Creative Arts FestivalCreative Arts FestivalCreative Arts FestivalCreative Arts FestivalCreative Arts FestivalHealing Power of the Arts — page 6

VAnguard

Inside: End-of-Life Care, 8 ✩ EEO Awards, 9 ✩ HR Conference, 10

U.S. DEPARTMENT OF VETERANS AFFAIRS

JANUARY 1999

2 VAnguard

Published by the Office of Public Affairs (80D)

Department of Veterans Affairs810 Vermont Ave., N.W.Washington, D.C. 20420

(202) 273-5746/5735E-mail: vanguard@mail.va.gov

www.va.gov/pubaff/OPAIndex.htm

INTRODUCINGCCCCCONTENTSONTENTSONTENTSONTENTSONTENTS

Pete Dougherty

VAnguard VA’s Employee Magazine

January 1999 Vol. XLV, No. 1

Printed on 50% recycled paper

Editor: Lisa RespessGraphics: Michael Nacincik

❏ Holiday Stand Downs 4Indianapolis homeless vets get help

❏ Y2K on the Horizon 5Will VA be ready?

❏ Creative Arts Festival 6Nearly 100 veterans participate

❏ Nurse Education 7New assistance program launched

❏ End-of-Life Care 8-9VA leads improvement effort

❏ EEO Awards 9Five employees honored

❏ HR Conference 10-12Second national meeting held

❏ Salute Chairman 12Dan Lauria to lead National Salute

CCCCCOLUMNSOLUMNSOLUMNSOLUMNSOLUMNS

11111On The Cover:Wes Grider, from Bowlus,

Minn., Rick Stang, from St. Cloud,Minn., and Elisha Thornton, fromFargo, N.D., three members of theV-Notes, sing “Silhouettes” (asrecorded by The Rays) at theNational Veterans Creative ArtsFestival in Houston.

Pete Dougherty was working lateone night in VA Central Office whenhe decided to walk to a nearby fast-food restaurant to grab a bite to eat.As he walked down the streets ofdowntown Washington, severalhomeless men approached him andasked for money.

But instead of giving them money,Dougherty invited the men toaccompany him to the restaurant,where he bought them dinner and,learning the men were veterans, toldthem about the resourcesthat are availableto them throughVA.

That’s the level ofcommitmentDougherty brings tohis job as director ofVA’s homelessprogram, where hecoordinatesDepartmentwideinitiatives to assist thisat-risk population.

He joined VA just before thenational summit on homelessveterans in February 1994, followingstints as a staffer on both the Houseand Senate Veterans Affairs Commit-tees, where his duties includeddrafting legislation and preparinghearings on the homeless veteransissue.

Dougherty served as a specialassistant on homelessness to theSecretary and the Under Secretaryfor Health, and also managed aspecialized homeless veteransprogram for the VA MarylandHealth Care System before recentlybeing named director of the home-less program.

What he enjoys about his work, hesays, is that “most people who workin the homeless program are reallydedicated employees, and thecommunity providers we work withare extraordinarily dedicated. Thereare some creative people out therewho are committed to getting the jobdone.”

In recent years, through the

Homeless Providers Grant and PerDiem Program and others, VA hasbranched out to involve a variety ofnonprofit community groups in itsefforts to help homeless veterans.

Dougherty likens VA’s bestpartnerships with these communityproviders to a good marriage. “Bothpartners contribute something, andboth gain something in return —nobody loses.”

He believes the most successfulpartnerships arethose that combineVA’s medical careand benefitsexpertise with thecommunity’sability to linkhomeless veteranswith housing,jobs and otherneeded services.

“I like to saythat true

collaboration withour community partners — where

we really work with each other andtake strengths from each other —affords us the opportunity to design,deliver and provide services thatcenter on addressing the totals needsof the veteran who is homeless.”

Dougherty would now like tofocus on increasing access to VA’sservices for homeless veterans. Hepoints out that although “homelessveterans are everywhere, homelessprograms are not. Some homelessveterans may be hundreds of milesaway from the nearest VA provider.We need to provide more opportuni-ties for them to receive the servicesthey need.”

And as the Department heads intothe new millennium, Dougherty sayshe would like to see VA make arenewed commitment to addressingthe health care, housing and employ-ment needs of all homeless veterans.

“There is virtually no VA office,from the Secretary on down, thatdoesn’t have some connection towhat we’re trying to do.” ❑

13-16

January 1999 3

OutlookRonald CowlesDeputy AssistantSecretary for HumanResources Management

In Novem-ber, VA leaders,human re-sources profes-sionals, veteranadvocates, andunion partnersassembled inAtlanta todiscuss ways tobetter supportemployees in

their efforts to serve veterans andtheir families.

It became clear early in theconference that VA would be unableto achieve its vision of having a highperformance work force if it didn’tspend more time and resources onattracting talented employees towork for VA and developing thosealready in the VA family.

It was also clear that humanresources professionals had animportant role to play as employeeadvocates in assuring that VA’s goalsand objectives were both employeeand veteran focused.

It’s no secret that the best busi-nesses in this country have achieveda high level of customer satisfactionwith their products and services byinvesting in employee developmentand providing a safe and family-

friendly workplace. Employees whowork in this type of environment arehighly motivated and capable ofproducing outstanding results.

When the discussions in Atlantaturned to how VA could bettersupport employees, conferenceattendees turned their attention toemployee development. A list ofskills, competencies and attitudesthat were characteristic of highperformers was developed. Theseincluded problem solving, computer,communication, interpersonal,negotiating and technical skills.

In addition, attendees felt itimportant that employees caredeeply about quality service, under-stand their role in helping VAsucceed, are flexible and adaptable tochange, have a take-charge attitudeabout their job, are open to construc-tive feedback, are creative, orga-nized, accountable for their perfor-mance and conduct, courteous and,above all, committed to providingthe best care and service possible toveterans and their families.

So what does all this mean forthose of us in the VA family? Quitesimply, it means that we need tocome together as never before andplan better ways to provide opportu-nities for all employees throughout

the Department to acquire andperfect the skills mentioned above.In addition, we need to promote andreward the types of attitudes andbehaviors that will result in VAachieving service excellence.

Planning is already underwaythroughout the Department toimprove and increase our efforts inemployee development. Throughwhat is being called the VA LearningUniversity (VALU), all employeeswill receive training in the competen-cies considered critical to successfulperformance.

For example, competency in usingcomputers is becoming increasinglyimportant in a variety of professions.Employees can expect to receiveincreased training in this area.

Once competencies have beenidentified, training sources will beidentified and made available toemployees. Take advantage of newopportunities that result from theseefforts and if you have suggestionson how we can better supportemployee development, please sharethem.

VA employees are the humanresource solution to achieve serviceexcellence. Based on my personalobservations, VA is well on its wayto achieving this goal. ❑

Service Excellence theHuman Resource Solution

Dallas VAMC was the site for the kickoff of theNational Partnership for ReinventingGovernment (NPR)’s Hassle Free Communitiesinitiative last month. The program is aimed atmaking government more user-friendly byproviding services from various local, state andfederal agencies at one site. In addition to VA,representatives from the IRS, HUD and DallasArea Rapid Transit, among others, were onhand providing assistance to veterans on suchtopics as disability benefits, housing and publictransportation. The agency representatives willvisit the VAMC one Monday each month.

4 VAnguard

T he holidays can be particularlylonely and difficult for thehomeless. Often separatedfrom their families, their focus

must remain on struggling to surviveon the streets, while the rest of thenation turns its attention to turkeyand pumpkin pie, brightly coloreddecorations, and exchanging giftswith family and friends.

That’s why Bob Rogers, homelesscoordinator at theIndianapolis VAMedical Center, andJim Powers, stateadjutant of the Indianachapter of the Dis-abled AmericanVeterans (DAV), gottogether in 1992 to plantwo homeless veteransstand downs to coin-cide with the Thanks-giving and Christmasholidays.

