ORDER N0.28444
RESOLUTION OF SUPPORT FOR
KERRVILLE VA FACILITY
On this the 8`h day of December, 2003 upon motion made by Commissioner
Williams, seconded by Commissioner Letz, the Court unanimously approved by
a vote of 4-0-0, a Resolution of support for retention of 20 acute beds and 5 ICU
beds at the Kerrville VA Facility as requested by the Hill Country Veterans
Council and authorize the County Judge and Commissioners to sign same and
include sending this resolution to all of these various people mentioned in the
final resolve.
d ~ y~'~
COMMISSIONERS' COURT AGENDA REQUEST
PLEASE FURNISH ONE ORIGINAL AND NINE COPIES OF THIS REQUEST
AND DOCUMENTS TO BE REVIEWED BY THE COURT.
MADE BY: William H. Williams OFFICE: Commissioner, Pct. 2
MEETING DATE: December 8, 2003 TIME PREFERRED:
SUBJECT: (Please be specific). Consider, discuss and take appropriate
action on a Resolution of support for retention of 20 Acute Care beds and
5 ICU beds at the Kerrville VA facility as requested by the Hill Country
Veterans Council.
EXECUTIVE SESSION REQUESTED
NAME OF PERSON(S) ADDRESSING THE COURT: Commissioner Williams, Gen. Walter
Schellhase.
ESTIMATED LENGTH OF PRESENTATION: 5 Minutes
IF PERSONNEL MATTER-NAME OF EMPLOYEE:
Time for submitting this request for Court to assure that the matter is posted in
accordance with Title 5, Chapter 551 and 552, Government Code, is as follows:
Meeting scheduled for Mondays: 5:00 P.M. previous Tuesday
THIS REQUEST RECEIVED BY:
THIS REQUEST RECEIVED ON:
All Agenda Requests will be screened by the County Judge's Office to determine if adequate
information has been prepared for the Court's formal consideration and action at time of Court
meetings. Your cooperation is appreciated and contributes toward your request being addressed
at the earliest opportunity. See Agenda Request Rule adopted by Commissioners Court.
Resolution
WHEREAS the major purpose of the CARES process is to recommend to the Secretary of Veterans
Affairs Anthony J. Principi how to realign VA assets to provide improved service to veterans
throughout the United States; and
WHEREAS Kerrville VA Hospital has adequate space for not only the current 20 Acute Care beds and
the 5 ICU beds but sufficient space to accommodate 20 or more additional beds as requested
by the Hill Country Veterans Council that represents over 16,000 Veterans in the Texas Hill
Country; and
WHEREAS transferring Kerrville VA Hospital Acute Care beds to Audie Murphy VA Hospital in San
Antonio will not improve service to these 16,000 Texas Hill Country Veterans; and
WHEREAS the cost per day for an actue care bed in Kerrville is $870., one of the lowest in the emtire
VA system, and far below the daily cost at Audie Murphy, and at the present time many Acute
Care patients are being sent from San Antonio to Kerrville due to the overcrowded conditions at
Audie Murphy; and
WHEREAS when given a choice between Kerrville and Audie Murphy, the veteran will always select
Kerrville because of the well trained, dedicated, professional staff and the quality of service
provided; and
WHEREAS a construction project at Audie Murphy to accommodate the 25 Acute Care/ICU beds now in
Kerrville will cost millions of dollars and cannot be completed before the veteran population
starts to decrease according to the VISN 17 figures; and spending millions on expansion in San
Antonio when space for additional beds in Kerrville is readily available is a wasteful use of
American Taxpayer money; and
WHEREAS all statistics used by VISN 17 and STVHCS show that the veteran population will continue
to increase until the year 2008-2010; while the proposal to build new facilities in San Antonio
will not be complete and ready for use until the year 2012, after the veteran population starts to
decrease, rendering this proposal unacceptable; and
WHEREAS the Kerrville VA Hospital is a major employer in the Texas Hill Country, and any reduction
In service to veterans will have a negative impact on the local economy; now therefore be it
RESOLVED the Kerr County Commissioners' Court does hereby urge all concerned to recommend to
Secretary Principi that the Kerrville Facility Acute Care beds not be transferred to San Antonio,
and consideration be given to immediately add an additional 20 Acute Care beds to the Kerrville
Facility to relieve the over-crowded conditions at Audie Murphy; and be it further
RESOLVED that copies of this Resolution be forwarded to The Honorable Kay Bailey Hutchison, The
Honorable John Cornyn, The Honorable Lamar S. Smith, The Honorable Henry Bonilla, The
Honorable Arlen Specter, The Honorable Christopher H. Smith, and the Honorable Rob
Simmons.
