"I have thoroughly enjoyed my stay in Central Texas," Husson said in a phone interview. "I have been accustomed to having a cadre of kind, caring and compassionate staff."

Husson, director of the Beckley, W.Va., VA Medical Center, and a team of three others came last month to oversee changes in long-term care in the system that operates hospitals in both Temple and Waco. The system also operates outpatient clinics in Waco, Temple, Marlin, College Station, Brownwood, Austin, Cedar Park and Palestine.

Husson said last month his team was acting on recommendations from VA officials who had previously visited the long-term care facility in Temple.

The Olin E. Teague facility was the focus of a VA medical inquiry that began after a hospital employee worked with a reporter from ABC's "Primetime Thursday" by conducting an investigation at the nursing facility with a hidden camera.

Adam Pockriss, an ABC spokesman, declined comment on whether the television newsmagazine was working on a story about problems at the Temple VA facility.

VA officials in Washington said a report has been issued as a result of the internal investigation. The Tribune-Herald filed a federal Freedom of Information Act request on Thursday with the VA to gain access to that report.

Husson and his team ordered, among other changes, new beds and a homestyle look for long-term care floors. These include new beds that are lower to the floor and easier for older patients to lie down upon.

In addition, alarms will alert personnel when certain elderly patients go past a certain point on the floor.

Most of the physical changes stem from looking at living facilities with an eye toward a long-term care setting instead of a hospital.

"The long-term care at the Temple site is housed in what was originally built for acute care," Husson said.

He also said matters as simple as calling those in long-term care "residents" instead of "patients" are part of the differences being implemented.

Residential floors for those in long-term care will get names reflecting a homier touch, such as "Chisholm Trail" and "Bluebonnet Patch."

Staffing was also evaluated during the Husson team's visit. He said training was one aspect of ensuring quality staff. So was adding personnel.

"We are looking at 40 staff members being added with the highest acuity of nursing home needs," Husson said.

While most of the additional staff would go to Temple, others would care for long-term residents at the Waco VA Hospital. Those additions will depend on decisions to be made by VA Secretary Anthony J. Principi on recommendations by the independent Capital Asset Realignment for Enhanced Services Commission, or CARES.

The commission recommended 117 long-term care beds remain at the Waco VA Hospital. However, the majority of remaining Waco VA inpatient beds in the 250-bed facility with psychiatric, post-traumatic stress disorder and blind rehabilitation patients would go to Temple.

Meanwhile, the outpatient clinic at the Waco hospital would be moved off campus to somewhere in the Waco area and combined with patients from Marlin, the commission recommended.

The VA uses a combination of inpatient long-term care services, contract nursing home care and state veterans homes to care for older veterans.

"I think it is agreed that there is a need for all these options," said Jeff Smolker, a spokesman for the American Health Care Association, an advocacy group for long-term care.

Veterans age 85 and older are expected to increase from 640,000 to 1.3 million by 2012, according to a Government Accounting Office report.

Follow the chronicles of their progress of their performance improvement plan as the Waco Tribune covered it by clicking here

The Veterans Health
Programs Improvement Act of 2004

Below is a brief summary of benefits to veterans and their families in accordance to H.R. 3936. To view the bill please use the VVA legislative action center on the VVA website at http://www.vva.org/ click on “government relations” or http://thomas.loc.gov/

Sec.201 Assistance For Hiring And Retention Of Nurses At State Veterans' Homes - The Secretary shall make payments to States under this section for the purpose of assisting State homes in the hiring and retention of nurses and the reduction of nursing shortages at State homes.

Sec. 202 - Treatment Of Department Of Veterans Affairs Per Diem - Payments To State Homes For Veterans shall not be considered a liability of a third party, or otherwise be used to offset or reduce any other payment made to assist veterans.

Sec. 204. Prohibition On Collection Of Copayments For Hospice Care. - Eliminate copayments for veterans receiving hospice care furnished by VA.

Sec. 301. Sexual Trauma Counseling Program - Permanently authorize VA’s sexual trauma counseling program. (VVA 04 legislative and policy initiative)

Sec. 302 - Requires the VA to establish the Centers For Research, Education, and And Clinical Activities On Complex Multi-Trauma Associated With Combat Injuries. provide for the improvement of the provision of health care services and related rehabilitation and education services to eligible veterans suffering from complex multi-trauma associated with combat injuries.

