VA Employees, Veterans, Fight Hospital Closures

Kim Bolen RN CCM ACM Here in Kansas, they kept closing hospitals and cutting staff and currently the best any civilian can hope for is a 3 day stay to detox or a mandatory 72 hour hold to determine competence to stand trial. We have put the cost of psychiatric care into the cost of the law enforcement system, frustrating everyone. They pick them up, the intake coordinator does an evaluation, a resident or Doctor may be called to do an Initial assessment and provide a diagnosis and orders if he/she determines they are necessary. Patients who aren't handcuffed have become combative, signed out AMA or lied their way back out. If I google average dally hospital cost per patient for each state, we can get a good guess at the cost. Law Enforcement transports to a civilian hospital unless they have information that tells them transport to a VA facility is necessary and not cost/time prohibitive for them. They are stretched too thin, also. Just listening to the news the other day, there is over a $15K pay difference between Sherriff and police working in the same area and firefighters are walking off the job because of lack of pay. (might as well take a seat, soapbox: you want the preacher or the choir badge?) SP5 Mark Kuzinski Col Val Finnell, MD, MPH do you have time to weigh in on this?

I certainly hope that if this proposal is accepted that they have done a gap and seam analysis to ensure all veterans in need of care are covered PO2 Kimberly Miller before they shutter any facilities.
Like any national federal business model, the VA and the US Congress which provides oversight and fund control must reassess at times based upon distribution of facilities and constituents.
Example, every 10 years there is a national census. After that Congressional seats are reapportioned based on where the people are.
The USPS went through a significant business model change and on a lesser scale AMTRAC did as well. I think the USPS business model is more applicable to VA than AMTRAC.
If the VA intends to serve all disabled veterans a public-private partnership model makes sense. The public portion would be in high density areas of disabled veterans. The private model should be focused on lower density areas. A proof of principal should be included in the design process; Example: (1) identify a VA facility targeted for closure; (2) Develop a private model contract to provide required services; (3) develop process to share medical records for specific veterans with the private model solution business which must be vetted thoroughly (4) execute the short term contract with caveat that if successful it would be extended and expanded; (5) turn off VA facility support for an area of supported disabled veterans and have the private model provide medical service; (6) run for 6 months and evaluate; (7) assess, expand or modify as necessary.
Thanks for tagging me COL Mikel J. Burroughs

Kim Bolen RN CCM ACM Great post. Let me see if I can some feedback from group of expert connections.
LTC Stephen C. LTC Stephen F.CPT (Join to see)CMSgt Mark SchubertLTC John Shaw Sgt Aaron Kennedy, MS COL Ted McPO1 John Miller SSG James J. Palmer IV aka "JP4" SN Greg Wright1LT Christopher SorgePO2 Ed C.SrA Christopher WrightPO3 Michael JamesLCDR (Join to see) SMSgt Minister Gerald A. "Doc" ThomasCapt Christopher Mueller SP5 Mark Kuzinski