LVMAC Tidbit — Valley’s Top Healthcare Execs Bless “Healthcare in Our Community” Initiative as Active Partners

Lehigh Valley’s Health Care Executives Met July 19 Regarding Military/Veteran Health Care

On July 19, 2012, after six months of collaboration with representatives from all the major health care providers in the Lehigh Valley, the Lehigh Valley Military Affairs Council (LVMAC) hosted a luncheon meeting at Northampton Community College to present a “Health Care in Our Community” project status report.  The following chief executive officers of the Lehigh Valley’s hospitals attended this historic gathering:

• Coordinated Health:  Emil DiIorio, M.D., President & CEO
• Easton Hospital:   Brian Finestein, CEO
• Good Shepherd Rehabilitation Network:  Frank Hyland, Vice President
• Lehigh Valley Health Network:  Ronald (Ron) W. Swinfard, M.D., President and CEO
• St. Luke’s University Health Network:  Richard (Rick) A. Anderson, President and CEO
• Sacred Heart Hospital:  John Nespoli, President and CEO
• Westfield Hospital:  Yasin Khan, MD, CEO

In addition, the following agency representatives were also present:

• VA Medical Center – Wilkes Barre:  Mark A. Scinico, M.D., Assistant Chief, Medical Service
• Air Force Reserve Command; Office Of The Command Surgeon:  Lt Col Alexander Alex, MSC, MHA, Chief of Operations Branch & Reserve Health Benefits Consultant
• HealthNet Federal Services (TRICARE Manage Care Support Contractor):  Kathleen Frost, TRICARE Area Representative
• Victory House:  Pasquale (Pat) E. DiLuzio, Jr., Executive Director
• Heartland Home Health/Hospice:   Deb Arrandale, General Manager and Leslie Mackey, Regional Director of Operations
• Treatment Trends:  Diana Heckman, Program Development

A closed session with the executives, their designated Veterans Affairs Liaison Officers (VALOs), and other representatives was held from 12:00 noon to 1:30 pm in the Gates Alumni Hall and provided courtesy of Northampton Community College, 3825 Green Pond Road; Bethlehem, PA  18020.  “With about 50,000 military veterans plus their families living in Lehigh and Northampton counties, the goal of ensuring our veterans receive the best possible care is challenging but achievable, if we all work together. Veterans and their family members already actively seek the excellent medical care available in the Valley,” said Major General Jerry Still, USAF (Retired), the President of LVMAC, as he welcomed the attendees.

“We are truly blessed in having this level of community commitment to the cause of improving military and veteran health care,” stated Eric Johnson, LVMAC’s project leader and a U.S. Air Force Operation ENDURING FREEDOM veteran.  “Each and every one of you as CEOs, along with your participating organizations, has a deep rooted desire to help a uniquely diverse group of military veterans and their families.  We kicked off a project that built upon these already evident commitments and now have a network of VALOs working actively together to support the Departments of Veterans Affairs (VA) and Defense (DoD), and each other, to become even more successful in providing the best possible care to our veterans.”

Susan Geise, Care Manager for Good Shepherd’s Brain Injury Program, provided a briefing on mild traumatic brain injury (mTBI) and traumatic brain injury (TBI)—issues commonly affecting veterans from Operations IRAQI FREEDOM and ENDURING FREEDOM who were exposed to road-side bombs and other explosives.  Ms. Geise suggested that, “it is common for patients with brain injuries to present first with mental health symptoms such as depression.”  She added that, “an undiagnosed brain injury can result in such comorbid mental health symptoms as such patients experience difficulty in concentration and in completing normal, daily activies.  As they struggle with feeling mentally slower than usual or less competent, they become depressed and may utilize substances such as drugs and alcohol to cope.  The sooner we recognize the patient has an underlying brain injury, the sooner we can provide appropriate treatment and get them on the road to recovery.”

Lieutenant Colonel (Lt Col) Alexander Alex from the Air Force Reserve Command Surgeon’s Office and Ms. Kathleen Frost, TRICARE’s Area Representative from HealthNet, provided the attendees with an overview of the Active Duty, Guard, and Reserve military presence and health care demand in the Lehigh Valley.  Lt Col Alex also discussed various health care services used (particularly by the Reservists, the Guard and their families) and how they depend upon cooperation between TRICARE and local health care providers to access services.  His briefing was specifically tailored to this area – offering demographics on beneficiary population, density centers, and where opportunities exist for increased services.

He also spoke about future initiatives that will affect TRICARE users and encouraged community leaders to work in unison to prepare.  In closing, Lt Col Alex stated, “TRICARE’s involvement in the project is critical to expanding the TRICARE network in the area and potentially transforming the Lehigh Valley into a Prime Service Area for those Active Duty (or activated Reservists/Guard) eligible for such care.  TRICARE cannot exist in any community servicing military veterans without the dedicated efforts of civilian and government healthcare leadership and an ‘all in’ approach.”

Johnson then gave a brief overview of the project mission, vision, and goals which set up the briefings which followed.

Working Group Members Briefed on Initial Project Recommendations:

Mr. Peter Schweyer, Director of Community and Government Relations for Sacred Heart Hospital and VALO, briefed on the first visible result of the effort.  “All the participating health care providers are now linked through a formally designated Veterans Affairs Liaison Officer (VALO) in each organization,” he said.  It was an important first step because it allowed the conversation to truly begin about the importance of veteran-unique health care delivery requirements and how best to fulfill them through more integrated partnerships.  The VALOs and their meetings have been the foundation upon which the LVMAC health care project has been built.

