Department of MEMORANDUM
Veterans Affairs

 

Date: February 9, 2000
From: Chief Medical Officer (11KD)
Subj: Space Utilization at Kerrville Division 
To: Chief of Staff (11)

1. The seventh floor surgical suite is vacant. Potential use is for a 16-bed State Veterans Home. Renovation costs are very high $1,750,000. Our sixth floor is vacant and has the potential for a 46-bed State Veterans Home at a cost of $1,000,000.
2. The remaining floor are utilized as follows:
5A-KTCC III 38 beds (fully utilized). This includes Hospice beds.
5B-20 acute medical beds, 5 ICU beds (fully utilized)
4A-Medical Service office, Respiratory Therapy, QA office, Social Work office, OD room. There are eight rooms which are utilized as private offices for Primary Care physicians. These offices, in my opinion, could be made available for additional patient care functions. The most appropriate would be expanded Specialty Clinic or acute care beds.
4B-Specialty Clinics, which include Surgical, Urology, GI, Neurology, GU, Women's Clinic, Dermatology, Minor Surgery Procedure rooms, Patient Education room. GU and Orthopedic Clinics are operational approximately one day each week, however Surgery Clinic and Neurology Clinic are used on alternate days. This space is utilized 85% of the time. With the establishment of a full-time GI Service (to include a Hepatitis C. Clinic), the fourth floor Specialty Clinic areas will see an increase in usage. The local union offices and conference room are also on the fourth floor.
3A-Bio-Med, Ophthalmology, Audiology, Texas Veterans Commission, Mental Health Clinic, one large room for x-ray storage.
3B-GEM Clinic, long-term care staff offices, which are utilized and Home-Based Primary Care.
2A-Imaging Service (crowded), Pathology and Lab (no vacant space available).
2nd central hall- Podiatry, Physical Medicine, Nuclear Medicine, SPD. 
2B-Nursing Service, Dental Service, Library Service, Room 250 is used for Satellite broadcasts, WHEN Coordinator offices.
1A-Urgent Care, Triage, Admissions, six Primary Care Teams, Telephone Operator, Lobby, MCCF office and Employee Health.
1 central hall- Police and Security Service, Pharmacy Service, morgue, warehouse, Release of Information, one Social Work Office and Medical Record file room.
1B- two Primary Care Teams, Agent Cashier, Director's Suite (which includes MAS office, Infection Control, Patient Representative, Administrative Officer, Chief Medical Officer), Prosthetics, Tricare, 147 Conference room, Travel, MAS Supervisor, Telecommunications office.
Basement A- Canteen, Canteen warehouse, Medical Records, Human Resources, Engineering Electrical storage, Engineering Plumbing office, OIT storage.
Basement B- Vending room, Mechanical room, Environmental Management offices, Patient Assistance Program office, employee clothing room, Recreation Hall, Recreation Offices, Voluntary Service, OIT offices, computer training room, chaplain Service, Chapel.
3. After review, spaces available include seventh floor, Surgical suite, entire sixth floor and there are three rooms previously occupied by the Surgical Service.

DAN W. BACON, M.D.
 

DEFCON 1

ENEMY ACTION IS IMMINENT!

This is bad news for nearly 450 Veterans. Many who have not yet been informed as to what new team they have been assigned to or what doctor will be seeing them. To get more details on your status if you are a Blue Team member call 830-792-3472.
 

Several good things have taken place at the Kerrville VA Hospital.
RECENT CHANGES AT KERRVILLE VA HOSPITAL
Reported at the last monthly staff meeting were the following actions.
1. Nurse practitioner will be added to the staff to allow primary care physicians more time with their clinics.

2. The Audie lab is going to be equipped with studio booths from the old Frank Tejeda Clinic in San Antonio. A full time doctor will be added to the Audie lab. A full time radiologist will be added to the staff of the Audie Clinic.

3. A doctor from the "Blue Team" is being assigned in the new Gastro entomology shop. This will provide Kerrville the ability to do all GI testing in house and reduce backlog of GI services both at Kerrville and Audie. A real plus for our Veterans, Target date, March 1, 2000. All of these are positive changes and will prove to be good for Kerrville. However, the elimination of the "Blue Team" is not good, but is being said as necessary to provide the other improvements.

In addition: It has been learned that a Hepatitis "C" testing lab is being set up on the fourth floor. Hepatitis "C" testing is mandated under H.B. 2116, although implementation is not required until May 2000.

