CARES Planning Initiatives

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CARES Planning Initiatives

• VISN 16 South Central VA Healthcare Network

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Presentation Outline

• February 2003 Changes in Planning Initiatives
• Changes in CARES Projections
• VISN Summary
• VISN-Level Issues
• Special Disability Programs
• Effective Use of Resources
• Proximity
• Vacant Space
• VISN/PI Team Identified Issues
• Collaborative Opportunities

• VISN Markets (4)
• Market Planning Initiatives
• Access
• Inpatient
• Outpatient
• Small Facility Planning Initiative

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February 2003 Changes in Planning Initiatives
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Changes in CARES Projections

• The Revised CARES Projections Incorporates the
  following
• The Census 2000 into the Veteran Population
  projections and therefore, the Enrollment
  projections
• The new Enrollment Policy Decisions
• Eligibility for new enrollment and
• Increased co-pays

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VISN 16 Summary

• Enrollees
• Projected to increase by 6 from FY 2001 level to
  FY 2022
• Planning Initiatives (PIs)
• Access
• Four Markets have a total of 4 PIs related to
  access in Primary Care
• One Market has a PI related to Hospital Care
• Inpatient Demand
• Four Markets have a total of 5 PIs related to
  increased inpatient demand
• One Markets has PI related to decreased inpatient
  demand
• Outpatient Demand
• Four Markets have a total of 7 PIs related to
  increased outpatient demand
• No Markets have PIs related to decreased
  outpatient demand
• Small Facility
• One facility is projected to require fewer than
  40 acute care beds.

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VISN 16 Overview

• Other VISN-Level Issues
• Proximity
• 4 Acute Care facilities are within the 60-mile
  standard
• No Tertiary Care facilities are within the
  120-mile standard
• VISN/PI Team Identified Issues
• Lack of acute and primary care in the Florida
  Panhandle, Eastern Southern Market
• Collaborative Opportunities
• Enhanced-Use Lease Top 15 Houston, TX
• Opportunities have been identified for VBA, NCA
  and DoD

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VISN 16 Overview

• Nursing Home Care
• The need for NHCU care remains high over the
  planning period. However, the NHCU component of
  VAs LTC Planning Model is in process of review
  to update the projections.
• Market Plans shall still consider any space
  and/or capital needs for NHCU care needs, such as
  realignment, renovations and conversion of space.

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Domiciliary Policy

• Domiciliary projections will not be part of this
  CAREs cycle.
• However, DOMs may and should be included in
  Market Plans to reuse vacant space or as a result
  of realignments (especially when homelessness or
  residential rehab is the focus of Dom bed use).

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VISN 16 Issues Special Disability Programs

• Blind Rehab Proposed Blind Rehab Center to be
  coordinated with VACO
• SCI Projected gap of 44 beds. Address new SCI
  Center in Planning Initiative.

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VISN Level IssuesEffective Use of Resources
Proximity

• Acute Care Hospitals with similar missions that
  are within 60 miles of each other
• Tertiary Care Hospitals within 120 miles of each
  other

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VISN Level IssuesEffective Use of Resources
Space

• Current Vacant Space 213,369 square feet.
• Once the future workload demand data is
  translated into future space needs, excess space
  will be added to the Vacant Space pool.
• The final Planning Initiative for all VISNs will
  be to reduce this total Vacant Space pool by at
  least 10 beginning in FY2004 and 30 in FY2005.

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VISN Level IssuesPI Team Identified Issues

• Listed below are other issues that the VISN will
  consider when developing the Market Plans
• Lack of acute and primary care in the Florida
  Panhandle, Eastern Southern Market

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VISN Level IssuesCollaborative Opportunities

• Collaborative opportunities for VISN 16 to expand
  services
• Enhanced-Use possible opportunities for vacant
  space
• Houston (VHAs Top 15).
• Gulfport Division (108 acres, 348,820 sq. ft.,
  vacant space 64,943 sq. ft. Potential for the
  entire campus).
• VBA
• North Little Rock AR (campus already co-located
  and has been identified for new VBA
  construction).
• NCA
• Sites Alexandria, Biloxi (consider potential
  opportunities in the development of the Market
  Plan).

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VISN Level IssuesCollaborative Opportunities

• Collaborative opportunities VISN 16 continued
• DoD
• Sharing potential for inpatient medical care at
  the Naval Air Station (Corey Station), Eglin, and
  Tyndall.
• Potential for Primary Care at Pensacola Naval Air
  station Cory Station, Hurlburt (Duke Field),
  and Tyndall.
• Potential collaboration sharing of Inpatient
  Medicine and Surgical programs with the Biloxi
  Division and Keesler AFB.
• Potential of shared services with Tinker AFB.

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VISN 16 Upper Western Market

• Description of Market Area
• The Upper Western Market includes 132 counties,
  largely rural areas with small population
  counties and large urban areas in each corner of
  the market. The market includes all Oklahoma
  counties, two Texas counties, the majority of
  Arkansas counties and ten Missouri counties. The
  market has experienced sizeable population growth
  in the past year, especially in the Tulsa, OK and
  Fayetteville, AR areas.

• Medical Center(s)
• Oklahoma City
• Muskogee
• Fayetteville
• Little Rock (NLR campus)
• Little Rock (LR campus)

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VISN 16 Upper Western MarketCARES Planning
Initiatives

• Access
• Primary Care A significant gap was found in
  access to care. The Upper Western Market area
  fell short by (16) in meeting the Access to Care
  Criteria for Primary Care.

