VA


VA Northwest Health Network 
(VISN 20) 
PO Box 1035 
Portland, OR 97207 
Phone (360) 619-5925 
Fax (360) 690-0868 
Dennis M. Lewis, FACHE 
Network Director 
Michael W. Fisher 
Deputy Network Director 
Frank Marr DO, MS, 
FAOCOPM 
Chief Medical Officer 
Allen Bricker 
Acting Chief Financial Officer 
Cathy Dickson 
Quality Management Officer 
NW Network News is published 
for veterans, employees, 
volunteers and the many other 
supporters of our VISN 20 health 
care system. To submit articles, 
editorials, letters, or story ideas, 
please contact Megan Streight via 
email at megan.streight@va.gov. 
NW Health Network Spring 2008 

Secretary Peake Visits Walla Walla


L to R, Hal Blair, Special Assistant to the Secretary; Dr. Khan, Acting COS, Walla Walla; Dennis Lewis, Network 
Director; Secretary Peake; Sharon Helman, Director, Walla Walla; Chris Martin, Associate Director, Walla Walla 
VAs new Secretary, the Honorable James B. Peake, MD, visited the VAMC Walla Walla 
on February 19, 2008. Secretary Peake is an impressive man. A West Point graduate, 
decorated Vietnam era veteran, and former United States Army Surgeon General, 
Dr. Peake began his government career as a GS-2, and was sworn in to VAs top post 
on December 20, 2007. 

As you may recall, during his confirmation hearing, Washington Senator Patty Murray 
presented General Peake with one of VISN 20s NO Business As Usual buttons, telling 
him that, should he put it on, shed know he was the man for the job. He did. 

During the hearing process, Senator Murray invited the Secretary to join her in a visit to 
Walla Walla so that he could see first hand the good work going on in the Southeastern 
region of Washington State. She also wanted to discuss with him VAs plans for the 
future of the facility and the veterans we serve there. On February 19th, almost two 
months to the day of his swearing in, he did. 

VISN 20s Network Director, Dennis Lewis, and Walla Wallas Director, Sharon Helman, 
had the honor of joining the Secretary during what evolved into a full day of briefings, 
walking tours, focus groups, media events and public forums. Dr. Peake was intent on 
speaking with as many veterans and employees as possible. He asked many questions, 
he took his time, and he listened to every answer. He was engaging and obviously 
passionate about the job he has just begun, and he impressed everyone he came into 
contact with. Joining the Secretary were Senator Patty Murray (D-WA) and 
Representative Cathy McMorris Rogers (R-WA). 

Specific to our Network, the Secretary expressed a keen interest in rural health initiatives, 
and, having worked for a period at Madigan Army Medical Center (Tacoma, WA), is 

> continued on page 2 > 


NW Network News VISN20 

> Secretary Peake Visits Walla Walla, continued > 

familiar with some of the access challenges that veterans face in the Pacific Northwest 
and Alaska. We provided him with a copy of VISN 20s draft Rural Health Care plan, and, 
while this document and our efforts is still very much a work in progress, we can take 
pride in knowing that we are well ahead of many other VISNs in this area. 

The Secretary also asked many questions about fee, contract hospital care, 
compensation and pension exams, grant and per diem, care coordination home 
telehealth (CCHT), enhanced use lease (EUL) possibilities, and IT/automation. He was 
particularly impressed to learn about two new contracts that Walla Walla put into place 
on February 1st with community hospitals Walla Walla General and Saint Marys, to 
enhance emergency care and medical services to veterans. Walla Walla has partnered 
with these two hospitals on a variety of other initiatives to include the development of the 
Walla Walla Health Care Alliance Leadership Council, a consortium focused on expanding 
access to care and the recruitment of health care professionals in rural Washington. Walla 
Walla has set precedence for us in this area, and we look forward to seeing their efforts 
replicated throughout the Network. Of note, DeWayne Hamlin and the staff at the Boise 
VA are close to a similar agreement in their catchment area. 