ADOPTED this 8~ Day of December, 2003.
HILL COUNTRY VETERANS COUNCIL
CONGRESSIONAL INPUT ON ACUTE BEDS
AT KERRVILLE VA HOSPITAL
FACT SHEET
BACKGROUND
In December 2002, The Hon. Anthony J. Principi, Secretary of Veterans Affairs, established the CARES
(Capital Assets Realignment for Enhanced Services) Commission to review all assets in the VA Health Care
System and recommend to the Secretary as to how these assets may be realigned to provide improved service
to veterans.
South Texas Veterans Health Care System (STVHCS) formed a CARES committee to provide input on this
area. The STVHCS CARES Committee recommended "all assets remain unchanged at the Kerrville VA
Hospital".
VISN 17 (the VA region that includes South Texas) formed a CARES Review Team to review input from all
of its stakeholders. VISN 17 rejected STVHCS's recommendation and recommended that "all acute-care
beds at the Kerrville VA hospital be transitioned to holding beds in conjunction with proposed construction
at the Audie Murphy VA hospital". VISN's recommendation includes an $11 million construction program to
be implemented of the next 4-6 years at Audie Murphy to accommodate 30 new acute-care beds.
VISN recommendations are included in the Draft National CARES Plan, sent to the National CARES
Commission. The Commission is to provide an objective, independent review of the draft and submit a
recommendation to the Secretary for his decision. The draft national plan is available at
~~«,~.C_ARISco_mmision _~a.„ov. The final plan will be posted on this site by December 15, 2003. However,
the CARES Commission has released information prior to the final report stating, "the 20 acute beds should
be moved as quickly as possible to Audie Murphy. Waiting unti12012 is unacceptable", according to
panel member Chad Colley. Therefore, based on an AP news release dated 22 Nov. '03, the CARES
Commission has already made their decision regarding Kerrville -move the beds to San Antonio.
The CARES Commission has conduct public hearings and site visits to solicit views from interested parties
and obtain public input that will give the Commission a better understanding of the VA health care system
before making their recommendation to the Secretary. There have been two hearings regarding Kerrville and
one site visit by the Commission. The Hill Country Veterans Council opposes VISN recommendations for
Kerrville and supports STVHCS's recommendation.
The Hill Country Veterans Council further recommends that Kerrville be given 20 additional acute-care beds,
that surgical services be restored and that waiting time for appointments and waiting time to see a doctor be
improved with addition of more specialists in areas such as urology, orthopedics, podiatry, surgery, audiology
and ophthalmology.
FACTS
1. Spending $11 million at Audie Murphy to accommodate acute-care patients now cared for in
Kerrville is not needed. Space is available in Kerrville. Such expenditure would be an injustice to
the taxpayer.
2. Turning the acute-care beds in Kerrville to holding beds in no way will improve care for veterans
-the basic purpose of the CARES process.
3. Parking already is a serious problem at Audie Murphy and would become much worse with any
type of acute-care bed expansion at Audie Murphy.
4. The VA is a major employer in the Hill Country and any reduction in service to veterans in this
area would have a major and negative impact on the economy.
5. No private hospital in the area has the capacity to provide acute-care beds if they were not
available at the VA.
6. Space is available for the existing 20 acute-care beds and the five intensive-care beds in the
existing facility.
7. Parking is never a problem in Kerrville.
8. The cost per day for an acute-care bed in Kerrville is $870.00 -- is one of the lowest in the nation
and far below the cost at Audie Murphy and the average of all VISN 17 hospitals.
9. Kerrville has awell-trained and dedicated professional and service staff.
10. Veterans drive through San Antonio and to Kerrville for treatment when allowed to do so.
11. The VA sometimes sends acute-care patients to Kerrville because Audie Murphy is full
12. Often, Kerrville patients needing specialty care cannot be sent to Audie Murphy because acute-
care beds are not available. They must be held in acute-care beds in Kerrville, sent to University
Hospital in San Antonio or go to a private hospital at their own expense.