Sec. 412. Annual Report To Congress On Inventory Of Department Of Veterans Affairs Historic Properties. (a) In General- Not later than December 15 of 2005, 2006, and 2007, the Secretary of Veterans Affairs shall submit to the Committees on Veterans' Affairs of the Senate and House of Representatives a report on the historic properties administered or controlled by the Secretary.

Sec. 414. Limitation On Implementation Of Mission Changes For Specified Veterans Health Administration Facilities. The Committees on Veterans' Affairs of the Senate and House of Representatives requires a written notice from the Secretary of before any mission changes occur on the following facilities; The Department of Veterans Affairs medical centers in Boston, Massachusetts; The Department of Veterans Affairs medical centers in New York City, New York; The Department of Veterans Affairs medical center in Big Spring, Texas; The Carl Vinson Department of Veterans Affairs Medical Center, Dublin, Georgia; The Department of Veterans Affairs medical center in Montgomery, Alabama; The Department of Veterans Affairs medical center in Louisville, Kentucky; The Department of Veterans Affairs medical center in Muskogee, Oklahoma, and the outpatient clinic in Tulsa, Oklahoma; The John J. Pershing Department of Veterans Affairs Medical Center, Poplar Bluff, Missouri; The Department of Veterans Affairs medical center in Ft. Wayne, Indiana; The Department of Veterans Affairs Medical Center in Waco, Texas and The Jonathan M. Wainwright Department of Veterans Affairs Medical Center, Walla Walla, Washington.

The following sections of the new law must be adhered to by the VA before any mission changes occur to the above facilities:

(d) Covered Mission Changes- For purposes of this section, a mission change for a medical facility shall consist of any of the following: (1) Closure of the facility. (2) Consolidation of the facility and (3) An administrative reorganization of the facility covered by section 510(b) of title 38, United States Code.

(e) Required Content of Notice of Mission Change- Written notice of a mission change for a medical facility under subsection (a) shall include the following:

(1) An assessment of the effect of the mission change on the population of veterans served by the facility; (2) A description of the availability and quality of health care, including long-term care, mental health care, and substance abuse programs, available in the area served by the facility; (3) An assessment of the effect of the mission change on the economy of the community in which the facility is located; (4) An analysis of any alternatives to the mission change proposed by--

(A) the community in which the facility is located; (B) organizations recognized by the Secretary under section 5902 of title 38, United States Code; (C) organizations that represent Department employees in such community; or (D) the Department. (f) Medical Facility Consolidation- For the purposes of subsection (d)(2), the term `consolidation' means an action that closes one or more medical facilities within a geographic service area for the purpose of relocating those activities to another medical facility or facilities. (g) Coordination of Provisions- In the case of a mission change covered by subsection (a) that is also an administrative reorganization covered by section 510(b) of title 38, United States Code, both this section and such section 510(b) shall apply with respect to the implementation of that mission change.

Sec. 602. Inventory of medical waste management activities at Department of Veterans Affairs health care facilities - The Secretary of Veterans Affairs shall establish and maintain a national inventory of medical waste management activities in the health care facilities of the Department of Veterans Affairs.

Sec. 603. All enrolled veterans among persons eligible to use canteens operated by Veterans' Canteen Service.

Sec. 604. Annual reports on waiting times for appointments for specialty care - Not later than January 31 each year through 2007, the Secretary of Veterans Affairs shall submit to the Committees on Veterans' Affairs of the Senate and the House of Representatives a report on waiting times for appointments for specialty health care from the Department of Veterans Affairs under chapter 17 of title 38, United States Code, during the preceding year.