In regards to the future, the Secretary fielded many questions from community and 
Congressional representatives, veterans and employees. He discussed the history of the 
campus as a former cavalry site, and he emphasized that times have changed, health 
care delivery has changed, veterans health care needs have changed, and that change 
is good. He announced the funding of the $6.7M, 36-bed Residential Rehabilitation 
Recovery Unit, and stated that the Outpatient building was still on track for consideration 
during the 2010-2011 budget cycle. 

At the end of a long and eventful day, the Secretary was off to his next destination, VISN 
19, with stops in Billings, MT and Salt Lake City, UT. The visit was a resounding success, 
and patients, volunteers, community representatives, Sharon Helman and her entire staff, 
are to be commended for a job well done. 
. 

New Appointments 
Ann Shahan 
Homeless Veterans Coordinator, 
VISN Office 
effective 10/29/07 
Diana Rogers 
Incarcerated Veterans Coordinator, 
VISN Office 
effective 1/19/08 
Nirmala Rozario 
Acting Director, VAMC Spokane 
effective 1/27/08 
Michael Fisher 
Deputy Network Director, VISN Office 
effective 3/16/08 
Melissa Robertson 
Fiscal Quality Assurance Manager, 
VISN Office 
effective 3/16/08 
Mark Lyons 
VIRS Coordinator, VISN Office 
effective 3/16/08 
Jim Jackson 
DSS Coordinator, VISN Office 
effective 3/31/08 
A Letter from your Chief Medical Officer 


Dear Colleagues: 

We are on an historic journey 
together, a journey to restore our 
Networks preeminence. There was a 
time when VISN 20 had some of the 
best performance in the nation. In 
recent years however, we have faced 
challenges in that regard. Today, I will 
share with you our road map back to 
preeminence. 

Patient Care Goals 

We have an important destination, to 
provide excellent patient-centered 
integrated patient care, excellent 
education and research. These words: 
excellent, patient-centered 
and 
integrated 
are powerful words. They 
define the kind of care that our patients 
deserve and the kind of care we want to 
give. They are the right things to do, 
work worth doing. These words guide 
my decision making, my actions. They 
are my North Star. 

Our Performance 

If excellent, patient-centered integrated 
care is our goal, how are we doing? How 
far are we from our destination? VHA 

uses about 100 measures to 
determine a networks standing. 
These 100 measures are divided into 
five categories: patient access, 
clinical performance, functional 
status, community health and patient 
satisfaction. There are 21 networks in 
VHA. We aspire to be the best, 
number 1. Below were our rankings 
as of the close of FY 2007: 

Domain 
Standing 

Patient Access 21 
Healthier Communities 21 
Functional Status 20 
Clinical Care 19 
Patient Satisfaction 7 
Aggregate Standing 19 

> continued on page 3 > 


NW Network News


VISN20 3 
Recruitment Activities 
Director 
VAMC Spokane 
Nomination submitted to VACO 
February 2008 
Chiefs of Staff 
VAMC Boise 
Nomination submitted to VACO 
April 2008 
VA Puget Sound HCS 
VAMC Walla Walla & 
Southern Oregon Rehabilitation 
Center and Clinics 
Interviews are ongoing at 
VA Puget Sound, VAMC Walla Walla 
& Southern Oregon Rehabilitation 
Center and Clinics 
VISN 20 
Chief Financial Officer 
Recruitment initiated 
> A letter from your Chief Medical Officer, continued > 

We aspire to be the best. We were the best, but now we are not. There is a more 
troubling part of our performance, our performance is getting worse. The graph below 
tells the story. 


The top line is the best performance in the VA. The second line from the top is the VA 
average performance. The third line from the top is the performance of our network. The 
bottom line is the performance of the worst performing VISN. Take a moment to think 
about this graph. What do you see? Here is what I see  other networks are learning 
how to be more efficient and effective. We are not. In fact, we are falling further behind. If 
we continue on this path, we could be the worst VISN in VHA at the end of 2008. 