13. Kerrville has more than 70 acres for expansion; Audie Murphy is landlocked.
14. Kerrville VA has strong support from the professional community. When Audie Murphy cannot
provide needed specialty care, local professionals are contracted to provide it.
15. The Hill Country Veterans Council urges the CARES Commission to support expansion of service
in Kerrville and not an unneeded $11 million building program at Audie Murphy.
16. To improve veterans health care service must be: accessible, affordable and available.
17. The VA must reduce waiting time for appointments, reduce waiting time to see a doctor
after appointments have been made and provide more accessible specialty care.
18. The stagtistics used by VISN 17 to amve at their decision to transfer the Kerrville VA
hospital acute beds to Audie Murphy are rather interesting. VISN 17 predicts a substantial
increase in requirements for primary care in South Texas from a 2001 base line of over
212,000 veterans that will require health care to nearly 278,000 in 2012 and then a slight
decrease to 256,000 to the year 2022.
19. Based on a projected veteran increase to the year 2012, VISN 17 selects to transition the acute
beds in the Kerrville VA hospital to Audie Murphy.
20. VISN 17's study shows that Audie Murphy VA hospital does not have the capacity to
accommodate Kerrville's 20 acute beds and other acute bed requirement due to the opening of
more VA clinics in the San Antonio areas. Therefore, VISN 17 recommends the building of a new
acute bed wing at Audie Murphy
21. There are no proposed plans for any construction at Audie Murphy at this time. Therefore, VISN
17 projects that it would take about 4-5 years to get a project approved and another 2 years for
construction. Hence, the new 30 acute beds would come on line in the year 2009 or 2010, only
two years before their projected decline in veteran count in the year 2412.
22. Opening more clinics in the STVHCS will create an additional require for acute beds. It is a well
established fact that each 20 to 40 patients seen in a clinic will refer at least one patient to Audie
Murphy for an acute bed. Many of these patients now come to Kerrville VA hospital is given a
choice.
23. STVHCS has recommended and supported by VISN 17 to remodel the Audie Murphy acute beds
suites with 4 beds to 2 bed suites. This will put an additional requirement for more acute beds.
There is no specifics as to how many acute beds will be eliminated by this remodeling.
24. Based on VISN 17's recommendation Audie Murphy must provide for 20 beds from Kerrville, at
least 12 from additional clinics, and 15 to 20 from the remodeling, yet VISN 17 proposes a
construction project for only 30 that will not come on line until 2009 or 2010.
The Hill Country Veterans Council urges that you contact the following in support of maintaining the 20
acute-care and five ICU beds in Kerrville, add an additional 20 acute beds to relieve the current shortage at
Audie Murphy, and add the specialty care needed at Kerrville:
The Honorable Anthony J. Principi
Secretary of Veterans Affairs
810 Vermont Ave. NW
Washington, DC 20420
Phone: 202-273-4800
Fax: 202-
e-mail: irttps:j/iris.va.~ov
The Honorable Kay Bailey Hutchison
Room 284 SR
United States Senate
Washington, DC 20510
Phone: 220-224-5922
Fax: 220-224-0776
e-mail: senator~'u-hutchison.senate.
The Honorable John Cornyn
Room CS SR
United States Senate
Washington, DC 20510
Phone: 202-224-2934
Fax: 202-228-2856
e-mail: cornyn.senate.gov/contact.efm
The Honorable Lamar S. Smith
Room 2231 RHOB
United States House of Representatives
Washington, DC 20515
Phone: 202-225-4236
Fax: 202-225-8b28
e-mail: w~~~ti.housr~o~/writcrep
The Honorable Henry Bonilla
Room 2458 RHOB
United States House of Representatives
Washington, DC 20515
Phone: 202-225-4511
Fax:202-225-2237
e-mail: ~«~~~.house.go~/~~riterep.
