent of the

pre-Katrina level.   

There are currently 76 physician residents compared to 120 before Hurricane Katrina.  In order to maintain the stability of the residency training programs and meet our obligation to educate America’s physicians, VISN 16 is working with its academic affiliates, The Tulane University School of Medicine and the Louisiana State University School of Medicine, to place VA faculty, medical staff and residents, and student trainees at VAMCs throughout the VISN 16 Network until such time as full and robust clinical programs return to the SLVHCS.  

VA continues to work as expeditiously as possible to initiate construction on our replacement medical center and has always been committed to building a new medical center in the Greater New Orleans area.  VA has initiated its space planning process in preparation for construction.  The analyses of architecture and engineering (A/E) firms to design the new facility are complete, and an announcement of the A/E selection will take place soon.  The replacement medical center is expected to provide acute medical, surgical, mental health and tertiary care services, as well as long-term care. 

VA and LSU have signed a Memorandum of Understanding (MOU) agreeing to jointly study state-of-the-art health care delivery options in New Orleans.  VA is pleased to learn of the State of Louisiana’s commitment of state funds for this project.  This collaborative venture has the potential to improve operating efficiencies for both institutions and, if designed properly, to contribute to reforms of the region’s health care system. The Collaborative Opportunities Planning Group’s (COPG) final report is to be presented by September 30, 2007.  VA will make a decision regarding the extent of its future collaboration with LSU after that report is completed.

While VA remains committed to exploring this partnership with LSU, delays have arisen.  To ensure these delays did not impact VA’s ability to reconstruct the VA Medical Center in a timely manner, VA initiated a search to identify alternative building locations.  This search resulted in two responsive offers.  An initial market survey of the two sites has been conducted, and further analyses are planned.  VA looks forward to completing this process and will make a decision on this site in the near future. 

Conclusion

Mr. Chairman, the Committee and the Louisiana delegation are partners with VA in seeing that southeast Louisiana veterans continue to receive the high quality health care they deserve and have come to expect.

The construction of our new medical center will be an important part of our commitment to uncompromised excellence in health care services for veterans in New Orleans.

Thank you for the opportunity to be here today.  I will be pleased to answer any questions you may have.