# Presentation: 071922

##  CARES Planning Initiatives

**VISN 7: VA Atlanta Healthcare Network**

## 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 (3)
- Market Planning Initiatives
- Access
- Inpatient
- Outpatient
- Small Facility Planning Initiative

## 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

## February 2003 Changes in Planning Initiatives

## VISN 7 Summary

- Enrollees
- Projected to increase by 14% from FY 2001 level to FY 2022
- Planning Initiatives (PIs)
- Access
- 3 Markets have PIs related to access in Primary Care, and 2Market has a PI for Acute Hospital Care
- Inpatient Demand
- 2 Markets have  a total of 4PIs related to increased inpatient demand
- There are no  PIs related to decreased inpatient demand
- Outpatient Demand
- 3 Markets have a total of 7 PIs related to increased outpatient demand
- There are no PIs related to decreased outpatient demand
- Small Facility
- Dublin is projected to require fewer than 40 acute care beds in both years.

## VISN 7 Summary

- Other VISN-Level Issues
- Proximity
- 0 Acute Care facilities are within the 60-mile standard
- 3 Tertiary Care facilities are within the 120-mile standard

## VISN 7 Summary

- PI Team Identified Issues
- Facility conditions
- Lease expiration of CBOC’s
- Collaborative Opportunities
- Significant DOD opportunities
- VBA co-location in progress
- Enhanced lease opportunities

## VISN OverviewNHCU

- Nursing Home Care:
- The need for NHCU care remains high over the planning period. The NHCU component of VA’s LTC Planning Model is in process of review to update the projections and should be available March 1st.
- Market Plans shall still consider any space and/or capital needs for NHCU care needs.  (Realignment, renovations, conversion of space, etc.)

## 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).

## VISN 7 – Issues Special Disability Programs

**Blind Rehab: ****VISN 7 is not anticipating a Blind Rehabilitation Gap.**
**SCI: ****VISN 7 has received recommendations to increase SCI acute & LTC beds. **

## VISN Level IssuesEffective 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:

| PI? | Facility Name
 | Second Facility Name | Miles | 
Rationale |
| --- | --- | --- | --- | --- |
| N | None |  |   |  |
|  |  |  |  |  |
|  |  |  |  |  |

| PI? | Facility Name
 | Second Facility Name | Miles | 
Rationale |
| --- | --- | --- | --- | --- |
| Y | Augusta, GA | Columbia, SC | 82 |  |
| Y | Columbia, SC | Charleston, SC | 116 |  |
|  |  |  |  |  |

## VISN Level IssuesEffective Use of Resources – Space

- Current Vacant Space: **683,370** square feet
- Once the future workload demand data is translated into future space needs, any excess space that is identified 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.

## PI Team Identified Issues

- Listed below are other issues that the VISN will consider when developing the Market Plans:
- Facility condition for Atlanta, Columbia and Charleston are in need of critical ward renovations
- CBOC lease expiration for Savanna OPC with co-location discussion underway with Hunter Army Air Base
- CBOC lease expiration for Greenville OPC with opportunity to address  Specialty  Care, Mental Health, and Primary Care (for demand & access) needs.

## PI Team Identified Issues

- Listed below are other issues that the VISN will consider when developing the Market Plans:
- Enhanced Use project in Columbia, SC including VBA co-location
- Enhanced Use potential with the Medical University of South Carolina with Charleston VAMC for a combined replacement hospital

## VISN Level IssuesCollaborative Opportunities

- The following collaborative opportunities have been identified for VISN 7 to consider when completing Market Plans:
-  VBA
- Columbia, SC
-  NCA identification of areas they would like to expand:
- None
- Enhanced-Use possible opportunities for vacant space:
- Approved EU project for Acreage at Columbia VAMC