Our Journey Back to Preeminence 

We have a road map back to preeminence and it is working. There are four parts to our 
strategy: focus, accountability, discipline and support. We have a clear goal, 
excellent patient-centered integrated care. VHA uses about 260 performance measures. 
One hundred of them determine our standing. We have focused our attention on the 
measures (34 measures) where we have the biggest gaps. We have agreed to hold our 
current performance on the rest. These vital few include providing care for patients using 
tobacco products and patients with acute coronary syndrome, providing immunizations 
and eliminating our patient 30-day waiting lists. 

We are establishing a clear line of accountability. Accountability begins with our 
leadership, Directors, Associate/Deputy Directors, Nursing Executives and Chiefs of Staff. 
We are also extending the accountability and authority to our clinical committees, making 
sure each chairperson and the committee members understand their accountability and 
authority for the performance measures related to their patient care service. Going 
forward, our clinical committees will be action oriented with a specific charge to achieve 
excellence. These committees and our leadership will extend the accountability and 
authority to the individual practice teams. 

We are becoming more disciplined, the discipline to adopt and enforce standards and 
best practices. We will be more disciplined in our approach to improving the way we do 
our work. We will always be on the look out for a better way to provide patient care. We 
will eagerly implement and test these new ideas and spread the ones that are successful. 

> continued on page 4 > 


NW Network News


VISN20 4 
> A letter from your Chief Medical Officer, continued > 

We are rebuilding our support. Great organizations have vibrant infrastructure that 
facilitates change and improvement. Over the last few years, we have allowed our 
infrastructure to fall apart. Committees arent meeting. Each facility or site is too often 
doing their own thing. Our success will depend on our ability to draw on our collective 
talent, energy and coordinated action. The VISN clinical information systems committee 
is a good example. A clinical information system is a critical component of every 
successful organization. Our clinical information systems committee was disbanded two 
years ago. We are in the process of systematically rebuilding our support infrastructure. 

Our Progress 

Our strategy is already working. As of this writing, our standing in access has improved 
from #21 to #9, and our clinical performance has moved from #19 to #13. These 
preliminary results are encouraging. Our journey back to restore our networks 
preeminence is just beginning. It will be a hard journey. It is not easy to change. But it 
will be an exciting journey, work worth doing, and the right thing to do for our patients. 
Thank you for all that you do to make excellent patient-centered integrated care possible. 

Patient Safety Corner 

Dennis Lewis, Network Director, and 
Frank Marre, Chief Medical Officer, congratulate 
Blake Lesselroth, MD, of the PVAMC for the APHID 
project presentation. 
Does your organization have something 
you think is worth doing everywhere? It is 
not too early to start getting a poster and 
presentation ready to share at the next 
round of VISN 20s Strong Practice 
Competition occurring at the June Tetrad 
meeting. 

A strong practice is a creative solution to 
a common problem. The solution meets 
or surpasses known standards and can 
be proved to have sustainable, positive, 
tangible results which you believe could 
be replicated anywhere. 

If this sounds like it fits a solution youve 
developed in your organization, think 
about sharing your success with the rest 
of the Network. You will be asked to 
submit an entry form explaining a 
problem your organization set about to 

solve; any documentation such as policies, presentations, communications; the results or 
data that demonstrates why you are excited about sharing this solution with others; and 
what lessons your organization learned that would be helpful to others wishing to adopt 
your practice in their settings. 

The first poster session, at the January 2008 Tetrad meeting in Portland, was an 
unqualified success. It provided a jumpstart of creative high-performance energy for 
our Network. Fifteen projects were shared. All participants came prepared to give 
presentations at a dinner event sponsored by the Portland VA Research & Education 
Foundation. 