A couple of major questions arise with the Hepatitis "C". Does Kerrville have the ability to serve the Hepatitis "C" patient? Is this testing lab just for Kerrville or is it for the entire STVHCS?

As the changes continue to develop, HCVC will keep you informed.

DEPARTMENT OF VETERANS AFFAIRS
SOUTH TEXAS VETERANS HEALTH CARE SYSTEM
Audie L. Murphy Memorial Veterans Hospital Division 
7400 Merton Minter Boulevard
San Antonio, TX. 78284
 

Mar 14 2000                                                 

General Walter R. Schellhase USAR, B.G. (Retired)
President, Hill Country Veterans Council
529 Water Street
Kerrville, TX 78028

Dear General Schellhase:

When the concept of initiating a Compensated Work Therapy (CWT) Program at the Kerrville Division (KD) of the South Texas Veterans Health Care System was first introduced, I pledged that we would not implement the program without the full support of the Hill Country Veterans Council and other community leaders.

Since that time, and after several meetings on the subject between community representatives and VA staff, various concerns about implementing the CWT Program at the KD have been brought forward. As a result of these expressed concerns, I have made the decision not to move forward with the program.

Please be assured that this decision will not in any way affect future provision of other types of services to the KD. I stand committed to efficaciously provide services to all veterans in South Texas including those served in the Kerrville vicinity.

I would be happy to discuss this issue with you, should you so desire, at your convenience. Thank you for your efforts and time spent in analyzing the CWT concept as it relates to the KD.

Sincerely, 
s/s Jose R. Coronado
Jose R. Coronado, 
FACHE Director
 

HILL COUNTRY VETERANS COUNCIL

1700 Sidney Baker, Suite 100

Kerrville, Texas 78028

830-896-1157          Fax 830-896-1175

www.ktc.net/hcvc

22 March 2000  

Mr. Jose Coronado, FACHE Director, STVHCS 
7400 Merton Minter Boulevard 
San Antonio, Texas 78284 
  
Dear Mr. Coronado: 
  
The Hill Country Veterans Council want to thank you and your staff for consulting with us on the CWT program for Kerrville. As you probably know, there was a very knowledgeable group of community leaders that was put together to evaluate and discuss the program with Mr. Gordon. All in attendance felt the Veterans Industries program was a good one but the lack of identifiable Veterans in the Kerrville VA Hospital catchment area needing training, made the program questionable for the area. 
  
Therefore, we strongly support your decision not to move forward with the program in Kerrville. However, during one of the meetings, it was surfaced that the Corpus Christi area and the Rio Grande Valley area does have a number of Veterans that meet the profile for this program. If there is any way the HCVC could assist you and your staff in establishing this training program in these areas for our Veterans, please let us know. 
  
Again, thanks for allowing the community to work with the VA in this decision making process. 
  
Sincerely, 
Walter Schellhase 
USAR-BG (Retired) 
President, Hill Country Veterans Council 
 

HILL COUNTRY VETERANS COUNCIL
1700 Sidney Baker, Suite 100
Kerrville, Texas 78028
830-896-1157 Fax 830-896-1175
www.ktc.net/hcvc

6 April 2000

Mr. Stuart W. Holliday
Policy Office, Assistant Director
P. O. Box 12428
Austin, Texas 78711

Dear Mr. Holliday:

This is a follow-up to our visit in Austin a few months ago, when the Governor signed our resolution supporting American's Veterans. At that time, we ask that the campaign accept our input, and urged that our position be incorporated into the Republican Platform.

While Veterans in the Hill Country have been assured that the Governor supports a complete over haul of the Veterans Healthcare, we're concerned at his silence on this isssue since a November speech in Hew Hampshire.

And while it's important that we have printed material affirming that position, it's even more important that he address Veterans issues at every campaign stop. These issues - healthcare, in particular - must become central to his campaign as he speaks to the nation between now and the election.

The last thing America - and Governor Bush - need is for veterans and veterans organizations which voted for Senator McCain to throw their support to Al Gore, simply because he's addressing the issue of Veterans Healthcare in early voting to shift over to Vice President Gore, just because he is taking on the issue of Veterans Health Care.