They knew homelessveterans inthe India-napolis areawould greatlybenefit fromthe opportu-nity to come inoff the streetsduring theholiday seasonand enjoytraditionalholiday meals,pick up warmclothing, andtake advantageof servicesincludingmedical screen-ings, flu shotsand mentalhealth counseling.

Organizing the events “was hardwork,” Rogers said, “but wheneverwe ran into an obstacle or had asetback, we overcame it. We didn’tturn tail and run.”

Attendance has increased enor-mously since the program firstbegan, when only 85 veteransattended a chicken dinner served in aback room of the state DAV head-

Annual Indianapolis Stand Downs BringHoliday Cheer to Homeless Veterans

quarters.This year, a total of more than

1,400 homeless veterans and theirfamilies attended the two annualholiday stand downs sponsored bythe Indianapolis VA Medical Centerand the Indiana DAV chapter.

Held at the Tyndall NationalGuard Armory in Indianapolis, theseevents brought together more

than 40 agencies andorganizations to

provide on-site assis-tance to the veterans, includ-

ing the Indianapolis VA RegionalOffice and Vet Center, the SalvationArmy, the Social Security Adminis-tration, Ford Motor Company andlocal homeless groups.

Nurses and other health care stafffrom the Indianapolis VAMC wereon hand providing medical screen-ings and care, while members of themedical center’s mental health,vocational rehabilitation, and home-

less staffs provided on-site counsel-ing.

Indiana University’s School ofOptometry offered free eye examsand glasses through a grant fromDAV, and warm winter clothes wereprovided courtesy of the citizens ofCrawfordsville, Ind. Since theIndianapolis holiday stand downsfirst began, 18 tons of clothing havebeen collected for homeless veteransby the people of this town of 14,000.

Their generosity reflects the spiritof cooperation evident among allorganizations involved in theseannual events that Rogers believeshas been the key to their success.Citizens from all over the state ofIndiana volunteer their time tohelp out at the stand downs.

“For the veterans, it’s a time torest, eat a good holiday meal,enjoy the camaraderie and getneeded services,” said Rogers.“For the staff and volunteers, it’sa time to assist others, help liftveterans’ spirits and reflect on

the things we have to be thankful for.It’s a win for VA, a win for DAV, andespecially a win for the veterans.”

Nationwide, VA participated inmore than 120 stand downs —named for the military term for abreak in battle during which soldiersare allowed to rest and recuperate —in 1998. A total of more than 40,000homeless veterans received assis-tance through these stand downs andbenefits assistance fairs. ❑

January 1999 5

New Atlanta VARO to be Built Next to VAMC

W ill planes fly? Will we beable to make phone calls?Will we have electricity?Will medical devices go

haywire? No one really knows whathavoc the millennium bug may ormay not wreak on January 1, 2000,because there is simply no precedent.

With only twelve more months togo, federal officials and computerexperts are joining their privatesector counterparts in the scramble tomeet the challenges the first day ofthe new century could bring.

Where does VA stand? TheDepartment has been tackling theproblem since 1996, and has madebetter progress than many of itsfederal counterparts, with 99.7percent of its mission critical com-puter software applications nowrenovated, including all payment-related applications and applicationssupporting health care.

Renovation, which involvesmodifying, replacing or eliminatingan application to make it Year 2000compliant, is the second of a simulta-neous four-phase program VA hasundertaken to resolve Year 2000problems. More than 300 applica-tions supporting 11 mission criticalsystem areas such as compensationand pension, loan guaranty, insur-ance, and medical computer andcorporate administration systems

needed to be renovated.The Department also has vali-

dated (tested) 88 percent and hasimplemented into production 73percent of the applications.

The third phase, which validatesnew or changed code for datehandling and functionality, isscheduled to be completed thismonth. The final phase involvesimplementation of all applicationsinto production and is expected to becompleted by the end of March, theadministration’s deadline for Year2000 readiness. VA completed thefirst phase, known as assessment,last January.

VA must also complete businesscontinuity and contingency plans tomitigate Year 2000 impacts onbenefits delivery and health care,according to Ernesto Castro, VA’sproject manager for Year 2000compliance in Information ResourcesManagement.

To alleviate fears veterans mayhave about interruptions in benefitspayments, all regular recurringbenefits payments, such as compen-sation and pension, most educationprograms, vocational rehabilitation,Restored Entitlement Program forSurvivors, and those for Vietnamveterans’ children with spina bifida,will be posted to beneficiaries’accounts and be available on the

morning of December 30, 1999.VA also has completed implemen-

tation and closed out three of the 11mission critical areas: the NationalCemetery Administration, FinancialManagement and Vocational Reha-bilitation.

Castro attributes VA’s overallsuccess to the fact that the in-housepersonnel who developed andmaintain VA computer systems havealso been responsible for identifyingand fixing Year 2000-related prob-lems.

Although VA’s own computersystems will be ready, Castro pointsout that smooth operations onJanuary 1, 2000, also will depend onthe readiness of third parties fromwhom VA gets support services suchas water and electricity. VA alsorelies on other agencies, such as theDepartment of Treasury, to helpcarry out some aspects of its mission.

Castro says VA is working closelywith those third parties, includingmanufacturers of biomedical equip-ment, telecommunications serviceproviders and commercial off-the-shelf products used at VA facilities toobtain the information needed toensure that those products andservices will be Year 2000 compliantas well. ❑

The Countdown to Y2K: Will VA Be Ready?

Artist’s rendering of the new Atlanta VARO building

G eorgia veterans andtheir families are astep closer to gettingone-stop service from

VA, now that ground hasbeen broken for a new VAregional office building rightnext to the VA medical centerin suburban Atlanta.

When completed at theend of this year, the four-story building will housemore than 540 employees andrepresentatives from veteransservice organizations. Afitness center, extra trainingrooms and a food court areplanned.

Under the terms of an “enhanced-use” lease agreement with theDevelopment Authority of DekalbCounty, the county will lease the

building to VA for 30 years, afterwhich it will revert to VA ownership.

“Veterans needing assistance withvocational rehabilitation, GI Bill or

any other veterans benefitscan get it at our new location,and get their health careneeds addressed next door atthe medical center,” saidAtlanta VARO Director J.Gary Hickman. “This movewill allow us to expand ourservices to veterans whileproviding more accessibility,ease of use and a qualitywork environment for ouremployees.”

Joining Hickman at thegroundbreaking were DeputySecretary Hershel Gober,Under Secretary for BenefitsJoseph Thompson, Develop-

ment Authority Chairman RobertAugustine and Georgia Departmentof Veterans Service CommissionerPete Wheeler. ❑

6 VAnguard

“ The most wonderful thingabout the National VeteransCreative Arts Festival is thehealing power of all the

veterans — talking from theirhearts,” said T.K. Laureano, amember of the Teague VA Singersfrom Temple, Texas. “I wasn’t goingto come; I wasn’t going to partici-pate. And then my therapist encour-aged me — ‘Go... just try and let ithappen.’ And it did!”

It happened in Houston withnearly 100 veterans from VA medicalfacilities across the countryparticipating in this unique eventthat showcases the therapeutic valueof music, drama, dance and art. Theveterans, all winners of nationalcompetitions, spent the week inrehearsals and art workshops thatconcluded November 8 with a galaperformance and art show.

The talent of these veterans is realand each one has a story of how thearts changed their life. Take, forexample, Army veteran WayneRichardson of Renton, Washington,winner in the Needlework category.Richardson’s piece, “In Fond Re-membrance,” is dedicated to thememories of his wife and only child,both killed in separate vehicleaccidents. The design is a rosemallows flower that came from apattern, but was modified by him toinclude symbols representing thecomplexity of life.