American Lake 
Volunteers & Programs 
Receive National 
Recognition 
One of American Lakes youth 
volunteers, Dani Clark, has won 
2nd place ($10,000), in the VAs 
James H. Parke Memorial 
Scholarship competition. There 
were 29 entrants this year. James 
H. Parke was VAs first Director of 
Voluntary Service, and the 
founding father of the Department 
of Veterans Affairs Voluntary 
Service (VAVS) National Advisory 
Committee (NAC). 
The scholarship may be used for 
tuition and fees, books and 
supplies, and/or room and board 
or other educational needs 
purchased through the school of 
the students choice. Scholarship 
winners must use their awards by 
their 24th birthday. 
To be eligible, candidates must 
complete 100 hours of regularly 
scheduled VAVS volunteer service 
in a 12-month period, be a 
student in the 10th grade or 
above, and have not reached their 
19th birthday. 
Dani will be presented with this 
award/scholarship April 11th in 
Orlando, Florida during the 
National VAVS Advisory 
Committee Meeting. American 
Lake is part of the Puget Sound 
Health Care System and is 
located in Tacoma, Washington. 
The American Lake Veterans Golf 
Course volunteer program has 
been chosen as a 2008 winner 
of the American Hospital 
Associations Hospital Awards for 
Volunteer Excellence (HAVE). The 
AHA HAVE Award celebrates the 
contribution and value of hospital 
> continued on page 5 >
> continued on page 5 > 


NW Network News VISN20 

> American Lake Volunteers, continued > 
volunteers  women and men who 
go the extra mile for their patients 
and communities. The work you 
do on behalf of the brave men 
and women who have served and 
sacrificed for our nation is 
inspiring. The award-winning VA 
Puget Sound Health Care 
Systems American Lake Veterans 
Golf Course volunteer program 
will be acknowledged during the 
AHA Recognition Breakfast April 
7th in Washington, DC. 
Congratulations! 
> Patient Safety Corner > 

Tetrad attendees viewed posters, talked with presenters, and then voted for their 
favorites. Three projects were selected for presentation to the group after dinner. The 
criteria for selection included consideration of the significance of the impact of the shared 
practice on quality, access, and cost; patient satisfaction and/or patient safety; and the 
degree to which the practice would be transportable to other organizations. 

The top three projects recognized were the Automated Patient History Intake Device 
(APHID) from Portland; A Systems Redesign Approach to Optimize Outcomes with 
Methadone Use from Spokane; and the Women Veterans Health Program at Walla Walla. 

To view all entries from the January project, please go to the VISN 20 website 
http://vaww.portal.visn20.med.va.gov/QMSP/default.aspx, then take a chance and 
consider entering your strong practice in June! 
. 

Fresh Eyes on Service



Fresh Eyes on Service (FEOS) is a 
new program intended to be a 
significant support mechanism for 
VHA Customer Service Program 
goals. FEOS consists of in-person 
visits by designated VHA staff 
members to shop customer service 
provided to veterans at Medical 
Centers and large CBOCs (over 1,500 
unique patients). 

The purpose of the program is to: 

 Help the VA build customer loyalty and 
infuse compassion into the work of all 
employees 
 Identify and share successful 
approaches 
 Gain another view of customer service 
performance 
 Reinforce existing training, desired 
behaviors and compliance with 
expectations 
 Focus on the entire patient experience 
The goals of the program are: 

 To assist VHA in moving from a 
service-satisfied culture to a service-
experience culture 
 To build loyalty with Veterans as 
Promoters of VA healthcare instead 
of merely being satisfied 
 To create a work culture that 
encourages personal responsibility on 
the part of every staff member to 
engage veterans, to make the 
veterans experience positive and 
memorable 
 To improve and reinforce VHA 
Customer Service programs 
In February, designated VISN 20 
FEOS observers participated in a 
nationwide training in preparation for 
site visits. Over the course of the 
next 17 months, two person teams 
will visit 28 VISN 20 sites of care to 
meet VHAs new performance 
monitor for this program. 

