STATEMENT OF
JAMES R. FLOYD, CHE
DIRECTOR, VA SALT LAKE CITY HEALTH CARE SYSTEM
VETERANS HEALTH ADMINISTRATION
DEPARTMENT OF VETERANS AFFAIRS
BEFORE THE
COMMITTEE ON VETERANS' AFFAIRS
UNITED STATES SENATE
ELKO, NEVADA, FIELD HEARING

May 5, 2005

Mr. Chairman and Members of the Committee, I appreciate the opportunity to appear before you today to discuss the topic of veterans healthcare in Elko, Nevada. I will discuss this issue from the perspective of the VA Salt Lake City Health Care System.

Administered from the 81-acre campus at the George E. Wahlen Department of Veterans Affairs Medical Center in Salt Lake City, Utah, this health care system is on course to provide primary, specialty, mental health, and tertiary care to over 37,000 veterans this fiscal year. This represents a 5.18% increase over FY 2004, equating to1,455 veterans thus far in FY 2005. Our service area encompasses the state of Utah and portions of Nevada, Idaho, and Wyoming. We operate Community Based Outpatient Clinics (CBOCs) in nine communities to provide primary and mental health care to veterans in rural and frontier areas. The VA-staffed clinics are located in Orem, Ogden and St. George, Utah, and in Pocatello, Idaho. We also provide health care through contracts in Roosevelt, Nephi, and Fountain Green, Utah; Green River, Wyoming; and Ely, Nevada.

Representatives of our health care system have been in discussion with veterans from the Elko area regarding their health care concerns for approximately five years. The hardships the 4,300 veterans face in obtaining affordable health care and their desire to benefit from the VA’s comprehensive health care benefits package are understandable. During the past year, we have been in discussion with the Elko County Community Based Partnership, which combines the interests of the veteran population with the local leadership in health care, the community, and education. We have also participated in town hall meetings and a veterans’ roundtable meeting, which you hosted last fall, Mr. Chairman. These coordinated efforts have resulted in the recent expansion of the Disabled American Veterans van service. Veterans now have free transportation between Elko and the medical center in Salt Lake City. In addition the VA Salt Lake City Health Care System Lake City Health Care System contracts for care in the local hospital and for local outpatient care for Elko veterans, at a cost of $448,150.

The efforts of the community partnership have resulted in the opening of a community dental and medical clinic in Elko. The group generously offered free space to VA to locate a CBOC in the same facility. Although the veteran population size and location merit consideration of a CBOC, the resource needs and the process to accomplish this are not likely to allow for this development in the next few years. The VA’s 2004 Capital Asset Realignment for Enhanced Services (CARES) did not identify Elko for the placement of a priority CBOC. The clinic location that was identified by CARES for our health care system will likely not be initiated for the next few years due to the need to fund our current services. The establishment of a CBOC in Elko could follow. A contractual arrangement with an existing provider seems most feasible. Additionally, Primary Care expansion requires resources for the growth in our mental health and specialty care areas, as, on average, every primary care visit results in referrals to mental health and specialists. These resources need to be acquired, as well, before a clinic in Elko is established.

In summary, the VA Salt Lake City Health Care System supports the concept of locating a CBOC in Elko, Nevada. When resources are available to provide for the comprehensive health care the needs of these veterans, we would be pleased to make them available in their hometown.

Thank you, Mr. Chairman. This concludes my formal remarks. At this time I would like to entertain any questions the Committee Members have.