It took him eight months tocomplete the piece. Using a new anddifficult technique, he chose theflower for its complexity and beauty.

He addedbuds to symbol-ize birth; deadstalks to illus-trate death; alittle frogclimbing up intothe plant todemonstratelife’s unexpectedturns; andbutterflies repre-senting sweet-ness. “It wasthe most compli-cated piece I hadever done,” he

after befriending Moor on St. CloudVAMC’s Respiratory Distress Unit.Moor was suffering from ALS,commonly known as Lou Gehrig’sDisease, and had been ventilator-dependent for more than 13 years.

During the course of their friend-ship, Roth was inspired to write asong about Moor — “one that reallyput into words the events of his lifeand set the facts straight,” Roth said.Songwriting is helpful for Roth aswell. “It is my therapy,” he said.

Why did he write the ballad? “Iwanted to pay tribute to one life —Loren Moor’s — a forgotten person,cut down in his prime, trying to keephis spirit up. There are a lot of guysout there just like him.”

Sadly, Moor passed away justdays after Roth performed his balladat the Festival in Houston. However,

one thing is certain — Loren Moorwill live on, thanks to Charlie Roth.

VA sponsors the annual NationalVeterans Creative Arts Festival withthe help of co-sponsor Help Hospi-talized Veterans, and long-time nat-ional sponsor, The Recording Indus-tries Music Performance Trust Fund.The Festival was hosted this year bythe Houston VA Medical Center andwill be held in Grand Junction, CO in1999. ❑

By Kathy SalazarHouston VA Medical Center

Showcasing the Healing Power of the ArtsNational Veterans Creative Arts Festival

Wayne Richardson with his winning needlework piece.

said. “It was my love for my wifeand daughter that saw me through it.”

Suffering from depression andseveral health problems after thedeath of his daughter, Richardsonentered the Seattle VAMedical Center in 1994.Bedridden, he foundcross-stitch a safe havenfrom his physical andemotional pain.

“Cross-stitch seemed toget my mind going on adifferent track. The magicmoment came when I putmy daughter’s name onthe piece. I felt a liftingoff of my shoulders,” herecalled. After that, thephrase, “When I am downi try to focus on thecolorful memories of thepast and the beauty of lifeto ease the present tribula-tion,” came to him. “Ikept the second ‘i’ inlower case to represent my insignifi-cance,” he added. “When it wasdone, I had something that I couldlook at and I could remember. Themeaning of the whole picture is thatlife is complex and it’s not perfect,but there is always beauty in life ifyou get that part of it.”

The Special Recognition Honor inthe music division was awarded toveterans Charlie Roth and LorenMoor of the St. Cloud, Minn.,VAMC. The song, written by Roth,is a tribute to a powerful friendshipbetween the two men. Roth com-posed “The Ballad of Loren Moor”

Charlie Roth composed a ballad honoring a fellow veteran.

January 1999 7

VA Launches Education Initiative for Nurses

T he nation’s largest integratedhealth care system is also thenation’s largest employer ofregistered nurses, and VA has

committed $50 million to a neweducation assistance program forthose seeking baccalaureate or highernursing degrees.

The program is part of a nationalinitiative to support VA’s nursingwork force. The scope of this initia-tive likely makes it the first of itskind in the nation. The initiative:

• adopts new performancestandards for VA’s more than 36,000registered nurses that establish neweducation and practice requirementsfor advancement;

• establishes the baccalaureatedegree as the level of educationalpreparation that VA’s professionalnursing work force must have by2005, and puts this requirement inplace for new hires immediately;

• earmarks $50 million over thenext five years to assist its nursingpersonnel to attain the baccalaureate(or higher) degree, as well as to meetother specific occupational trainingneeds; and

• provides the nursing workforce innovative academic opportu-nities and educational programs inpartnership with professionalnursing organizations.

The first step in achieving the finalelement of the initiative was takenlast month with the signing of aMemorandum of Understanding(MOU) between VHA and theAmerican Association of Colleges ofNursing (AACN). Under the termsof this MOU, the AACN will workwith VHA to find innovative ways ofbringing nursing education opportu-nities to the VA workplace.

The aim of this program is toensure that VA nurses are education-ally prepared to provide the highestquality health care to veterans acrossthe full range of current clinicalpractice roles and settings, as well asthe many new roles for nurses thatare evolving.

The standards and implementa-tion plans were developed in col-laboration with a variety of profes-sional nursing organizations andinstitutions, including unions, theAmerican Nurses Association, theNurses Organization of VA, and theAmerican Association of Colleges of

Nursing. Provision is made forcontinuation of nurses in theircurrent grades and for entry levelhiring of all nurses.

The education assistance elementof the initiative will largely beimplemented locally by VHA’s 22VISNs under national guidelines thatwill assist local education initiativesin meeting best-practice principles.It is estimated that more than 5,000VA nurses are likely to return toschool.

VA’s nursing performance andeducation requirements are con-

tained in nurse qualification stan-dards that were last revised in 1982.The former five-grade nurse classifi-cation system has been revised by aVA task force that collaborated withprofessional nursing organizations,unions and VA management, usingthe American Nurses Association’s“Standards of Clinical NursingPractice.”

The education assistance incen-tives and revised qualificationstandards reflect VA’s need fornurses with additional educationbeyond entry-level credentials. ❑

Members of the 1958 Baltimore Colts championship football teamreunited recently at the Baltimore VA Medical Center to help research-ers from the Geriatric Research Education & Clinical Center (GRECC)with their study to determine the cardiovascular risk factors for retiredprofessional athletes versus non-athletes as they age.

Five of the former players, along with other members of the NFLRetired Players Association, underwent a series of tests at the medicalcenter, including a complete physical with blood work, a stress test, anda dual emission x-ray absorptiometry test, which provides informationabout body composition.

The results of the professional athlete study will be compared to thatof a similar study done at the medical center that investigated non-athlete veterans who are 60 and older.

The former players were in Baltimore to celebrate the 40th anniver-sary of what was dubbed “The Greatest Game Ever Played,” betweenthe Colts and the Giants.

Above, research nurse Joyce Evans, RN, who attended that game,visits with study participant and NFL Hall of Famer Lenny Moore.

Former Pro Athletes Participate in Study

8 VAnguard

A dvances in medical treatmentand technology in recentyears have dramaticallyincreased the ability of health

care professionals to save or prolongthe lives of countless Americans.

And while the arsenal of ad-vanced procedures and sophisticatedequipment available to medicalprofessionals in their battle againstillness and disease has continued togrow at an unparalleled rate, thequality of care for one group ofpatients may have been neglected inthe face of all of this progress —those who are terminally ill.

VA is positioning itself tobecome a national leader inimproving end-of-life andpalliative care provided topatients for whom medicalscience does not yet offer acure.

What qualifies VA to leadthe way in improving end-of-life care? First of all, VA’spatient mix tends to be olderand more seriously andchronically ill than thegeneral population, so italready has substantialexpertise in this area. Andthat expertise is expected to grow inthe new century as the veteranpopulation continues to age.

“Many of our World War II andKorean Conflict veterans are ap-proaching an age when serious, life-threatening illnesses are morecommon, so it is important for theVA health care system to be able toprovide reliable, high quality end-of-life care,” explains Bonnie Ryan, RN,VA’s Chief of Home and Commu-nity-Based Care, Geriatrics andExtended Care Strategic HealthcareGroup. Ryan is providing leader-ship for VA’s national strategy toimprove end-of-life care.

In addition, since VA operates thenation’s largest integrated healthcare system, it can provide the fullarray of services needed to offer acomprehensive approach to caringfor the terminally ill. Add to that thefact that VA can tap into its numer-

ous academic and other affiliations toform the alliances needed to improvethe way end-of-life care is provided,and VA’s leadership potential in thisarea begins to emerge.