70
65
This represents the Travel Time Guideline.
NOTES Significant Gaps are determined by first
applying the percentage threshold and then a
volume criteria.
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VISN 16 Upper Western MarketCARES Planning
Initiatives
NOTES Significant Gaps are determined by first
applying a percentage change criteria for each
CARES Category. If the gap meets this threshold,
then it must meet the workload threshold criteria
(beds for inpatient categories and stops for
outpatient categories).
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VISN 16 Upper Western MarketCARES Non-PI
Workload Gaps
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VISN 16 Upper Western MarketCARES Planning
Initiatives

• Small Facility Planning Initiative
• The following facilities were projected to have
  less than 40 beds in FY 2012 and/or 2022.

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VISN 16 Central Lower Market

• Description of Market Area
• Includes 84 counties from the Eastern Gulf Coast
  of Texas through Southern Gulf Coast of Louisiana
  and Central Louisiana. The market includes one
  large urban tertiary medical center, one medium
  tertiary medical center and a secondary medical
  center with large extended care and mental health
  programs. This market encompasses the highest
  density of veteran population within VISN 16.

• Medical Center(s)
• Houston
• Alexandria
• Shreveport

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VISN 16 Central Lower MarketCARES Planning
Initiatives

• Access
• Primary Care A significant gap was found in
  access to care. The Central Lower Market area
  fell short by (15) in meeting the Access to Care
  Criteria for Primary Care.

70
65
This represents the Travel Time Guideline.
NOTES Significant Gaps are determined by first
applying the percentage threshold and then a
volume criteria.
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VISN 16 Central Lower MarketCARES Planning
Initiatives
NOTES Significant Gaps are determined by first
applying a percentage change criteria for each
CARES Category. If the gap meets this threshold,
then it must meet the workload threshold criteria
(beds for inpatient categories and stops for
outpatient categories).
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VISN 16 Central Lower MarketCARES Non-PI
Workload Gaps
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VISN 16 Central Lower MarketCARES Planning
Initiatives

• Small Facility Planning Initiative
• The following facilities were projected to have
  less than 40 beds in FY 2012 and/or 2022.

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VISN 16 Eastern Southern Market

• Description of Market Area
• The Eastern Southern Market includes 11 counties
  in Alabama and Florida. It has experienced
  considerable population growth in the past year
  and is a significant Department of Defense
  retirement community with active military
  facilities. The market presently does not have a
  VA hospital and is supported by a large
  Community-Based Outpatient Clinic (CBOC) in
  Pensacola, FL. The closest VA hospital is in
  Biloxi, MS, a significant travel distance for
  most veterans in this area.

• Medical Center(s)
• None

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VISN 16 Eastern Southern MarketCARES Planning
Initiatives

• Access
• Primary Care A significant gap was found in
  access to care. The Eastern Southern Market area
  fell short by (10) in meeting the Access to Care
  Criteria for Primary Care
• Hospital Care This market fell short by (61) in
  meeting the Access to Care Criteria for Hospital
  Care .

70
65
This represents the Travel Time Guideline.
NOTES Significant Gaps are determined by first
applying the percentage threshold and then a
volume criteria.
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VISN 16 Eastern Southern MarketCARES Planning
Initiatives
NOTES Significant Gaps are determined by first
applying a percentage change criteria for each
CARES Category. If the gap meets this threshold,
then it must meet the workload threshold criteria
(beds for inpatient categories and stops for
outpatient categories).
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VISN 16 Eastern Southern MarketCARES Non-PI
Workload Gaps
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VISN 16 Eastern Southern MarketCARES Planning
Initiatives

• Small Facility Planning Initiative
• The following facilities were projected to have
  less than 40 beds in FY 2012 and/or 2022.

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VISN 16 Central Southern Market

• Description of Market Area
• The Central Southern Market includes 80
  Mississippi and Louisiana counties/ parishes that
  transverse the Mississippi River includes Lake
  Ponchartrain, the New Orleans metropolitan area,
  and the Gulf Coast of Mississippi. Tertiary care
  facilities are located in two urban areas with
  large veteran population density, New Orleans and
  Jackson.

• Medical Center(s)
• Jackson
• New Orleans
• Gulf Coast Veterans Health Care System
• Biloxi
• Gulfport

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VISN 16 Central Southern MarketCARES Planning
Initiatives

• Access
• Primary Care A significant gap was found in
  access to care. The Central Southern Market area
  fell short by (12) in meeting the Access to Care
  Criteria for Primary Care

70
65
This represents the Travel Time Guideline.
NOTES Significant Gaps are determined by first
applying the percentage threshold and then a
volume criteria.
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VISN 16 Central Southern MarketCARES Planning
Initiatives
NOTES Significant Gaps are determined by first
applying a percentage change criteria for each
CARES Category. If the gap meets this threshold,
then it must meet the workload threshold criteria
(beds for inpatient categories and stops for
outpatient categories).
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VISN 16 Central Southern MarketCARES Non-PI
Workload Gaps
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VISN 16 Central Southern MarketCARES Planning
Initiatives

• Small Facility Planning Initiative
• The following facilities were projected to have
  less than 40 beds in FY 2012 and/or 2022.