The Honorable Arlen Specter, Chairman
Committee on Veterans' Affairs
Room 711 SH
United States Senate
Washington, DC 20510
Phone: 202-224-4254
Fax: 202-228-1229
e-mail: arlen ~~ecterrut, specter.senate~o~~
The Honorable Christopher H. Smith, Chairman
Committee on Veterans' Affairs
Room 2373 RHOB
United States House of Representatives
Washington, DC 20515
Phone: 202-225-3765
Fax: 202-225-7768
e-mail: w~~w.house.~~ov~«riterep
The Honorable Rob Simmons, Chairman
Committee on Veterans' Affairs
Sub Committee on Health
Room 215 CHOB
Washington, DC 2051 S
Phone: 202-225-2076
Fax:20Z-225-4977
e-mail: ~~a~~.hcx~se.~~o~isimmonsiima/send-email.htmf
SAMPLE LETTER
For
CONGRESSIONAL MEMBERS
This letter is not to be duplicated. This is a draft letter for you to use, as a guide in the prepazation of you own letter using the FACT
SHEET as background material letter using the FACT SHEET as background material. PLEASE right your own letter of support.
Date
The Honorable
Washington, DC
Dear
SENT BY FAX
date
This is to call your attention urgently to a threat that would deprive many thousands of Texas veterans of the
quality healthcaze that they deserve -and have been promised by their Government repeatedly.
The director of VISN 17, the regional VA headquarters in Dallas, has recommended moving Kerrville VA's 20
acute-care beds and 5 ICU beds to Audie Murphy Hospital in San Antonio and spending $11 million at Audie
Murphy to accommodate this transfer. All veterans' organizations in the Texas Hill Country oppose this and
support the recommendation of the South Texas Veterans Health Care System director that the 20 acute-care
beds and 5 ICU beds remain unchanged.
The CARES Commission, appointed to recommend realigmnents that would improve veterans healthcare, has
told the AP- prior to its report being submitted to Veterans Affairs Secretary -that "the acute inpatient services
should be moved as quickly as possible to San Antonio. This information was in a Nov29 AP dispatch.
Kerrville VA operated for years as a 420-bed hospital and has floor space and more than 70 acres of land for
expansion. Spending $11 million at Audie Murphy when there is more than ample space in Kerrville would be
an injustice to U.S. taxpayers.
CARES Commission recommendations are supposed to "improve veterans healthcare". There is no way that
depriving veterans of acute-care in Kerrville will accomplish that.
Uwe urge that you request Secretary Principi, in reviewing the final CARES report, to support expansion of
acute-care and specialty services in Kerrville and to oppose a large, unneeded construction project at Audie
Murphy solely to provide acute-care beds when the same objective can be accomplished in Kerrville at
minimum cost.
Sincerely,
Sign
SAMPLE LETTER
For
Secretary Principi
This letter is not to be duplicated. This is a draft letter for you to use, as a guide in the preparation of you own letter using the FACT
SHEET as background material letter using the FACT SHEET as background material. PLEASE right yow own letter of support.
Date
SENT BY FAX
The Honorable Anthony J. Principi date
Secretary of Veterans Affairs
810 Vermont Ave. NW
Washington, DC 20420
Dear Secretary Principi:
This is to call your attention urgently to a threat that would deprive many thousands of Texas veterans of the
quality healthcaze that they deserve -and have been promised by their Government repeatedly.
The director of VISN 17, the regional VA headquarters in Dallas, has recommended moving Kerrville VA's 20
acute-care beds and 5 ICU beds to Audie Murphy Hospital in San Antonio and spending $11 million at Audie
Murphy to accommodate this transfer. All veterans' organizations in the Texas Hill Country oppose this and
support the recommendation of the South Texas Veterans Health Care System director that the 20 acute-caze
beds and 5 ICU beds remain unchanged.
The CARES Commission, appointed to recommend realignments that would improve veterans healthcare, has
told the AP -prior to its report being submitted to Veterans Affairs Secretary -that "the acute inpatient services
should be moved as quickly as possible to San Antonio". This information was in a Nov. 29 AP dispatch.
Kerrville VA operated for years as a 420-bed hospital and has floor space and more than 70 acres of land for
expansion. Spending $11 million at Audie Murphy when there is more than ample space in Kerrville would be
an injustice to U.S. taxpayers.
CARES Commission recommendations aze supposed to "improve veterans healthcare". 'There is no way that
depriving veterans of acute-care in Kerrville will accomplish that.
Uwe urge that you, in reviewing the final CARES report, reject the transfer of our acute-care beds to San
Antonio and support expansion of acute-care and specialty services in Kerrville to relieve overcrowding at
Audie Murphy. Uwe also request that you oppose the proposed construction project at Audie Murphy solely
for the purpose of providing acute beds when the same objective can be accomplished in Kerrville at minimum
cost to the taxpayer.
Sincerely,
Sign