VA conducted a national summitlast spring to develop a comprehen-sive, system-wide strategy forimproving the care of patients whoare terminally ill. The health careprofessionals, managers and patientrepresentatives from all over thesystem who participated in thesummit, along with experts fromoutside VA, established goals for

improving end-of-life care. Theyagreed that VA’s priorities for end-of-life care should be:

• no dying veteran should sufferfrom preventable pain while beingcared for in the VA health caresystem;

• every veteran with a serious,life-limiting illness receiving care inthe VA health care system shouldhave an individualized plan forcomprehensive services that mini-mizes physical, psychological, socialand spiritual suffering and optimizesthe patient’s quality of life; and

• every veteran with a terminalillness who is receiving care in theVA health care system should haveaccess to hospice care and/or com-prehensive palliative care servicesand should understand that thoseservices are available.

Significant strides are alreadybeing made in each of these priority

areas. To ensure that dying veterans,as well as other patients who areexperiencing acute and chronic painfrom a wide range of illnesses, do notsuffer needlessly from preventablepain, VHA has adopted a nationalpain management strategy.

The elements of the strategyinclude implementing standardprocedures at all VA health carefacilities for recognizing and treatingpain, expanding research on painmanagement, and ensuring thatclinicians are adequately trained toassess and treat pain effectively. Infact, pain will soon be considered thefifth vital sign (after heart rate, bloodpressure, body temperature andrespiration), and every patient willroutinely be assessed for it.

“The pain assessment willbe systematically charted onevery patient’s medicalrecord, just like the other vitalsigns,” Ryan says. “Doctorsand nurses should be ex-pected to treat a patient’s painpromptly and appropriately,just as they are expected totreat an elevated temperatureor an abnormal blood pres-sure.”

VA is quickly achieving thegoal of having an individual-ized plan for each terminallyill patient as well, with thepercentage of patients having

a documented plan increasing from67 percent in 1997 to 91 percent in1998.

And progress also is being madein improving access to hospice andpalliative care services. Ninety-eightpercent of VA facilities have ahospice consultation team, and 80facilities offer inpatient hospice care.

One innovative initiative in theend-of-life care national strategy, theVA Faculty Leaders Project, capital-izes on VA’s strong affiliations with107 of the nation’s 125 medicalschools. This two-year program issupporting 30 VA faculty physiciansfrom VA-affiliated internal medicineresidency programs to developapproaches that will promote awider acceptance of end-of-life careconcepts in education and trainingprograms.

The Robert Wood Johnson Foun-dation awarded a grant of nearly one

VA Leads Effort to Improve End-of-Life CareThe VA health care system is expanding its specialized expertiseand using its vast resources and affiliations to lead the nation inimproving the quality of care provided to patients at the end of life.

“The overall goal is to assure that everyveteran who is facing a terminal illnesscan count on the VA health care systemto provide the kind of compassionatecare that each one of us would want forourselves and those we love.”

- Bonnie Ryan, Chief of Home and Community-Based Care

January 1999 9

million dollars to fund this project,which focuses on developing bench-mark curricula for end-of-life andpalliative care — and strategies fortheir implementation — for trainingresident physicians in generalinternal medicine and thesubspecialties of internal medicine.

This project is expected to have animpact on as many as 25 percent ofthe nation’s medical schools. Eachyear, about one-third of the nation’sresident physicians and one-half ofmedical students receive part or allof their training at VA medicalcenters.

Dr. David Stevens, VA’s chief of

academic affiliations, is directing theproject, and a steering committeecomposed of national experts willhelp guide the work of the facultyleaders. Three national meetings ofthe faculty leaders and steeringcommittee members will offer anopportunity to share ideas anddiscuss strategies to improve resi-dency attention to the issues sur-rounding end-of-life and palliativecare.

Ultimately, VA’s national strategyfor improving end-of-life care willstrive to ease the suffering andpreserve the dignity of dying pa-tients as much as possible, while at

the same time empower them andtheir families to make informeddecisions about available treatmentoptions and support services.

“The overall goal is to assure thatevery veteran who is facing a termi-nal illness can count on the VAhealth care system to provide thekind of compassionate care that eachone of us would want for ourselvesand those we love,” says Ryan. “Noveteran should suffer from prevent-able pain, and every veteran shouldhave access to comprehensivepalliative care services at the end oflife.” ❑

Secretary’s EEO Award Winners Announced

F ive VA employees werehonored recently in Washing-ton, D.C., for their outstandingsupport of VA’s Equal Em-

ployment Opportunity (EEO) goals.The recipients of the Secretary’s

11th annual EEO awards were:Stephan D. Nowling, administrativeofficer at the Omaha, Neb., VAMedical Center; Charlotte F. Carter,employee relations and developmentspecialist at the Roseburg, Ore., VAMedical Center; Robert O. Stringer,EEO manager for the Jackson, Miss.,VA Medical Center; Alan H. Sinclair,assistant director of the Phoenix,Ariz., VA Regional Office; andRobert Perreault, director of theAtlanta VA Medical Center.

Nowling was recognized for his

contributions to programs for peoplewith disabilities. He was cited for hiscreativity, motivation and insightinto the problems people withdisabilities face by helping to bring avariety of educational programs tothe VAMC. He also has madesignificant contributions towardeliminating physical barriers at theVAMC for disabled patients, em-ployees and visitors.

Carter was selected for her workas an EEO program representative.She has served as the FederalWomen’s Program manager atRoseburg VAMC for more than 20years. As a certified EEO counselor,she has provided training to all VISN20 medical centers and has assistedin the resolution of many difficult

employee relations issues.Stringer was recognized in the

category for supervisors and manag-ers through GS-14 for outstandingleadership in administering majorEEO programs. His accomplish-ments include conducting EEOtraining for service chiefs andsupervisors, and facilitating sexualharassment prevention training forall Jackson VAMC employees.

Sinclair was selected in thecategory for managers and execu-tives GS-15 and above for his dedica-tion and interest in advancing theEEO program both at the PhoenixVARO and in the community. Heparticipates and actively involves theVARO’s division chiefs and supervi-sors in various special emphasisprograms.

Perreault was honored in thecategory for managers and execu-tives GS-15 and above for institutingprograms that develop the educa-tional and professional skills ofAtlanta VAMC employees, such asthe Upward Mobility Tuition Pro-gram, VA Leadership DevelopmentProgram and the Atlanta EnrichmentProgram.

The Upward Mobility programgrants funds for tuition and books toemployees who want to attendcollege, the VA Leadership Develop-ment Program provides careerdevelopment opportunity for em-ployees at the GS-8 (and equivalent)grade level and below, and theAtlanta Enrichment Program isdesigned to identify and implementupward mobility positions through-out the VAMC’s service lines. ❑

From left: Charlotte F. Carter, Alan H. Sinclair, Stephan D. Nowling, SecretaryTogo D. West, Jr., Robert Perreault and Robert O. Stringer.

10 VAnguard

T o those whose business is tomanage major change in largeorganizations like VA, RealTime Strategic Change means

bringing together people fromvarious ranks to talk in small groupsabout what works and what doesn’t,to question and challenge topexecutives, and finally to recommendactions. At least that was the formatthat 350 human resources profession-als and top managers from VA’snationwide system followed in afour-day conference in early Novem-ber.

Before it ended, top executivesfrom VA’s three operating armsexhorted HR professionals to becomeclose, tight partners with the linemanagers they support, consultingwith them to help managers reorga-nize and recruit, develop and retainemployees. For their part, lineexecutives said they would be opento suggestions about the trainingthey will have to provide managersso they can take more responsibilityfor their work force planning as wellas training for their HR staffs.