Veterans and their families need to hear:

1. Specifics of the Governor's plan to fix the Veterans Health Care System. 
2. Where, and to whom, he will look for leadership on Veterans issues.
3. His vision for Healthcare for our dedicated Veterans in the 21st Century.
4. His position on VA hospitals being closed and downsized by as many as 25,000 beds when thousands of Veterans are being denied care.

5. How he will cure inept management all the way from Secretary of Veterans Affairs down to administration of hospitals and clinics.

Publishing a paper on Veterans issues is good, but it isn't nearly enough. Veterans need to hear the Governor speak out.

The Hill Country Veterans Council stand ready to help in every way possible in restoring Veterans Healthcare and making it as far - reaching as is necessary to meet the needs of those who put their lives on the line for their country.

Sincerely,

Walter Schellhase
USAR-BG (Retired)
President, Hill Country Veterans Council
 

Walter Schellhase
USAR-BG (Retired)
President, Hill Country Veterans Council

6 April, 2000

The Honorable George W. Bush
Governor's Office
State Capital
Austin, Texas 78711

Dear Governor Bush:

As Veterans, we welcome your commitment for a complete over haul of the Veterans Healthcare System, and we're eager to help in any way that we can.

We're troubled, however, at not having seen a public reference to that position since a November speech in New Hampshire.

We believe it's important that you have printed material stating this position, and that it's essential that you speak to this and other Veterans issues at every campaign stop between now and the November election.

In our view, this is the time to hammer away at the VA's steady and tragic decline during the Clinton-Gore Administration, and to say "loud and clear":

1. Precisely what you will do to fix the Veterans Health Care System.
2. Where you will look for leadership on Veterans issues.
3. How do you envision Healthcare being provided to America's dedicated Veterans in the 21st Century.
4. How you will reverse the decline in the number of beds in VA hospitals - as many as 25,000 beds! - when thousands of Veterans are being denied care.
5. How you will address the problem of poor management all the way from the Secretary of Veterans Affairs down to administrator of some of our VA hospitals. 

We cheered when you said in New Hampshire that "... it is not right for those that we asked to stand in the front line and now have to stand in line with hat in hand to get health care".


Now, Veterans need to hear you follow up on that position. It would be tragic for you and for the nation if veterans who supported Senator McCain in early voting should swing over to the Gore Camp because they fail to see their issues being addressed by the Republican nominee.

Sincerely,

Walter Schellhase
USAR-BG (Retired)
President, Hill Country Veterans Council
 

Generals Bacon and Schellhase along with Judge Henneke met with VA staff members Mr. Tim Shea, Dr. Dan Bacon and Ms. Robin Gutierrez to discuss the Texas Veterans Home proposal. It was clearly established by all that there was a need, there was space available, and all that was needed was the desire. The earlier proposal by the VA has been sent to the Texas Land Commissioner. A meeting to discuss this proposal was postponed by Mr. Dewhurst's office. No other meeting is pending at this time.

Mr. Shea agreed to:

1. Look into what would be required for VA to expand long-term beds into existing facilities.
2. Look into the Assisted Living Program as mandated by HR 2116 and how it could be applied to the vacant space at the Kerrville VA Hospital.
3. Determine exactly what moves would be needed by the VA to make available the space needed for the Texas Veterans Home Program (i.e., open up the 5th and 6th floor) and what would be the cost.
4. To meet with the Texas Veterans Home staff to define what space at the hospital would be acceptable.
5. Determine what type of financial agreements can be negotiated between the Texas Veterans Home program and VA (i.e., market lease, a dollar a year lease, etc.) and what cost for services support.

The HCVC agreed to:

1. Provide congressional assistance where needed for any expansion, if feasible.
2. Support the Assisted Living Program as a positive addition to the Veterans.
3. Support the use of the 5th and 6th floor for the Texas Veterans Home and assisting in obtaining funds to do the work.
4. Assist in whatever way possible.
5. Assist in whatever way possible.

In addition, the following topics were also discussed: a) the use of the Sid Peterson Memorial Ambulatory Clinic by VA staff doctors. b) adding the anesthetist back to the VA staff. c) return some surgery in Kerrville using Dr. King and Dr. Kilgore.

As for the use of the ambulatory clinic, there seems to be a problem with the VA doctors not being on the SPMH staff, they're not qualified to use the clinic. It was agreed the General Schellhase and Dr. Bacon would initiate a meeting with Pat Murray to explore this issue.

Mr. Shea agreed to review the anesthetist and surgery issue.