"Jim Nicholson is a patriot, a man of deep conviction, who has answered his country's call many times," Bush said of his nominee.
Nicholson has been ambassador to the Holy See in Vatican City since August 2001.
"Jim has worked with the Vatican to advance many vital foreign policy goals, including fighting poverty, hunger, AIDS, expanding religious liberty around the world and ending the brutal practice of human trafficking," Bush said.
Nicholson was chairman of the Republican National Committee from 1997 to 2000. He was an Army Ranger and a paratrooper during the Vietnam War.
Nicholson said his experiences as a cadet at West Point and as a soldier "have defined my life, shaped my abilities and my desire to serve."
"Our military is the pride of our country, " he said. "We can't pay them enough to do the things that we ask of them: the sacrifices, the separations, the heroics.
"They answer the call for one reason: Their country needs them. Our country depends on them, and they have never, ever let us down. We must not let them down either."
The Department of Veterans Affairs is the second largest in the federal government. The secretary is in charge of 219,000 personnel, responsible for a nationwide system of health care services, benefits programs and national cemeteries for U.S. veterans and dependents.
The Senate must confirm Nicholson's nomination. Confirmation hearings have been scheduled for Margaret Spellings, nominated for education secretary, on January 6, and Condoleezza Rice, nominated for secretary of state, on January 18-19.
The White House also said Thursday that Bush had asked Labor Secretary Elaine Chao, Interior Secretary Gale Norton, Transportation Secretary Norman Mineta and Housing and Urban Development Secretary Alphonso Jackson to remain for his second term, and all agreed to stay.
Nine of 15 Cabinet secretaries have announced plans to leave the administration.
Principi submitted his resignation letter to Bush on November 16, saying it is "time to move on" for him personally and praising the president for giving veterans "dramatic increases to quality health care."
The president lauded Principi on Thursday, saying that veterans and their families have seen many improvements in veterans services under his leadership.
"Tony Principi has made it the department's highest priority to assist veterans with service-related disabilities, low incomes and other special needs," Bush said.
"[He] has shown himself to be an outstanding executive, a friend to his fellow veterans and a good-hearted man. I'm proud of his service."
Principi, 60, did not give a reason for his resignation but said that after four years of dedicated service "it is now time for me to move on to fresh opportunities and different challenges."

Bush Administration Steps On the Gas

VA Budget Crunch Cancels Surgeries : Part one and Part Two

Portland VA Budget Crunch Cancels Surgeries

About the Author

Larry Scott (former E-5) served four-plus years in the U.S. Army

with overseas tours as a Broadcast Journalist at AFKN HQ, Seoul, Korea and AFN Lajes Field, The Azores, Portugal and a stateside tour as a Broadcast Journalism

Instructor at the Defense Information School (DINFOS). Larry was decorated four times including the Joint Service Commendation Medal with Oak Leaf Cluster.

He was awarded DOD's First Place Thomas Jefferson Award for Excellence in Journalism. After the Army, Larry went back to radio news, working in Indianapolis

as a News Anchor on WIFE Radio and then in New York City as a News Anchor on WNBC Radio. He receives VA compensation for a service-connected disability

and uses the Portland, Oregon/Vancouver, Washington VA facilities for healthcare. Today, Larry resides in Southwest Washington and operates the veteran's

help website YourVABenefits.org. To contact Larry Scott email

larry@yourvabenefits.org.

Author's View

Earlier this year the VA announced findings for CARES (Capital Asset Realignment for Enhanced Service), with plans to build new facilities and programs.

At the same time, three VA hospitals were closed. Does the good news outweigh the bad news? In a May 2004 article posted on the VFW website, then-VFW National

Commander Edward S. Banas, Sr. supported the CARES program, stating, "The VFW fully understands that the closing or consolidation of some facilities may

inconvenience some veterans, but the VA has offered reassurances that no veteran will be denied or have their health care delayed during the transition."

Mr. Banas must be very disappointed, as are the veterans served by the Portland VA who have been "denied" needed surgery or been told there will be a "delay"

before a medically necessary procedure can be performed.

The real problem is under-funding of the VA. While the VA could not have been expected to anticipate this "dramatic increase" in patients, and it goes begging

for proper funding every year, Congress sits idly by and lets this problem grow geometrically. This problem could be solved once and for all with full

and mandatory funding for VA health care.

Don't let your VA facility be the next Portland, the next victim of under-funding. Register to vote. Vote your conscience for the candidates who you feel

will properly fund the VA. Let your friends and neighbors know we need their help with more than just words. Write your local newspaper about your concerns.

Call, write or email your elected representatives (and those running for office), and let them know millions of veterans will hold them accountable for

their votes. Demand a vote on pending legislation instead of letting it fall victim to partisan brawling because we must have full and mandatory funding

for VA health care. Call me an optimist, because I am. I know we can change this frightening situation. With one simple piece of legislation the VA could

be funded properly. We did it for a war! We can do it for our veterans who have fought the war.