An outsider could be forgiven forseeing the event as a grand love fest.After all, in small table groups,participants delved into ways to linkVA’s “human resources” — employ-ees — to improved services forveterans. They were stimulated bycalls to arms from leaders of thenational veterans organizations (seesidebar). Underlying the brainstorm-ing and exercises in collaboration,however, was a call for help from HRprofessionals in carrying out theirtraditional HR work at field stationswhile preparing their diminishedstaffs for new roles as employees andmanagers assume some of theirtasks.

Participants expressed interest infilling training and developmentalneeds. They voted to continueinitiatives started a year earlier at thefirst national HR conference. One offour work groups formed last yearnow has the added task of helpingdevelop HR␣ competencies formanagers and employees. Consen-sus was that a growing partnershipbetween HR, the Veterans HealthAdministration Employee EducationSystem and the VA Learning Univer-

sity will support that effort.

Managers Linked Onlineto Planning Tools

HR LINK$, the key tool forchanging how managers and em-ployees handle many aspects of“personnel” functions, was a center-piece of questioning. Phase 2 of

LINK$, automated personal transac-tions by employees, has not yet cometo most VA facilities; it’s being usedwith 12 sites, including some CentralOffice organizations. But Phase 3,management assistance, waslaunched September 28 at theprototype sites, so it’s clear that theDepartment has committed tocentralizing many HR processes andputting the tools for work force

The future for HR people is changing, and VA executives at the recentHR conference in Atlanta spelled out just how.

Deputy Assistant Secretary for Human Resources Ronald Cowles saidcorporate HR — the Office of Human Resources Management in VACO— views itself as a strategic partner to help the Secretary of VeteransAffairs move the department forward with a high-performing work force.Several actions are underway or needed to help make this happen:

• The National Partnership Council, comprised of management andlabor, is reexamining its goals to become a stronger advocate for employ-ees.

• Individual performance plans must be linked to organizational plans.• Field HR employees must become more self-sufficient, and using

web-based technology will help.The Veterans Health Administration will hold a summit February 8-11 in

St. Louis to begin planning field use of a model for a high-performing workforce in which all employees have eight core competencies. Larry Deal,director of the Atlanta VHA network, announced the event. He alsopointed out that the old image of a VA personnel officer was of a transac-tion executor and police officer. Under the new model, to be a valuedconsultant to management HR people must anticipate their customers’needs.

Speaking for the Veterans Benefits Administration, Bill Stinger, directorof the St. Petersburg, Fla., VARO, told HR people their future lies inaligning themselves with VA’s business lines. The crucial question theywill be asked is, “Were you there” when line operations were designingtheir strategic plans?

Ventris Gibson, Deputy Assistant Secretary for Resolution Managementand advisor on equal employment opportunity to the Secretary, identifiedthree areas that have produced EEO complaints, which have escalated inthe last year: restructuring, reassignment and non-sexual harassment.

Gibson urged HR people to keep managers informed of trouble in theseareas before they become EEO complaints. She reminded managers thattheir front-line employees who serve veterans away from main facilitiesoften serve people representing many diverse cultures. She askedmanagers and HR people to do more to end discrimination and save thecosts of investigating and resolving EEO complaints. She promised thatthe Office of Resolution Management will respond to complaints in atimely way. “But,” she added, “I challenge you to put us out of business.”

Larry Blevins, Ed.D., dean of the new VA Learning University, said heplans to produce a One-VA orientation program. He called the conferencea first step in partnership with HR staff to provide training which, he said,will use the latest technology. Blevins also said he hopes to see em-ployee training become a line item in VA’s appropriations.

Executives Set Stage for HR Future

National HR Conference Participants

January 1999 11

ers located in smart rooms, whereemployees who do not have personalcomputers at their work stations cando their transactions, have privateIVR phone access and make aprinted record of transactions.

Phase 3 began recently at the 12prototypes with training of managersto perform online classification.Staffing — creating vacancy an-nouncements to fill positions — isexpected to begin at the prototypesites early in 1999. Payroll, and timeand attendance record keeping,could begin next fall for Title 5employees (and later for Title 38) atthe same sites.

In the meantime, VA will sellpayroll services to other federalagencies, including the FederalEnergy Regulatory Commission,providing valuable experience inusing the PeopleSoft softwareprogram.

With this additional phase ofassisting management withclassification and staffing, theautomated HR LINK$ softwareprogram — Coho — will become the

tool by which managers can achievetheir staffing and organization goalsmore quickly, said Carruthers.LINK$ will have teams assigned toassist facilities in various areas andanswer managers’ questions.

Carruthers said VA’s unions havebeen involved at both local andnational levels in HR LINK$ plan-ning and implementation. At theprototype sites they participate onimplementation support teams(ISTs).

David Cox, vice president ofAmerican Federation of GovernmentEmployees and a member of VA’sNational Partnership Council, said,“HR LINK$ has done more than anyother program to bring in theunions.”

A panel representing the VAmedical center prototype sites inVISN 2 told the conference audiencethey know of several corporate HRoffices that plan to use some of thesame electronic technologies VA haschosen.

To enhance their role as partnerswith management, HR staff at all five

planning directly in the hands ofmanagers. Many classification andstaffing specialists at field facilitieswon’t be needed. Preparing for thesechanges to be rolled out nationwide,HR positions have been reduced.

Bruce Carruthers, director of theShared Service Center (SSC) inTopeka, Kan., the operational arm ofHR LINK$, anticipates that allemployees will be able to makepersonal transactions online at PCsor by toll-free telephone by the endof 1999.

Employees interviewed in focusgroups at prototype sites said theylike the ability to track the status oftheir transactions online, systemprompts, speed of making changes,convenience and the consistency ofinformation they receive.

Between the start of Phase 2 inMarch and the end of September1998, more than 13,600 automatedtransactions were made.

Kiosks at facilities used to makepersonal transactions — whichrequired frequent re-calibration —will be replaced by personal comput-

Representatives of nationalveterans service organizations whospoke at the 1998 Human Re-sources Management Conferencetold the audience that they mustbelieve they have a stake and acareer in serving veterans.

Although many in the audiencecurrently face challenges in theirown changing work environments,they responded enthusiastically tothe call to arms issued by represen-tatives of the American Legion, theVeterans of Foreign Wars, theParalyzed Veterans of America andthe Disabled American Veterans.

Fred Juarbe, veterans servicedirector for the VFW, and PhilWilkerson, deputy director ofoperations for the Legion, emphati-cally urged the audience not to callveterans “customers.” Juarbe said,“There’s a communication problemwhen you call them customers; they

are veterans.” Wilkerson added,“Veterans believe very strongly thatthey are not customers. They can’tgo elsewhere, like they would toSears.”

Juarbe called VA “the disabilityinsurance program of the active-dutymilitary.” To fill the role, VA will haveto provide more long-term care andburial sites for older veterans,assistance for families, catastrophicmedical care and employment aid foryounger ones. “We must share theveterans’ sense of urgency,” saidJuarbe, and utilize informationtechnology to work together and actas one VA.

Jeff Dolezal, director of fieldservices for PVA, said HR managersshould provide new employees withan orientation program that conveysthe sacrifice veterans made. “We’reall from a veterans service organiza-

tion,” he added. “VA is the motherof all veterans service organiza-tions.”

Dave Gorman, executive directorof the DAV, said future VA employ-ees should have multiple tasks. Hesaid too often VA takes shortcuts toimprove a system that benefits thedepartment but not veterans. “Keepthe focus on veterans,” he urged.

Wilkerson urged employeeveterans to enroll in VA health carebecause they may want that caresome time in the future.

Allen “Gunner” Kent, specialassistant to the Secretary for liaisonto veterans organizations, urgedemployees to see their own parentsin the older veterans who appearbefore them for care. A show ofhands in the audience revealed thatmost had not been born whenWorld War II participants becameveterans.