LETTER FROM GOVERNOR GEORGE W. BUSH
May 1, 2000

Brig. Gen. Walter Schellhase
Hill Country Veterans Council
529 Water Street
Kerrville, TX 78028

Dear Walter,

Thank you for your letter and your interest in my views on issues affecting the lives of America's veterans. I appreciate your concern about this important area of national policy.


There is no question that we are the freest people, in the freest nation on earth, because of the courage and commitment of America's veterans. These men and women Put duty and country above self, and in so doing, brought honor upon themselves and our country.
I believe we owe it to our veterans to remember what they have done for us through daily advocacy on their behalf. A good place to start is in the areas of health care and compensation claims. Soldiers once ordered to stand in the line of fire should not now be ordered to stand in line at the nearest federal bureaucracy, waiting with hat in hand.

In a September address at The Citadel, I outlined many of my proposals to keep America's military strong and repay our debt of gratitude to our veterans. If I am fortunate to be elected President, I will insist on reforms that say to America's veterans: The nation you fought to protect will now fight to protect you.

I appreciate your taking the time to write. As the campaign moves forward, I will continue to develop specific proposals on my vision for America, and I welcome your thoughts and advice.

Sincerely,
George W. Bush

Enclosures 
www.GeorgeWBush.com
Post Office Box 1902, Austin, Texas 78767-1902 OFFICE 512-637-2000 FAX 512-637-8800

HILL COUNTRY VETERANS COUNCIL
1700 Sidney Baker, Suite 100
Kerrville, Texas 78028
830-896-1157 Fax 830-896-1175
www.ktc.net/hcvc

18 May 2000

Sent by Fax
Governor George W. Bush 
P. O. Box 12428
Austin, Texas 78711 

Dear Governor Bush:

As directors of The Hill Country Veterans Council, we appreciate your assurances of your commitment to the men and women who have served this nation in the Armed Forces. 

At the same time, we feel justified m asking for something considerably more specific and detailed than a general statement of your intention to make things better.

As you know, there are two major failings in the current system of caring for the nation's veterans:

* Funding for healthcare is billions of dollars below what it would take just to get the level of care back to where it was in the mid-1990's. Wards, floors and entire hospitals are being closed or turned into nursing homes; doctors and nurses are being retired or laid off by the thousands.

* The Department of Veterans Affairs may well be the least accountable cabinet-level agency in the federal government. The Secretary of Veterans Affairs and his subordinates can and do act in an arbitrary and capricious manner, knowing that little or nothing is likely to be done when wrongdoing is exposed.

We feel totally justified in asking that you offer specifics on how you propose to deal with these serious and large-scale problems affecting the former servicemen and women of this country.

You have courageously provided details of your plan to reform Social Security, and we believe that explaining in detail your plans for helping the nation's veterans would be following the same commendable pattern.

We look forward to hearing from you on this vital request.

Sincerely,
Walter Schellhase 
 

The "Blue Team" at Kerrville has been closed
This is bad news for nearly 450 Veterans. Many who have not yet been informed as to what new team they have been assigned to or what doctor will be seeing them. To get more details on your status if you are a Blue Team member call 830-792-3472.
Some Good News
Several good things have taken place at the Kerrville VA Hospital.
RECENT CHANGES AT KERRVILLE VA HOSPITAL
Reported at the last monthly staff meeting were the following actions.
1. Nurse practitioner will be added to the staff to allow primary care physicians more time with their clinics.

2. The Audie lab is going to be equipped with studio booths from the old Frank Tejeda Clinic in San Antonio. A full time doctor will be added to the Audie lab. A full time radiologist will be added to the staff of the Audie Clinic.

3. A doctor from the "Blue Team" is being assigned in the new Gastro entomology shop. This will provide Kerrville the ability to do all GI testing in house and reduce backlog of GI services both at Kerrville and Audie. A real plus for our Veterans, Target date, March 1, 2000. All of these are positive changes and will prove to be good for Kerrville. However, the elimination of the "Blue Team" is not good, but is being said as necessary to provide the other improvements.

In addition: It has been learned that a Hepatitis "C" testing lab is being set up on the fourth floor. Hepatitis "C" testing is mandated under H.B. 2116, although implementation is not required until May 2000.

A couple of major questions arise with the Hepatitis "C". Does Kerrville have the ability to serve the Hepatitis "C" patient? Is this testing lab just for Kerrville or is it for the entire STVHCS?