Observers will focus on Access, from 
parking to signage; Facilities, from 
cleanliness to safety; and Behavior, 
from interaction to staff appearance. 
At the close of each visit, observers 
will identify and share successful 
practices with facility leadership as 
well as identify opportunities for 
improvement. The focus is on 
systems improvement, not individual 
employees, and the provision of a 
consultative service for facilities. For 
additional information about VISN 
20s FEOS program, please contact 
Megan Streight via email 
megan.streight@va.gov, or 

(360) 619-5934. 
. 

NW Network News


VISN20 6 
VISN 20 Completes MOVE 
Challenge 
100 Days. 1,000,000 Steps. A Healthier You. 

For three months this winter, November 2007 February 2008, VISN 20 challenged 
employees to walk, run, bike, dance, or otherwise MOVE themselves to better health. 
The goal was to log 10,000 steps a day, the number recommended by the American 
Heart Association, and the exercise equivalent of 30 minutes of continuous movement, 
in a 100 day time frame. Employees who achieved at least 500,000 steps were rewarded 
with a commemorative t-shirt emblazoned with the MOVEmployee II logo and the 
slogan, Im one in a million. 

Each of our 8 facilities outdid themselves with creative activities, promotions and support 
from their executive leadership. Many of our Directors hosted weekly staff walks and 
employees formed groups for daily outings, with some taking it a step further and training 
for marathons and 1/2 marathons. In all, 165 people earned a t-shirt, and the VISN office 
received numerous testimonials and words of appreciation for sponsoring the program. 
One of the most inspirational came from Robin Gorashi, a Radiology Service employee 
at the VAMC Walla Walla: 

I just want to thank you for leading all of us in such good habits!!! I completed my million 
steps a few weeks ago and am still going strong! I am just proud because in February of 
2007, I was completing my 6 rounds of chemo and then 37 rounds of radiation 
treatments from March  May. I started exercising, but thanks to the challenge I was 
motivated to exercise everyday! I feel awesome and have lost 10 pounds! My goal is to 
have at least 20 off by my 51st birthday the end of May!! Thank you again and I am 
looking forward to the next challenge!!! 

Congratulations to all, and dont forget to keep MOVING. 
Remember, it all begins with a single step. 