A Call to Arms from VSO Representatives

(continued on page 12)

Outline Goals for the Future

12 VAnguard

sites in the network (Buffalo andBatavia VAMCs are considered oneconsolidated site), plan to formteams of HR staff across the networkwho will improve their competenciesin five areas: employee developmentand employee relations, laborrelations, workers’ compensationand performance management.

The network HR Council ap-pointed a strategic developmentteam to get information from themedical center care lines and HRemployees. With it they have begunto assess future HR functions and areconsidering identifying “centers ofexcellence” where strengths existacross the network. One of theirchallenges lies in the fact that areduction in force is scheduled tooccur in VISN 2 early this year, andHR people will be among thoseaffected.

SOGs Staging the HR Future

This year’s conference in Atlantabuilt on last year’s in Topeka. Out ofthat conference came four initiativesand Strategic Opportunity Groups,or SOGs, comprised of 83 HR peoplefrom across the country and VA’sorganizational lines who worked onthem continuously, plus almost asmany back-up participants and anadvocacy group to facilitate thework. The four SOGs reported theirprogress and problems at Atlanta. SOG 1 formed to help HR people“learn the business” of VA’s pro-grams. On the Office of HumanResources Management web site,they created links to sites withprogram information, “best practice”information and sources of trainingfor VA professions. They asked fieldfacilities to provide intranet accessfor their HR staffs; since the Topekaconference, many HR offices gainedit.

SOG 2 consolidated VA’s HRregulations into one document,eliminating more than 200 issuances.They combined Title 38 and Title 5personnel regulations and put themon the intranet for access by HRprofessionals and managers. ThisSOG will assist OHRM to developlegislative proposals to give VAmore flexibility in managing itshuman resources.

SOG 3 researched HR learningsystems, selecting the model of theSociety for Human ResourcesManagement. VBA purchased thesystem for its HR professionals. VHAand OHRM are pilot training em-ployees with it. In a survey, thegroup asked VA managers what corecompetencies HR people shouldhave. Then they identified technicalskills, resources for developing themand a budget needed to deliver them.Delivery has started with severalsatellite broadcasts. This SOG hascommitted to develop trainingoptions to help managers with theirnew HR challenges, includingtechnological ones. It will absorb thework of SOG 1.

SOG 4 presented for adoption awork force planning model. Themodel takes managers throughplanning stages, including assess-ment of existing skills in theirorganizations, of future needs andstrategies for gaining skills throughrecruitment and employee develop-ment. The SOG said VA needs thetools to develop a national databaseabout work force requirements of thefuture. SOG 4 recommended thatVA carry out three pilot projects tobuild management capability forwork force planning — one each foran organization (preferably a VISN),an occupational group (VBA’s ratingspecialists) and a specific population(VHA members of the Senior Execu-tive Service).

Eugene Brickhouse, AssistantSecretary for Human Resources andAdministration, cited for conferenceattendees what he sees as the VA-HRworld’s challenges to achieve:

• Work force planning mustbecome part of strategic organiza-tional planning;

• HR people and line managersneed tools to maximize their efforts.They must make HR LINK$ work.VA has specially allocated funds forit and the Office of Management andBudget supports it;

• Build on partnerships withlabor, line managers, veteransorganizations and other VA stake-holders;

• Recruit, develop and retaingood people. ❑

By Jo Schuda

Actor Dan LauriaNamed NationalSalute Chairman

National HR Conference (cont.)

Lauria

Dan Lauria, veteran actor offilm, stage and television, is 1999Chairman of the National Salute to

HospitalizedVeterans.

As chair-man, Lauria,a Vietnamveteran whoserved from1970-73 in theU.S. MarineCorps, willlead VA’sannualValentine’s

Day program honoring hospital-ized veterans across the country.

Lauria is most recognized asFred Savage’s Dad, Jack Arnold,on the Emmy-winning ABCtelevision series, “The WonderYears.” However, his acting careerhas kept him busy on stage and infilm as well.

His feature films include“Prince of the City,” “Without ATrace,” and “Stakeout” withRichard Dreyfuss and EmilioEstevez. Recent film creditsinclude “Another Stakeout,”“Independence Day,” and “DogWatch,” which he co-wrote.

He has been a part of the off-Broadway scene for most of hiscareer and performed, wrote ordirected more than 30 New YorkCity productions before moving toLos Angeles ten years ago.

Lauria starred in scores of primetime television shows, includingrecurring roles in “Hooperman”and “Cagney and Lacey.” Hismore than 20 television movies ofthe week include four “In the Lineof Duty” films for NBC. He co-starred with Bernadette Peters inthe Emmy Award-winning“David.”

In 1991, Lauria co-produced theplays “A Bronx Tale” and “Faith-ful.” Both plays were later madeas movies starring, respectively,Robert De Niro and Cher.

Lauria resides in Los Angeleswith his wife Eileen. ❑

January 1999 13

MEDICALadvances

VA Initiates Major Colon Cancer Study

A new VA-funded clinical trial to study the ability of folic acidto prevent the recurrence of colon polyps has begun at theDetroit VA Medical Center and three Detroit Medical CenterHospitals. Colon cancer is the second most common cancer inthe United States and other western countries, with about140,000 newly diagnosed cases per year in the U.S. alone.Most colon cancers are believed to arise in benign colon polypsthat occur in as many as 30 to 40 percent of people over age50. The mortality rate of about 40 percent has remainedunchanged over the past 40 years.

Richard Jaszewski, M.D., Chief of Gastroenterology at theDetroit VAMC, and Adhip Majumdar, Ph.D., Professor ofMedicine at Wayne State University, are the principal investiga-tors. Their team includes physicians and scientists from theVAMC, the Detroit Medical Center Hospitals, Wayne State

University and the Karmanos Cancer Institute.

Albuquerque Explores Medical Uses ofHolographic Camera

The VAMC in Albuquerque has been test-running a holo-gram machine, the Voxcam manufactured by Voxel Inc. ofCalifornia, to see how it can be useful as a medical tool.Albuquerque is the only hospital in the country that has theVoxcam on site.

With its ability to reconstruct bones, organs and bloodvessels in a three-dimensional image, the hologram provides aunique view of the human body. The hologram is compiledfrom CT (computerized tomography) scans or MRIs (magneticresonance imaging) data. Those images consist of a series ofvisual slices through the part of the body being studied. TheVoxcam, using a laser, puts them together into a three-dimensional whole.

Dr. George A. Brown has used more than 100 of the imagesin treating people with broken pelvises. The hologram canshow layers of bone fragments, without one obscuring another,says Dr. Brown, who is on the VA staff and is assistant profes-sor of orthopedic surgery at the University of New MexicoSchool of Medicine. Knowing exactly where the pieces of boneare can help doctors be more precise, making smaller surgicalopenings.

Since the image is an exact duplicate and is presented in thesame size as the actual body part, a doctor can make actualmeasurements and test angles on the image. Before going intosurgery, for instance, a doctor could use the hologram to test ifa pin or screw to correct a fracture is long enough.

The holograms have been particularly useful for doctorslooking at blood vessels in the brain. They also have been

used to examine blood vessels in the legs to pinpoint block-ages.

Ultimately, the holograms may be most useful for someonewith severe trauma, an auto accident victim, for example. Butright now it takes too long, 35 minutes, to get the pictures. Anewer version of the machine, scheduled for release later thisyear, should cut the time to 15 minutes.

Voxel currently has arrangements with about 38 hospitalsaround the country to translate their scans into holograms. Thehologram images are returned to them one day after hospitalssend the information to the company’s Laguna Hills headquar-ters.

Albuquerque operates as a beta site, where Voxel providesthe machine and associated equipment for free, along with thetechnologists to run it. In return, doctors give feedback onproblems and possibilities with the technology.