September 7, 2004

[Have an opinion on this article? Go to the

Discussion Forum

to sound off.]

[Update, September 13:

Surgeries Back On]

By Larry Scott

In the last few weeks the Portland, Oregon VA hospital has been sending a letter to veterans informing them that their non-"life-or-limb" surgery has been

cancelled or postponed. The Portland VA facility, with a satellite campus in Vancouver, Washington, serves veterans in Oregon, southwest Washington and

parts of Northern California.

It all boils down to dollars, or lack of them. The Portland VA, like every VA facility, is caught in a funding crisis with no end in sight. Funding for

the VA has increased every year, Internet myths aside. But the dollars have not kept up with the number of veterans seeking health care. While VA funding

has increased about 50 percent in the last eight years, the number of veterans applying for benefits has increased nearly 150 percent in the same time

frame.

Who are these veterans? There are two major groups. The first is veterans who, because of a sagging economy, are now unemployed or under-employed, have

no health care benefits, have never used the VA system before, and are now applying for VA benefits for the first time. The second is veterans on Medicare

who have never used the VA for health care, but find the savings offered by the VA system necessary to maintain a decent standard of living. Simple math

shows that the $7 VA co-pay for prescriptions can be a great savings compared to Medicare prescription costs. One veteran interviewed for this article

stated he is saving over $400 a month because he no longer uses Medicare for his prescriptions.

Patricia Forsyth, Public Affairs Officer for the Portland, Oregon VA hospital, cites "a dramatic increase in the number of veterans" who now seek health

care as the reason surgeries are being cancelled or postponed. "Some examples of surgeries that might be postponed are arthroscopies (diagnostic or treatment),

total joint replacements and hernia repairs," she said.

Ms. Forsyth could not give exact figures as to how many veterans are having surgeries postponed or cancelled, but stressed that no surgeries for service-connected

conditions are being affected. It is important to note that there is no such thing as elective surgery at the VA. Every surgery has been scheduled by a

medical doctor who has ascertained that the veteran has a debilitating condition that can only be remedied by a surgical procedure.

Ms. Forsyth cannot anticipate when the cancelled or postponed surgeries might be rescheduled other than to say it would be as soon as possible. When asked

for an estimate as to what time that would be, Ms. Forsyth said, "I would guess until spring [2005]." It is a difficult situation, as 2004 monies have

thinned to the point where the Portland VA cannot keep its operating rooms up and running. Currently there is no 2005 budget and everyone is holding their

breath, hoping for the best. A document leaked from the White House indicated a $910 million cut in the 2006 VA budget (although the administration has

backed off on this number).

Part two : Portland Veterans Affairs Medical Center has reversed a decision to postpone surgeries:

Portland Veterans Affairs Medical Center has reversed a decision to postpone surgeries for about 100 patients, a cost-saving measure that would have

denied care to people needing procedures such as hernia operations or joint replacements. The move might have gone unnoticed if a Vancouver, Wash., veteran

hadn't posted a copy of the letter about the decision on his Web site.

Larry Scott, a partially disabled veteran who maintains a Web site designed to help veterans navigate the federal agency's labyrinthine bureaucracy, received

an anonymous copy of the letter in mid-August.

"The first thing I did was verify the authenticity of the letter," Scott said. "But nobody could give me numbers on how many went out."

The blank form letter he posted was dated July 28 and signed by James Edward's, chief of surgery.

"I regret that your surgery scheduled for [blank) must be postponed. We apologize for the inconvenience and frustration this may cause you," the letter

begins.

It goes on to explain that an increase in the demand for care forced the hospital to prioritize:

"To provide these urgent surgeries, we have had to temporarily reduce the amount of operating room time available to treat those conditions that are not

life-or-limb threatening. This has resulted in cancellation or postponement of many cases such as yours."

After posting the letter on his Web site, Scott started spreading word about it on various military bulletin boards. He eventually received a call from

Military.com, a Web site devoted to military issues, and was asked to write a story about it, which appeared in the site's Sept. 7 newsletter.

By Sept. 8, Scott said, "All heck broke loose." He started fielding e-mails from all around the country from veterans who had experienced similar problems

or who were afraid of being denied care because of financial cutbacks.