ALASKA 
Doreen Auletta 
Jill Bennett 
Deedee Brandeberry 
Ben Fischer 
Brant Grifka 
Robert Guenther 
Bobbie Hjelmgren 
Leaf Myki 
Pat Martin 
Trelane McKinney 
Lisa Pascale 
Chantel Pemberton 
Dana Rich 
Victor Rosenbaum 
Ro Rotunno 
Cindy Sauro 
Jacqueline Schimper 
Mark Schwartz 
Nancy Walsh-Robart 
Betty Weir 
BOISE 
Paul Black 
Brent Luks 
Ron Blanton 
Victoria Rogers 
Linda Hilton 
Grant Ragsdale 
Ramona Duron 
Pamela Kocina 
John Boice 
PORTLAND 
Ryan Siemens 
Denise La Lande 
Corinne Tippit 
Jan Patterson 
Lily Lee 
PUGET SOUND 
Linda Clark 
Skip Dreps 
Rosa Young 
Weldon Plett 
Dave Tostenrude 
Connie Phillips 
Pat McPherson 
Susan Dier 
Cathy Spataro 
Diane Fowler 
Johnny Hardy 
Earlene Green 
Karol Brown 
Rose Evans 
Lisa Chisa 
Pam Williams 
Sandr Soul 
Deborah Hammond 
Cynthia Olson 
Quyen Tran 
Mary Hampton 
Wanda Burton 
Michelle Power 
Stephen Campbell 
Carol Tomas 
Nina Jue 
Barbara Dickson 
Diane Styskal 
Stafanie Hillman 
Christina Helton 
Michael Zeka 
Julie Nicholas 
Cathy Stapel 
Carol Walker 
Gary Herrero 
Bryan Guzman 
Karen Kettelberger 
Miles Urbano 
Veronica Foster Jones 
Walt Werkhoven 
Gloria Carlson 
Chuck Marsden Ron Opsal 
Merlita Affholter 
Mary Delozier 
Peggy Warner 
Janis Manning 
Alicia Lopez 
Cecile Bagrow 
Carol Johnson 
Shirley Aikin 
Mark Hinton 
Nadine Smith 
Melva Duran 
Tyana Shabazz 
Vicki Booth 
Vonnie Clay 
Chris Woods 
SORCC 
Truman Sanderson 
Melody Hall 
James Hostick 
Jennifer Ragan 
Jim Figone 
Andy Paperman 
Jeanette Miller 
Don Cowsert 
Rudy Pinedo 
Paula Nettles 
Mary Neill 
Denise Roberts 
Karen Allen 
SPOKANE 
Dave Perkins 
Tokbi Brickweg 
Nancy Brown 
Ginny Winters 
Kevin Smith 
Linda Tieaski 
Lina Hughes 
Rita Hoag 
Mike Lepkowicz 
Becky Hay 
WALLA WALLA 
Susie Aldrich 
Debi Bernasconi 
Catherine Biggs 
Phuong Brown 
Toama Brunton 
Mary Cooper 
Jennifer Crown 
Jimmie Daves 
Darlene Fleming 
Ann Forbes 
Sharon Gerbino 
Darla Gonzalez 
Roger Gotch 
Dannette Knight 
Mary Kutch 
Liz Lee 
Sandy Lee 
Ann Lehman 
Jack Lenihan 
Hawk Moore 
Kelli OKert 
Chris Oliver 
Carol Perfect 
Sally Riggs 
Jake Shaw 
Shawn Shugars 
Wanda Singer 
Patty Strange 
Carrie Swift 
Gary Tash 
Mary Tock 
Dayna Turner 
Cindy Williams 
Jim Willard 
Sarah Denton 
Yolanda Gies 
Mary Hustead 
Cara Smith 
Norma Timmons 
Chris Martin 
Mary Freeman 
Jonathan Hibbs 
Lou Holm 
Larry Werst 
Robin Gorashi 
Larry Luxton 
Clark Schmidt 
VISN OFFICE 
Dennis M. Lewis 
IN TOTAL, 165 VISN 20 EMPLOYEES COMPLETED 500,000  1,000,000 STEPS! 
CONGRATULATIONS!!!! 

NW Network News


VISN20 7 
Memorial Honors Walla Walla VA Employees 

-Contributed by Jake Shaw 
Gray skies and swirling winds gusting up to 40 miles per hour didnt stop 50 
Walla Walla VA Medical Center employees from gathering on December 3rd to 
dedicate a memorial to former employees whove passed away over the 
years. Nine former employees were honored during the ceremony: Donnie 
Hauer, Jack Thompson, Twila Crist, Jim Pack, Clara Crockett, Bill Winters, 
Melinda Eversole, Deanna Milligan and Claire Budd. Several family members 
and friends of those being remembered also attended the ceremony. 

The idea for the memorial started last fall when housekeeper Charlie Keating 
asked co-workers if they wanted to do something to honor fellow employee 
Donnie Hauer after he passed away. Carol Perfect, an employee in Facilities 
Support Services, listened to Charlie and decided to do something to honor 
all former employees who served veterans at the Walla Walla facility. 

During the dedication ceremony, Medical Center Director Sharon Helman 
spoke briefly about the importance of the memorial. 

Our greatest strength and our most important asset as an organization are our employees; they are our backbone. We depend on 
each other heavily every day. We grow close and experience things together  good and bad  which stay with us in our hearts and 
minds as memories long after we go our separate ways. 

When we lose a fellow employee its always a tragedy; it feels like we lose a part of ourselves. But we must find ways to remember 
them for the times we shared together. This memorial is a tribute to the many employees who left us after serving our nations heroes. 
They dedicated their lives to a worthy mission, and we will never forget them for that, she said. 