Study Finds Physicians Should TreatHigh Blood Pressure More Aggressively

A study conducted at five New England VA medical centerssuggests that physicians are not being aggressive enough intheir treatment of patients with high blood pressure.

Dr. Dan R. Berlowitz of the Bedford, Mass., VAMC, thestudy’s lead author, says that physicians should take someresponsibility for poor hypertension management amongpatients. Although the hypertensive veterans followed in thestudy saw their doctors an average of six times a year, thephysicians repeatedly delayed making changes in the patients’medications that could have reduced their blood pressure, thestudy found.

The study, published in a recent edition of the New EnglandJournal of Medicine, suggests one reason treatment may be laxis that hypertensive patients often break promises to loseweight or monitor their diet in an effort to control their bloodpressure without drugs. But Berlowitz and his colleagues saydoctors should monitor patients’ records more aggressively and

make appropriate changes in treatment.

Richmond and Beckley VAMCs Linked withTelepathology Connection

The Pathology and Laboratory Services at the Richmond,Va., and Beckley, W.V., VA Medical Centers are using televi-sion technology to exchange pathology and laboratory services.Dr. Paul Welisz-Carrington functions as Chief of Pathology atboth sites.

Using the Apollo Telepathology System, technicians atBeckley prepare and place slides on a microscope, enablingpathologists at Richmond to render immediate diagnoses.Clinicians at Beckley receive pathology reports and hematologyand urinalysis consults with instantaneous on-line speed.

It is anticipated that the bulk of biopsies performed atBeckley VA Medical Center will be reported directly usingtelepathology, although a few difficult cases may not bereported until the actual slides reach Richmond. The videoteleconferencing system is also being used for documentreview and continuing education. ❑

14 VAnguard

HONORSand awards

The Miami VA MedicalCenter presented a speciallydesigned pendant to BeulahMeier honoring her for morethan 50 years of voluntaryservice at the center. Shevolunteers seven hours a day,five or six days a week, andworks with many of thecenter’s volunteer programs.She is coordinator of theAmbassador Program thatgreets newly admittedpatients and co-chairs the VACommunity Resource FundRaising Committee. She hasaccumulated more than61,000 volunteer hours withVA.

Kevin M. Means, M.D.,Chief of the Physical Medicineand Rehabilitation Service atthe Central Arkansas Veter-ans Healthcare System,received the 1998 Distin-guished Service Award fromthe National Medical Associa-tion at their annual meeting inNew Orleans. This award ispresented to recognize aphysician’s outstandingcontribution to society in thearea of health care, as well asprevention of disease, injury,disability and prematuredeath.

The Veterans HealthAdministration received aCheers Award from theInstitute for Safe MedicationPractices (ISMP) for takingaction last year to removeconcentrated potassiumchloride for injection from allpatient care areas throughoutthe VA health care system.Concentrated potassiumchloride for injection iscommonly mistakenly forother drugs, which has

resulted in numerous patientdeaths from erroneousinjections. The ISMP knowsof no other large health caresystem that has taken similaraction. Under Secretary forHealth Kenneth Kizer, M.D.,accepted the award during theannual meeting of theAmerican Society of HealthSystem Pharmacists in LasVegas. Charleston VAMCPharmacist Dennis Dunnalso received a Cheers Awardrecognizing his individualefforts to promote safemedication practices. TheCheers Award honorsindividuals, organizations andcompanies whose actionshave set a superlativestandard of excellence forothers to follow in the preven-tion of medication errors.VHA also was recognized bythe ISMP for its efforts tocreate a non-punitive medica-tion error reporting program.

Carlos B. Lott, Jr.,director of the Detroit VAMC,was recognized by theMichigan Civil Rights Com-mission and Department forthe outstanding contributionshe has made to both theveteran community andpeople with disabilities.

The National RehabilitationAssociation (NRA) recognizedthe Indianapolis VA Re-gional Office’s VocationalRehabilitation and Counselingpartnership with public andprivate resources with itsannual Excellence in Mediaaward. The 19th Star Partner-ship is a combined effort ofveterans employmentrepresentatives from theIndiana Workforce Develop-

ment offices, private enter-prise job developers, theIndianapolis VAMC andVARO. The partnership’snewsletter, which highlightssuccess stories of veterans,was recognized with the NRAaward for outstandingachievement in portrayingpeople with disabilities in apositive way.

The Association of MilitarySurgeons of the United States(AMSUS) honored four VHAleaders during an awardsprogram at its annual meetingin San Antonio. Dr. KennethKizer, Under Secretary forHealth, received the John D.Chase Award for PhysicianExecutive Excellence; LarryDeal, VISN 7 Director, waspresented with the Outstand-ing Federal Services HealthAdministrator Award; Dr.Robert Rosenheck, directorof the Northeast ProgramEvaluation Center at the WestHaven, Conn., VAMC,received the William C. PorterLecture Award for his lectureentitled, “Mental HealthService Delivery in the 21st

Century: Bringing theCommunity Back In”; and Dr.John Feussner, ChiefResearch and DevelopmentOfficer, was presented withthe Sustaining MembershipLecture Award for his lectureentitled, “Healthy Policies forHealthy People: PuttingResearch to Work.”

Phillip Pugh, who workswith the eye clinic at theDurham, N.C., VAMC,received the Mayor’s Trophyfrom the Durham Mayor’sCommittee for Persons withDisabilities for his efforts tohelp visually impaired peopleremain active and productivewhile learning new skills todeal with vision problems.Pugh, who is almost totallyblind himself, conducts visiontraining, medical assessmentsand vision rehabilitation

programs for more than 400veterans every year.

Spinal cord injury physi-cians at Milwaukee and St.Louis VA Medical Centersdistinguished themselves onthe first board certificationexamination in Spinal CordInjury (SCI) Medicine. Dr.Sunil Sabharwal, chief of theSCI Service at MilwaukeeVAMC, achieved the highestscore on the exam. All of thephysicians associated with theSCI Service at St. LouisVAMC passed the exam,making it the only SCI Servicein the VA health care systemand probably the only SCICenter of similar size in thecountry where all physiciansare now board certified.

Receiving a diamondusually signifies an engage-ment. In the case of employ-ees of the Nutrition andFood Service at the WestPalm Beach, Fla., VAMedical Center, it signifiesthat they are engaged in thepursuit of safe food productionand handling. Their state-of-the-art food service practiceshave been recognized with aninternational award. Theyrecently received the Dia-mond Award for Food Safety,sponsored by HealthcareFood Service, an internationalfood industry publication.West Palm Beach VAMC isthe first VA medical center toreceive this award.

Donna Chirwa, financialservice supervisor at theColumbus, Ohio, VA Outpa-tient Clinic, received theDistinguished Local FinancialManagement Award at theannual VA Fiscal Officersmeeting in San Antonio. Shewas cited for introducingprogram-budgeting methodol-ogy by combining annualfunctional reviews with budgetcalls, and for the success ofthe clinic’s Medical Care CostRecovery program. ❑

January 1999 15

you heardHAVE

For the first time, the JointCommission on Accreditationof Healthcare Organizations(JCAHO) has surveyed anentire Veterans IntegratedService Network, and VISN 1— the VA New EnglandHealth Care System —received JCAHO’s highestlevel of accreditation. Thenetwork received accredita-tion with commendation afteran on-site review found thatthe network met standardsregarding the rights andresponsibilities of patients,organization ethics, educationand communication withpatients, human resources,management of informationand improving networkperformance. VISN 1, whichincludes nine medical centersand 52 ambulatory care andcommunity-based outpatientclinics, received a score of 99out of a possible 100.