As the changes continue to develop, HCVC will keep you informed.

LETTER TO H. HILDEBRAND
6 July, 2000
The Honorable Harvey Hildebrand
125 Lehmann Drive
Kerrville, Texas 78028

Dear Harvey:

The Hill Country Veterans Council needs your help in getting our concerns about Veterans healthcare and other Veterans issues before Governor George W. Bush.

We sent the enclosed letters to the Governor and one of his key aides, but the responses were such obvious 'thank you for writing' form letters that we doubt seriously that Bush ever saw the letters addressed to him.

Early-on it may have been appropriate for Bush to speak in generalities about Veterans Healthcare and other issuers. But now that he's beginning to flesh-out his positions, we feel justified in asking that he provide specifics of his plan to keep America's promises to its former serviceman and women.

We're sure that you have a channel - several, in fact - to get our letters to Bush, and we look forward to hearing that you've succeeded in doing so.

Many thanks for your continuing interest and assistance in this vital area.

Sincerely,

Walter Schellhase
USA-BG (Retired)
Hill Country Veterans Council

Thoughts of a Soon-to-be Veteran
By SSgt Bruce T. Forbes,
US Air Force, ret. 2000

 

Although my name will not be found in any history book;
I have helped make history.
Although there will be no memorial with my carved face,
I have still done great deeds.
Although I will never be quoted or referred to,
I have still said and done great things.
Although I have never meet the Great and Famous of my country,
I feel I have served with them -

I feel as if I have stood with Washington as he faced armies
That made his look so very small.
I feel as if I have stood on-deck with Jones
As he swore he'd never give up the ship;
Or with MacArthur as he strode across that foreign beach
And announced that he'd returned.

And what, you ask, have I learned?
I have learned that there are two ways to give your life for your country:

One way to give your life for your country
Is to die that others may live free;
To fall in combat in defense of those principles which make us free.
On foreign soil as well as here at home
I have walked among the rows of stones
That stand as silent testament
Of the price the very few pay
That many, many others might live
With the freedoms
The dead will never enjoy.

At Gettysburg I have walked where so many of my brothers
Gave their last full measure of devotion -
And there I vowed to give my full measure each and every day
That their sacrifice might not have been in vain.

In Hawaii I have walked in silence
Among the mass graves with no names,
Graves that were filled on the quiet day in December -
That will forever live in Infamy.
Among the silent there I swore I would live a life of vigilance.

In England and Germany and France I have stood in the Fields of Stone
And whispered to my comrades that their country is still free
And that their sacrifice will never be forgotten.

Many of my comrades have paid this final price,
But Fate has chosen for me
The other way of giving one's life -
Fate chose that I must live, offering my life every day
To make the world a little more free.

Fulfilling this commission of living for my country
Has meant an almost-daily sacrifice -
It has meant being on-duty through birthdays and holidays -
So that others remain free to celebrate.

It has meant my seat at church has often been empty -
So that seats in all houses of worship can be freely occupied.
It has meant sacrificing many personal dreams
So that a nation might remain free to fulfill its dream.
It has meant leaving my family
While I went out into the world -

I was not at my mother's side when she was so very sick,
Because I was planting a garden for someone else's mother
While others rebuilt her ancient house
That had been destroyed by a bomb.

I was not at my father's side when he needed me so badly,
Because I was chasing sheep for someone else's father-
Sheep that was his family's only income
And had been scattered by a war.

I was not with my wife when our baby was born
Because I was in a forest, holding the hands
Of a young widow escaping her country
As she give birth to her first child.

I was not there when my daughter was in the hospital
Because I was in a refugee camp,
Clutching a dying orphan to my chest,
Praying she might live.

There are times I truly wonder
If my own country has seen my sacrifice,
But I know the rest of the world has seen it -
They have seen that a soldier can bring life and hope
Into a world without life or hope.
And, perhaps, these quiet acts overlooked by my own people
Will be my only memorial.

But my real memorial will be
To always live for Freedom
As valiantly as others
Died for it.
In doing so,
We have both given our lives.

As a Veteran,
I stand tall and proud with those who came before me.
I stand as a companion to those who secured my freedom,
For I have fulfilled their commission
Of securing liberty
For my children.

And now, it is my children's turn
To secure those freedoms
For their children.