Chaplain Vegors agrees. I think this memorial will grow for years as more employees make donations to remember their co-workers 
and friends, he said. For at least one VA employee, the ceremony had special meaning. Gloria Clark, a pharmacy employee, is the 
daughter of Clara Crockett, one of the employees whose name is now part of the memorial. 

Years ago, my mom brought me here to volunteer, and now I work here, and my son Donny also works here. I am so proud that my 
mother is part of this memorial. I will definitely stop by from time to time to remember her, and Im sure my son will do the same, she 
said. The memorial is located on the northeast side of building 75, near the rose garden. The total cost to add a name to the memorial 
is about $25. To learn more about the memorial or to purchase a plaque, contact Carol Perfect at (509) 525-5200, 
ext. 22489. 
. 

VISN 20 is #1 in MCCF Collections! 

After ending Fiscal Year 2007 #4 in
the country in our assigned target Feb Collections Feb Cum Collections % to Target (Cum)


MCCF goal to the actual amount ALASKA $869,861.81 $5,486,714.00 109.91% 

collected, VISN 20 has moved to 1st 

place with a record setting February! BOISE $825,829.99 $4,148,519.00 123.20% 

Special recognition goes to VA Puget PORTLAND $1,692,765.32 $8,189,769.00 123.43% 


Sound for their efforts in assisting 
other facilities with collections  a 
ROSEBURG $939,372.39 $3,150,101.00 123.10% 
commendable example of integration PUGET SOUND $2,722,696.42 $12,913,665.00 122.58% 
in action, especially when one SPOKANE $816,465.76 $2,970,731.00 108.78% 
considers how important these funds 
are to enhancing our health care WALLA WALLA $370,036.24 $1,895,610.00 124.90% 
budget. Congratulations to all! WHITE CITY $214,943.80 $891,075.00 99.67% 
NETWORK $8,451,971.73 $39,646,185.00 119.31% 


NW Network News


VISN20 8 
VISN 20 Opens 
2 New CBOCs 

February 2008 marked a banner month in 
access improvement with the activation 
of Community Based Outpatient Clinics 
(CBOCs) in interim locations in Mt. 
Vernon, Washington and Coeur dAlene, 
Idaho. Both facilities are currently housed 
in temporary sites as the VISN searches 
for permanent space. 

The Mount Vernon clinic opened on 
February 15th, as a mobile unit, on the 
grounds of the Skagit Valley Hospital. 
This central location allows VA Puget 
Sound to partner with the hospital and 
local pharmacies for its laboratory and 
pharmaceutical needs. This temporary 
site will also allow VA Puget Sound to 
work with community leaders to finalize 
plans for a permanent clinic in the region. 
While working to increase patients 
access to care in Northwest Washington, 
VA Puget Sound will be contacting currently enrolled patients whose providers will be locating at the interim site on a rotating basis. 
This will be a phase-in process as we grow from an interim site to a permanent location. 

When the permanent clinic is fully up and running, it will have 15 primary care, mental health providers and support staff bringing 
primary and mental health care to the Northwest Washington region. VA Puget Sound continues to work with VA officials and state 
and community stakeholders to bring on line its permanent site in Northwest Washington, which will ultimately serve more than 
6,500 veterans. 

In addition to Mt. Vernon, the VAMC Spokane activated the Coeur dAlene CBOC on February 19th, also at an interim site. The new 
clinic is located at 2177 Iron Wood Court Drive, Coeur dAlene, and will allow veterans living in North Idaho and Northwest Montana 
to receive their primary care closer to home. While working to increase patients access to care in North Idaho, the Spokane VA will 
be contacting current patients to determine if they would like to receive care at the interim site. This will be a phase-in process as 
the clinic grows from an interim site to a permanent location. When the permanent clinic is fully up and running, it will have about 25 
employees, including providers and support staff, to serve primary and mental health care needs to the North Idaho region. The 
clinic will ultimately serve more than 7,800 veterans. 
. 


