• FUTURE of HOLDERMAN HOSPITAL

Aerial View of Holderman Hospital Taken by Home Member, Bill Sturgeon

FUTURE of HOLDERMAN HOSPITAL

Dear Blurbers:
Ever since I arrived at the Home, I have had a special love for Holderman Hospital, its history and mission.  Perhaps due to me being a medical corpsman in the Air Force and later working as an emergency room nurse, I have been interested in hospitals - or maybe because I have spent so much time working in them.  Anyway, we are in a time where significant changes are happening with Holderman Hostpital and I think it is important that, 1) we are kept informed regarding developments affecting Holderman Hospital, and, 2) that we ALL have a say and opportunity to express our views about the future of our hospital.

There was an informational meeting scheduled for July 31, 2009 at Holderman Hospital to be held by the California Senate Veterans' Affairs Committee that I knew nothing about, which was apparently cancelled at the last notice. 

While I do not know enough about the issues to make a decision or recommendations, I have done an internet search which brought up the following articles for your review.

In reviewing these, keep in mind some key issues, which are: quality of care vs. cost of care, convenience for Members, Members desires vs. the State's decisions, and, care at Holderman Hospital vs. care at Queen of the Valley or St. Helena Health Care Center.  Another question that I have is: What is the future of Holderman Hospital?

Please let me know your feedback, ideas and concerns and I will post them.  Regardless of the "politics" involved, the decisions made WILL affect US!
~Miles Whitley, Website Owner

 

Weekly Calistogan

 

End to acute care for vets is just wrong

By Joanne C. Fox [M.D.]

Tuesday, August 11, 2009

Changes at the Veterans Home in Yountville are going to adversely affect the availability and quality of medical care. With the closure of the acute ward, 1 South, in Holderman Hospital all acute care services at the Veterans Home will be eliminated.

One South is located on the grounds of the Veterans Home. This convenient location allows our frail, elderly, sick World War II, Korean and Vietnam veterans quick access to essential and life-sustaining medical care. Because of 1 South, our veterans can have “come and go” procedures, such as cystoscopies, colonoscopies, esophago-gastric-duodenoscopies, blood transfusions and GI clean-out procedures. It is also used for telemetry for irregular heartbeat, observation after falls, observation for acute alcohol intoxication, dehydration, chest pain, seizures, acute respiratory problems, stabilization for cardiac arrest and there is an isolation room for possible communicable diseases. The closure of 1 South will require that our weak, elderly residents will be transferred to other acute hospitals, often unnecessarily.

Currently we offer 24-hour on-site physician coverage. With the closure of 1 South, the regular staff of doctors for nights, weekends and holidays will be eliminated. These positions are referred to as MODs. Instead, the physicians who work during the day will be contacted at their homes. Some of these physicians live great distances from the Veterans Home and work long hours. We have been told by administration that we will no longer have an MOD on grounds to assess the critical medical needs of our patients. Instead, this responsibility will fall on the shoulders of an already overworked and stressed nursing staff, who, despite their skills, do not have the years of training and expertise to assess high-risk situations that physicians do. The nurse will then contact the day physician by phone to address extremely serious and complicated medical problems. So instead of receiving assessment and care by highly trained doctors, our elderly, frail, sick veterans will be transported by ambulance via 911 call to the emergency room of the nearest hospital. We all know what it is like to wait in an ER when you are sick. It is traumatizing to the patient and highly compromising to quality medical care.

Along with the elimination of 1 South, there are also plans to close the laboratory at the Veterans Home. The laboratory is essential for physicians and other medical personnel to do their jobs with safety and competency. Veterans Home lab techs will no longer run the lab tests on our veterans. Instead, they will be replaced by lab personnel outside the Veterans Home. The outside lab techs will draw the blood and send the results to the Veterans Home staff by paper copy instead of obtaining immediate computer medical data. The outside/community hospital computer doesn’t “talk to” the Veterans Home computer system. In this age of advanced technology it is unacceptable and unethical to use these archaic methods for our veterans. Valuable time will be wasted, time that could save lives. Important medical information will be lost. There will be destruction of electronic medical records. Physicians and pharmacists will have to walk great distances to the wards to review a patient’s “paper chart” instead of having computer technology available to make life-saving decisions in a timely manner. Diminished lab services will delay evaluations when patients are acutely ill and will decrease the ability to provide timely care.

As of this date it is unclear how radiology service, currently staffed by on-site technicians, will be provided. Because of these changes the tools we need to take care of our patients will be eliminated. Veterans do not deserve this.

(Fox, a medical doctor, lives in Napa.)