Johnson, who is also the VALO for the Lehigh Valley Health Network, then gave the executives the results an initial assessment of existing and proposed (future) veteran- and military-unique service provisions in their organizations.  He pointed out that demands for health care seem to be increasing, not decreasing, despite the passing of the World War II generation. He remarked, “It is seemingly counter-intuitive with a decreasing total veterans population, but nevertheless the increased demand is real and the expectations for service higher.”

St. Luke’s University Health Network representatives Kate Raymond, Coordinator of Marketing Outreach Services and Robert Murphy, Associate Vice President of Planning and Business Development, briefed on the Screening and Identification Project.  In November 2011, the project VALOs recommended that hospitals and other significant health care providers should actively screen for/pre-identify veterans and military members at patient points of entry.  Over the past several months, the project leaders for this portion of the overall project have explored the best way to ask the question, the challenges and associated training requirements associated with implementing such procedures, and the benefits anticipated.

Mrs. Raymond and Mr. Murphy reported, “The most significant benefits anticipated are an improved ability to tailor care to veterans that potentially have service-unique needs, and the ability to examine/understand the volume of veteran/military patients served in the civilian health care sector.”

The project’s medical-legal and risk management consultants stated there are no Federal or State regulations/standards that require uniquely different medical care for a person identified as a veteran in the civilian health care setting.  However, VALOs and risk management personnel agree that formal identification of veterans in the patient registration process and/or the medical record should be preceded by clinician/staff education and training.  As a result, the VALOs asked the CEOs to support the VALO recommendation that each area hospital/health care provider:

• Support the objective of screening/pre-identifying veteran patients
• Identify a system to capture data
• Not start the system until training is completed
• Determine their own thresholds for “ready to begin” capturing veteran status

Johnson emphasized, “In order to provide the best possible care and other social services to this community, we need to know who the veterans are when they hit our many points of entry.  Once we know they are veterans, we can better ensure service-connected injuries are addressed and the appropriate coordination with the VA and other government health care providers is accomplished.”

Heartland Home Health, Hospice and IV Services’ Alternate VALO, Janet Daly, then provided an update on the most ambitious VALO project to date:  the development of a “ Comprehensive Resource Guide for Military/Veteran Health Care.”  Ms. Daly said, “This document will help clinicians and other medical staff throughout the valley better navigate the myriad of health care resources available to support the veteran and his/her family.”  Ms. Daly added that the VALOs have recommended this resource guide contain the following sections:

• Section 1 – Clinician/Provider Resources
• Section 2 – Financial Counselor Resources
• Section 3 – Case Management/Social Work Resources
• Section 4 – VALO Contact Info

Executives Gave Go Ahead to Proceed:

The executives were then invited to respond to the project report.  They were also asked to support the LVMAC health care effort as full and active partners working together.  Rich Hudzinski, Chairman of the Veterans Committee, under which this project falls, then reviewed what they had agreed upon:

• To institutionalize the VALO concept  (a definition of roles and duties will be necessary as we go along; continue monthly meetings and project work)
• To implement procedures to screen for and identify veteran patients to assist in appropriately tailoring/rendering care … and in collecting useful health care utilization data
• To help create the Resource Manual (we will be looking to obtain clinician, social worker, etc. feedback on what would be most helpful; manual will be a hard copy and possibly an intranet product; LVMAC is willing to bear printing cost)
• To introduce clinician/non-clinician education and training opportunities to improve health care personnel competency in providing veteran/military health care
• To agree to reconvene as an Executive Steering Committee in about six months for a project strategic update (January 2013)

President of LVMAC  Thanked the Participants and Spake to the Media:

In opening the meeting to the media, Major General (retired) Gerald Still, LVMAC President, made these concluding remarks:

I want to personally thank this working group of chief executives from all of the health networks and also our other participants for coming today.  It has a been a remarkable occasion and, as I said previously, an historic one because – while our representatives have met monthly to begin the process – it marks the first time we, as Executives, have all sat down together to review how we can better help our returning service members, past generations of veterans, and also their families, in achieving the dream that – when it is needed – no veteran is left behind once his or her duty is done.

 We all have heard of the high rates of Post Traumatic Stress (PTS) and depression among service members and their families, of the alarming rates of suicides of both deployed and non-deployed service members and also veterans.  And while true, they only underscore the fact more can be done locally if those resources we have among us are ‘tapped into’ better for these and other areas of health risk.  It is important we do so, for the wars we now fight are heavily dependent upon the use of Reserve Component forces.  Indeed a large number obtain their health care through the civilian medical establishment.

 And then, there are those who return from Active Duty service, who return without benefit of unit support such as a Guard or a Reserve unit provides.  They need more attention, not less, as has often been the case, for they typically see the heaviest of the combat action.  Plus, let’s not forget we are still making up for the past neglect of Vietnam veterans in their health concerns.

 Therefore it is wise and fitting, that we come together like this as a community — in which we include the VA and Department of Defense establishments — to better address what our local military veterans community have been experiencing.

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As of 19 July 2012