## VISN Level IssuesCollaborative Opportunities

- The following collaborative opportunities have been identified for VISN 7 to consider when completing Market Plans:
- DOD
- Maxwell AFB with CAVHCS	Shaw AFB with Columbia
- Lawson AFB with CAVHCS	Fort Jackson with Columbia
- Fort Rucker with CAVHCS		Hunter Army with Charleston
- Fort Benning with CAVHCS	Fort Stewart with Charleston
- Robins AFB with Dublin		Beaufort Naval with Charleston
- Fort Gordon with Augusta		Charleston Naval w/ Charleston

## VISN 7 Alabama Market

- Medical Centers:
- Birmingham, Al (Tertiary Care)
- CAVHCS- Montgomery, Al
- CAVHCS – Tuskegee, Al
- Tuscaloosa, Al

- Description of Market Area:
- This area consists of most of the state of Alabama and 13 counties in west-central Georgia.  73% of the counties are rural.  96% of the VISN is designated as MUA/MUP (medical underserved areas/medical underserved populations).

## VISN 7 Alabama MarketCARES Planning Initiatives

**Access**
**Primary Care**: The market area fell short by 7%.
**Hospital Care**: The market area fell short by 12% and the number of enrollees met the threshold.
- Tertiary Care: 100% of the veterans residing within the Market are within the Access Standard

**70%**

**65%**

- This represents the Travel Time Guideline.

## VISN 7 Alabama MarketCARES Planning Initiatives

## VISN 7 Alabama MarketCARES Planning Initiatives

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

| PI? | Facility Name
 | FY2012 (Beds) | FY2022 (Beds) | 
Rationale |
| --- | --- | --- | --- | --- |
| N | None
 |   |   |  |

## VISN 7 Georgia Market

- Medical Centers:
- Atlanta (Tertiary Care)
- Augusta (Tertiary Care)
- Dublin

- Description of Market Area:
- This area consists of the majority of the state of Georgia and 5 counties in SC.  76% of the counties in this market are rural.  Areas of this market continue to have an expanding population, including veterans as retirees and businesses move into the area.

## VISN 7 Georgia MarketCARES Planning Initiatives

**Access**
- Primary Care: 57% of the veterans residing within the Market are within the Access Standard
- Hospital Care: 80% of the veterans residing within the Market are within the Access Standard
- Tertiary Care: 100% of the veterans residing within the Market are within the Access Standard

**70%**

**65%**

- This represents the Travel Time Guideline.

## VISN 7 Georgia MarketCARES Planning Initiatives

## VISN 7 Georgia MarketCARES Planning Initiatives

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

| PI? | Facility Name
 | FY2012 (Beds) | FY2022 (Beds) | 
Rationale |
| --- | --- | --- | --- | --- |
| N | Dublin
 | 36 | 30 | Both 2012 & 2022 fall below the 40 bed threshold. |

## VISN 7 South Carolina Market

- Medical Centers:
- Columbia, SC (Tertiary Care)
- Charleston, SC (Tertiary Care)

- Description of Market Area:
- This area consists of the majority of the state of South Carolina and 6 counties in east-central Georgia.  77% of the counties in this market are rural.  Augusta VAMC also provides tertiary and secondary services to this market area with Columbia and Charleston.  Areas of this market continue to have an expanding population, including veterans as retirees and businesses move into the area.

## VISN 7 South Carolina MarketCARES Planning Initiatives

**Access**
**Primary Care**: The market area fell short by 7%.
**Hospital Care**: The market area fell short by 12% and the number of enrollees  met the threshold.
- Tertiary Care: 100% of the veterans residing within the Market are within the Access Standard

**70%**

**65%**

- This represents the Travel Time Guideline.

## VISN 7 South Carolina MarketCARES Planning Initiatives

## VISN 7 South Carolina MarketCARES Planning Initiatives

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

| PI? | Facility Name
 | FY2012 (Beds) | FY2022 (Beds) | 
Rationale |
| --- | --- | --- | --- | --- |
| N | None
 |   |   |  |