News on a National Front 

VA Increases Budget and Expanded Services for Mental Health and Suicide 
Prevention 

The Department of Veterans Affairs (VA) has significantly increased its budget and services for mental health programs, and has 
greatly enhanced its suicide prevention services, the VAs Chief Mental Health official said in recent testimony before the House 
Veterans Affairs Committee (HVAC). 

Dr. Ira Katz, Deputy Chief of Patient Care Services for VAs Office of Mental Health, testified that the VA will spend $3 billion in fiscal 
2008 on mental health services for veterans  a 50 percent increase since 2001. VA has hired more than 3,600 new mental health 
employees since 2005, bringing the current total to more than 10,000. 

Testifying at the Committees December 12 hearing focusing on suicide prevention, Dr. Katz said VA has expanded its services in 
several ways, including the recent addition of a 24-hour, seven-day a week Suicide Prevention Hotline (1-800-273-TALK). 

> continued on page 9> 


NW Network News


VISN20 9 
> VA Increases Budget and Expanded Services, continued > 

He said VA now has suicide prevention coordinators at each of its 153 hospitals nationwide, and has more than 200 mental health 
providers whose jobs are specifically devoted to preventing suicide among veterans. In addition, VA educates veterans and family 
members, and trains employees about suicide risk factors and warning signs of suicide. 

The Department of Veterans Affairs believes that it is our obligation to work to prevent suicide both in individual patients and in the 
entire veterans population, Katz said. Our suicide prevention activities are based on the principle that in order to decrease the rates 
of suicide, we must provide enhanced access to high quality mental health care and to develop programs specifically designed to 
help prevent suicide. 

VAs suicide prevention program includes two centers which conduct research and provide technical assistance for all locations to 
use. The Mental Health Center of Excellence in Canandaigua, NY focuses on developing and testing clinical and public health 
intervention, and serves as home base for the Suicide Prevention Hotline. The Mental Illness Research and Education and Clinical 
Center in Denver focuses on research in the clinical and neurobiological sciences. 

Dr. Katz said the Suicide Prevention Hotline has already made a significant impact in providing immediate, crisis-oriented counseling 
to veterans, as well as their family members and friends, when they call. 

He pointed out that suicide prevention coordinators at each facility follow up each call to provide enhanced treatment monitoring for 
veterans at risk and ensure follow up on any missed appointments. The coordinators also educate their colleagues, veterans and 
families about the risks for suicide, and work with the entire staffs of their medical centers to maintain awareness and care for those 
who have previously attempted suicide, and ensure their care is enhanced. 

Since the Hotline began service in late July, it has received more than 250 calls resulting in immediate emergency services that may 
have helped save a life. From October 7th to November 10th, 1,636 veterans and 311 family members called the Hotline number. 
Those calls led to 363 referrals to suicide prevention coordinators and 93 rescues involving emergency services. 

Dr. Katz said VA has completed a preliminary evaluation of suicide rates among veterans returning from service in Iraq and 
Afghanistan that shows the rate of suicide for those veterans is not statistically significantly different from the suicide rate for age, sex 
and race matched individuals from the general population. 

Nevertheless, one suicide among those who have served their country is too much, Katz said. He said the population of veterans 
who receive care from VA have more risk factors for suicide than the general population. Those who come to the VA for care tend to 
be older, less socio-economically well-off, and more likely to have a mental health condition or another chronic condition, Katz said. 
This increased need can be associated with increased risks. This, in fact, was one of the major factors leading to VAs focus on 
suicide prevention. 

Katz said about 100,500 of the 750,000 veterans from the conflicts in Iraq and Afghanistan have come to VA with a mental health 
condition since the beginning of the war, representing about 10 percent of the total number of veterans with mental health issues that 
the VA sees in any one year. While a significant number of veterans of the conflicts in Iraq and Afghanistan have required treatment 
for mental health conditions on their return home, the number is well within our capabilities for providing treatment, Katz said. 
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