- COASTAL POST ONLINE -
MARIN COUNTY'S NEWS MONTHLY - FREE PRESS
(415) 868-1600 - (415) 868-0502 (fax)
P.O. Box 31, Bolinas, CA, 94924
- JULY 2009 -
California Veterans Affairs Slashes Medical Care 
for Napa Valley Vets
UAPD Protests Physician Layoffs and Planned Unit Closure at Yountville Veterans' Home.
Staff and residents of the Yountville Veterans' Home, administered by the California Department of Veterans' Affairs (CDVA), were given word just before the Memorial Day holiday that CDVA plans to close the acute care unit (1-South) of the home's Holderman Hospital. CDVA put its plan in motion by issuing layoff notices for half of the home's Medical Staff last week. If allowed to proceed, the layoffs and unit closure would severely compromise the quality of medical care given to the 1,100 veterans who reside at the home, according to representatives of the Union of American Physicians and Dentists (UAPD), which represents the physicians and dentists that provide patient care there. Moreover, according to UAPD, the short-term savings generated by these cuts would be dwarfed by the long-term costs associated with providing the veterans' medical care in area private hospitals.
Eight UAPD-represented doctors employed by the Veterans' Home were sent layoff notices last week, in addition to several physician-managers, a number much larger than what state-mandated budget cuts require. The layoff notices followed a proposal last month by the local Strategic Planning Committee to close 1-South, which the Governing Body, which includes the Secretary of Veterans' Affairs, later approved. Yountville Veterans' Home Administrator Marcella McCormack has cited the need to save on staff costs as the primary motivation for the closing of 1-South.
"The CDVA is using the budget cuts as an excuse to close down this acute care unit and cut other medical services, which it has wanted to do for a long time," states UAPD President Stuart Bussey, MD, JD. "But this is one of the largest groups of veterans in the country, and they need the care that this unit and these physicians provide. Providing that care on-site is actually much more affordable." By going forward with the large number of physician layoffs, UAPD asserts, the CDVA is doing a de-facto unit closure without following proper procedures or allowing community involvement. UAPD is encouraging citizens to contact their local state legislators to voice their concern about the CDVA's decision. 
UAPD estimates that closing 1-South and laying off physicians will cost the State about $11 million in lost reimbursement revenue each year, compared to a savings of about $4 million in staff time. The Veterans' Home will also incur the costs of treating the residents at area hospitals, as well as the costs of transporting them back and forth to outside facilities. 
Physicians worry that veterans who are accustomed to receiving medical care at the home will not be able to maintain the same treatment plans if required to travel, resulting in more serious complications. In emergency situations, particularly on nights and weekends, the cuts would cause a dramatic rise in response times and decline of care. 
CDVA administrators made no mention of the cuts at the Memorial Day festivities hosted at the Veterans' Home. 
Founded in 1884, the Yountville Veterans' Home is the largest state-run veterans' home in the country, and houses the nation's largest group of World War II veterans, many of whom require advanced medical care. 
* * * * * *
Thursday, June 11, 2009
UNION OF AMERICAN PHYSICIANS AND DENTISTS
PROTESTS PHYSICAN LAYOFFS AND PLANNED UNIT
CLOSURE AT YOUNTVILLE VETERANS' HOME
by Robert L. Weinmann, MD
In a masterpiece of timing just before Memorial Day, staff and residents of the Yountville Veterans' Home were told that the California Department of Veterans' Affairs is closing the acute care unit of the home's Holderman Hospital. Layoff notices have been sent.
1,100 veterans who reside at the home are being ignored as though they didn't exist, like battle-worn boots that saw their best days at Bastogne, or maybe somewhere in Korea or Vietnam. Eight layoff notices were received by doctors represented by the Union of American Physicians and Dentists (UAPD). Yountville's Home Administration office explained that the state needs to save money. Evidently, slicing medical care from veterans is California's preferred choice.
Stuart A. Bussey, MD, JD, president of the UAPD, declared that the California Veterans Affairs Department (CVDA) "is using the budget cuts as an excuse to close down this acute care unit and cut other medical servces, which it has wanted to do for a long time."
Bussey stated that the Yountville facility "is one of the largest groups of veterans in the country, and they need the care that this unit and these physicians provide." Bussey pointed out that providing equivalent care off-site will increase costs and that the premature layoffs are a thinly disguised method of unit closure before the actual closure.
This action by the state reportedly will save California about $4,000,000 in staff time. No mention was made about the $11,000,000 annual lost reimbursement to the state. No mention was made about the shoddy treatment shoved down the throats of America's veterans. No mention was made of the shame this move bestows on California.
The UAPD states that the CDVA is not following proper procedures such as allowing community involvement and advises concerned citizens to register protests with state legislators.
www.Politicsofhealthcare.blogspot.com points out that the State of California, simultaneously with this cutback to veterans, panders to the insurance industry and willingly foregoes fees that could be paid by out-of-state utilization review doctors (see stories about AB 933, Fong) to the benefit of California's coffer.
* * * * * * *