The San Francisco VAMedical Center teamed upwith the California Palace ofthe Legion of Honor onVeterans Day to offer localveterans the opportunity toget a dose of both health careand culture. The VAMCsponsored a basic healthscreening for local veterans,and in collaboration with thePalace of the Legion ofHonor, offered free VIP ticketsfor a special Picasso exhibit toveterans who attended thehealth screening. The Palaceof the Legion of Honor, built tohonor Armistice Day andveterans of World War I, is thepremier Northern Californiamuseum dedicated toEuropean art. The VAMCalso offered parking and

shuttles for those who wantedto see the exhibit.

More than 200 homelessveterans obtained clothing,blankets, immunizations,referrals and a hot meal at thePersonal Care Day eventsponsored by the KennyNickelson MemorialFoundation (KNMF) inNovember at the Greater LosAngeles VA HealthcareSystem’s ambulatory carecenter. Secretary Togo D.West, Jr., was the keynotespeaker at the event, whichhighlighted the contributionsthe KNMF makes towardsassisting homeless veterans.In 1991, homeless veteranscomprised 54 percent of thehomeless served by theKNMF; today, the portion isdown to 38 percent.

A memorial honoring the86 African Americans whohave received theCongressional Medal ofHonor throughout history wasunveiled in Wilmington, Del.,in November. Attendees atthe ceremony includeddescendants of AfricanAmerican Medal of Honorrecipients from the Civil Warto the Vietnam War. HoustonVA Regional Office employeeClarence Sasser, whoreceived the Medal of Honorfor his service in Vietnam,made the trip from Texas toparticipate in the unveilingceremony.

VA and the OneidaNation of Wisconsin havesigned an historic sharingagreement that will enhanceservice to Native Americanveterans and serve as a

national model for additionalpartnering between theDepartment and Indian nationtribes. The agreement willallow the Oneida CommunityHealth Center to provideprimary health care tohundreds of veterans who aremembers of the Oneida Tribeof Indians of Wisconsin. Theagreement sets up a fee-for-service program in which thetribe will directly bill VA whenit serves veterans. This is thefirst such agreement with anIndian nation.

Recognizing thatsurrounding Alzheimer’sdisease patients with familiarobjects from their past helpsspark their memories andmakes them more responsive,the Alzheimer’s unit at theKerrville division of theSouth Texas VA Health CareSystem recently acquired aWorld War II vintage vehiclefor their patients. TheM151A1 Jeep was donated byan Army Reserve unit basedin Laredo, Texas. Staffmembers note that whilemany of the Alzheimer’spatients no longer recognizeloved ones, they almostalways salute a person inuniform when they see one.

The Chillicothe, Ohio, VAMedical Center found aunique way to observeNational Disability AwarenessMonth in October. To helpemployees understand thechallenges faced by thedisabled, staff membersconducted the “Walk a Mile inMy Shoes” program.Supervisors were blind folded,had one of their limbsstrapped to them or had theirjoints taped to help themexperience what it would belike to work at or visit theVAMC as a person with adisability. Each participantwas followed around by anobserver who was notpermitted to assist as theparticipant struggled to move

about, cross streets ornegotiate doorways.

VA will mark its 10th

anniversary as a Cabinet-leveldepartment in March.President Ronald Reagansigned legislationtransforming the VeteransAdministration into theDepartment of VeteransAffairs, the 14th Cabinetdepartment, on October 25,1988, and it became effectiveon March 15, 1989. A varietyof activities are being plannedto mark this milestone.

The 1998 CombinedFederal Campaign (CFC) inVA Central Office concludedlast month with near-recordresults. VACO employeesmade more than $473,000 incash and payrollcontributions, exceeding thegoal of $383,000 by nearly 25percent. It is the highestdollar amount contributed byVACO employees since 1995.More than 62 percent ofVACO employees contributedto the campaign, and 11percent of those whocontributed donated at least 1percent of their salary to theCFC.

The Wilmington, Del., VAMedical & Regional OfficeCenter (VAMROC) recentlysponsored a day-longinformation fair for veterans inDelaware and neighboringstates (Pennsylvania, NewJersey and Maryland). The“Veterans Homecoming 1998”event brought together morethan 50 federal, state andcommunity agencies, as wellas colleges and universities,to assist veterans with a widevariety of benefits. DelawareGovernor and veteranThomas Carper attended thefirst of what organizers hopewill be an annual event toprovide one-stop service forarea veterans. ❑

16 VAnguard

HEROES✩ ✩ ✩ ✩ ✩

Eleven of the 16 children of VA Central Office employees who participated in VA’s firstQuit Smoking Poster Contest joined Secretary Togo D. West, Jr., in VACO on November 19for the announcement of the contest winners. The winner in each of three age groupsreceived a $100 savings bond, while the three runners-up received $50 savings bonds.Sponsored by VHA’s Office of Public Health and Environmental Hazards in conjunctionwith the VACO Health Unit, the event was one of several Great American Smokeoutactivities conducted at Central Office. VA Smoking Program Director Oliver Parr says thecontest, the only one of its kind among cabinet agencies, will be an annual event.

Thirty years after hisheroism on the battlefield inVietnam was rewarded with a

Congres-sionalMedal ofHonor,RobertHoward,a ratingspecialistat theHouston

recently. While dining in alocal restaurant, she heardsomeone screaming for help.She rushed to investigate,and found a man lying on thefloor. Determining that he hadno pulse and was not breath-ing, she began CPR. Afterabout three minutes, the manresponded. Paramedicsarrived and transported him toa local hospital, where herecovered. Later, the mansought out Creekmore tothank her for saving his lifeand, since he turned out to bea veteran, he now chooses toreceive his health care fromthe Las Vegas VAMC.

Charlie Gustafson, aprogram support assistant atthe Health AdministrationCenter in Denver, helpedrescue a woman and her dogafter they became trapped inthe woman’s motor home.Gustafson was following themotor home when a gust ofwind blew it onto its side andit burst into flames.Gustafson climbed on top ofthe vehicle and managed toopen the passenger door,while another man arrived onthe scene and kicked in thewindshield. They were able torescue the woman and herdog before the vehicle wasconsumed in flames.Gustafson was severelyinjured when he jumped fromthe burning vehicle, but he isnow back at work.

✩ ✩ ✩ ✩ ✩

Howard

Saturday, October 17,1998, will long be remem-bered in San Antonio as theday of the 500-year flood.Early that morning, Howardwas driving on a majorthoroughfare when the SanAntonio River pushed into theSalado Creek, overflowing itsbanks and sending a largewall of water across a bridge.Within seconds, three carswere swept into the creek.

Although Howard’s carremained on the bridge, it wasquickly submerged. Hemanaged to get a windowdown enough to allow him toswim out of the car. As heswam to higher ground, heheard a taxi driver calling forhelp from his partially sub-merged cab. Howard swamto the cab, helped the driverget out, and both of thempulled a totally submergedpassenger from the back seat.As the water began to recede,they were able to wade out inchest-deep water to safety.

✩ ✩ ✩ ✩ ✩

Karen Creekmore, aregistered nurse at Las VegasVAMC, saved a life andrecruited a new patient for VA

once again.VARO, displayed heroism

While shopping at a localstore, Fayetteville, Ark.,

Correction

In the November/December issue of VAnguard,we erroneously creditedAlbany VAMC registerednurse Rosemary Duncan withsaving the life of New YorkCongressman James T.Walsh. Duncan in fact savedthe life of CongressmanWalsh’s District Director, JohnMcGuire, and not thecongressman. We regret theerror.

VAMC registered nurse JudyGardenhire came to the aidof a man who had collapsedon the floor after suffering aseizure. He had hit his headduring the fall and wasbleeding from a head wound.Gardenhire stayed with theman until the ambulancearrived, making sure he didnot suffer further injury, andgave the ambulance crew adetailed account of theseizure and head injury. ❑

✩ ✩ ✩ ✩ ✩