The Military.com story also caught attention in Washington, D.C., where staff from the office of Rep. Nancy Pelosi, D- Calif., alerted Oregon Rep. Peter

DeFazio's staff, who contacted the Portland Veterans Administration office to find out more about the agency's budget problems, DeFazio spokeswoman Kristi

Greco said.

Both Scott and DeFazio received an e-mail from the Veteran Affairs Washington office on Friday stating that the Portland decision to postpone care had been

reversed.

A spokeswoman at the Veterans Affairs Northwest Health Network Office in Vancouver, Wash., confirmed the change.

"In retrospect, the decision was premature," spokeswoman Megan Straight said.

The initial letters went out three weeks ago to nearly 100 patients, she said.

None of those whose surgeries were postponed were in any danger of dying or in extreme pain, she said. The agency was responding to an enormous increase

in demand for services, she said.

But the postponed surgeries weren't elective, either, and another spokeswoman for the VA who spoke with Scott earlier in the week gave examples such as

hernias or joint replacements as the kind of procedures that were being postponed.

Letters and phone calls will be made to the veterans whose procedures had been postponed, allowing them to reschedule, Streight said.

Meanwhile, the national VA office will be reviewing the Portland hospital's budget and finding additional resources to help with funding, according to the

e-mail sent to Scott and DeFazio from the VA's deputy assistant secretary for public affairs in Washington.

Scott, who has received care for the past 18 years for a service-connected injury to his hands, said the Veterans Administration is staggering under an

influx of people seeking care for the first time.

The economic downturn has sent newly unemployed veterans who once had health benefits from their employers to the VA, Scott said.

"These are vets that haven't used the system before," he said.

And senior citizen veterans are learning that they can get much cheaper prescription medicine through the VA than through Medicare, he said.

"You have a ton of vets that qualify that are straining the system," Scott said.

The additional pressure from injured soldiers coming home from the Iraq war is only beginning to be felt, he said.

"My brothers and sisters over there fighting a war, their biggest battle is going to be with the Veterans Administration for health care," he said.

The quality of care isn't the problem. It's top-notch, Scott said. "It's just a matter of working your way through the bureaucracy."

Support: Military.com  and keep up with the latest news  on  our  Veterans and those that are now serving.

WASHINGTON * U.S. Rep. Sue Kelly today introduced legislation that would restore equitable veterans funding to Northeast veterans health care facilities before recommendations of the CARES Commission are implemented, including the transfer of some inpatient services from the FDR Montrose campus to the Castle Point campus of the Hudson Valley VA Hudson Valley Healthcare System.

"If the VA wants to relocate our veterans from Montrose to Castle Point, then the funding needs to come first," Kelly said.

Kelly's legislation notes that the Veterans Equitable Resource Allocation (VERA) formula, implemented in 1997, has proven to be an ineffective means of fairly allocating veterans medical care dollars across the country. A General Accounting Office study found that, through 2002, the current VERA formula misallocated nearly $1 billion in funding that previously would have been awarded to Northeast veterans hospitals, instead sending the funds to the South and Southwest.

"The VERA funding allocation system has robbed Northeast veterans of critical federal financial support," Kelly said. "The VA Secretary's final decision on CARES, which reduces veteran health care options in the Hudson Valley by transferring some inpatient services out of Montrose, further demonstrates the inequities imposed by VERA on New York veterans.

"I continue to oppose the VA Secretary's final decision," Kelly added. "My legislation would postpone the proposed transfer of patients from Montrose to Castle Point until the inequities of VERA are fixed. This critical funding issue must be addressed first in order to make the CARES decision more endurable for our Hudson Valley veterans."

Kelly's bill * the SAVE U.S. VETS Act ("Securing Access to Vital Entitlements for U.S. Veterans") * would limit the VA Secretary from implementing any recommendation in the CARES Commission report that would eliminate or severely reduce a medical service for veterans until the VERA allocation system is replaced with a new, more equitable formula for the allocation of VA funding.

"The VA needs to properly fund this transfer plan before it happens," Kelly said. "We need to restore equitable funding to our veterans in Hudson Valley before the VA starts rearranging their services."

Download the Bill as it was presented to Congress by clicking here you will need a copy of Adobe Reader to open the file.

U.S. Rep. Sue Kelly has expressed an interest in the Veterans Advisory Council and will be meeting with it's representatives in the near future.