UNION OF AMERICAN PHYSICIANS AND DENTISTS
-- Press Release --
For Immediate Release
Thursday, May 28, 2009
Contact: Sue Wilson, 510-926-0408 (cell), 510-510-839-0193 (office), swilson@uapd.com
California Department of Veterans Affairs Slashes Medical Care for Napa Valley Vets
UAPD Protests Physician Layoffs and Planned Unit Closure at Yountville Veterans’ Home Staff and residents of the Yountville Veterans’ Home, administered by the California Department of Veterans’ Affairs (CDVA), were given word just before the Memorial Day holiday that CDVA plans to close the acute care unit (1-South) of the home’s Holderman Hospital . CDVA put its plan in motion by issuing layoff notices for half of the home’s Medical Staff last week. If allowed to proceed, the layoffs and unit closure would severely compromise the quality of medical care given to the 1,100 veterans who reside at the home, according to representatives of the Union of American Physicians and Dentists (UAPD), which represents the physicians and dentists that provide patient care there.  Moreover, according to UAPD, the short-term savings generated by these cuts would be dwarfed by the long-term costs associated with providing the veterans’ medical care in area private hospitals.
Eight UAPD-represented doctors employed by the Veterans’ Home were sent layoff notices last week, in addition to several physician-managers, a number much larger than what state-mandated budget cuts require. The layoff notices followed a proposal last month by the local Strategic Planning Committee to close 1-South, which the Governing Body, which includes the Secretary of Veterans’ Affairs, later approved. Yountville Veterans’ Home Administrator Marcella McCormack has cited the need to save on staff costs as the primary motivation for the closing of 1-South.
“The CDVA is using the budget cuts as an excuse to close down this acute care unit and cut other medical services, which it has wanted to do for a long time,” states UAPD President Stuart Bussey, MD, JD. “But this is one of the largest groups of veterans in the country, and they need the care that this unit and these physicians provide. Providing that care onsite is actually much more affordable.” By going forward with the large number of physician layoffs, UAPD asserts, the CDVA is doing a de-facto unit closure without following proper procedures or allowing community involvement. UAPD is encouraging citizens to contact their local state legislators to voice their concern about the CDVA’s decision.
UAPD estimates that closing 1-South and laying off physicians will cost the State about $11 million in lost reimbursement revenue each year, compared to a savings of about $4 million in staff time. The Veterans’ Home will also incur the costs of treating the residents at area hospitals, as well as the costs of transporting them back and forth to outside facilities. Physicians worry that veterans who are accustomed to receiving medical care at the home will not be able to maintain the same treatment plans if required to travel, resulting in more serious complications. In emergency situations, particularly on nights and weekends, the cuts would cause a dramatic rise in response times and decline of care.
CDVA administrators made no mention of the cuts at the Memorial Day festivities hosted at the Veterans’ Home.
Founded in 1884, the Yountville Veterans’ Home is the largest state-run veterans’ home in the country, and houses the nation’s largest group of World War II veterans, many of whom require advanced medical care.
* * * * * *


UNION OF AMERICAN PHYSICIANS AND DENTISTS
July 31, 2009
Doctors Fight to Save Medical Care for Veterans
Late on Thursday, July 30th, UAPD was notified of the cancellation of the planned Senate Hearing in Yountville.  It appears progress is being made on talks between the Committee and the Governor's office--UAPD will release details as they become available.    

Staff and residents of the Yountville Veterans’ Home, administered by the California Department of Veterans’ Affairs (CDVA), were given word just before the Memorial Day holiday that CDVA plans to close the acute care unit (1-South) of the home’s Holderman Hospital . CDVA put its plan in motion by issuing layoff notices for half of the home’s Medical Staff. If allowed to proceed, the layoffs and unit closure would severely compromise the quality of medical care given to the 1,100 veterans who reside at the home.  Moreover the short-term savings generated by these cuts would be dwarfed by the long-term costs associated with providing the veterans’ medical care in area private hospitals.

Founded in 1884, the Yountville Veterans’ Home is the largest state-run veterans’ home in the country, and houses the nation’s largest group of World War II veterans, many of whom require advanced medical care.
* * * * * *


• If you hear additional information or of scheduled meetings
or have other pertinent information, please contact me at: 
Miles@VetsOrg.org.  Thanks!