Hefner VA Medical Center director Carolyn Adams on the right speaks to reporters at a news conference. photo by Wayne Hinshaw, Salisbury Post

Hefner VA Medical Center director Carolyn Adams on the right speaks to reporters at a news conference. photo by Wayne Hinshaw, Salisbury Post

By Kathy Chaffin

kchaffin@salisburypost.com

The director of the Hefner VA Medical Center admitted Friday that her communications plan did not work well when it came to informing members of Congress about upcoming changes in veterans services.

"And I will make sure that doesn't happen again," Carolyn L. Adams said at an afternoon news conference on "Improving Veterans' Access to Care" initiative.

When asked to elaborate, she responded that her efforts to ensure the medical center's 1,500 employees were informed before anyone else had led to other key parties — such as U.S. Rep. Mel Watt, D-N.C. — not hearing about it until the official news was announced in Sept. 18 e-mails and faxes.

"I missed a beat," she said. "That was not the best way for me to get it there."

News of the Hefner VA Medical Center's plans to eliminate emergency and inpatient services and focus mainly on mental health and long-term care has upset elected officials, veterans and employees alike.

Adams, who has been director since April of 2007, tried to put to rest warnings by two national union leaders that the changes could result in the loss of up to 1,000 jobs. She said only 140 to 145 positions would be affected, and that "each and every one of these employees will be offered job opportunities."

Eventually, as the mental health and long-term care programs are expanded, Adams said new positions will be added.

The expansion of mental health services will allow for better treatment of combat-related diagnoses such as post-traumatic stress disorder.

The plan to transition the Hefner VA Medical Center to a Clinical Center of Excellence for Mental Health and Long-Term Care was based on the findings of an independent study of demographic trends and in keeping with the VA's latest model of care.

As part of the new offerings, the Salisbury VA will maintain a wide array of outpatient services and establish an Employee Learning Center on campus.

Adams, who served previously as associate director of the Salem VA Medical Center, said she has explained the upcoming changes at Veterans Support Organizations and focus groups.

Veterans appear to be the most concerned about the elimination of emergency services, she said. Some have said they fear waiting four to five hours to be seen in a private hospital emergency department.

In preparation for the transition in services, Adams said VA officials have talked with officials at Rowan Regional and other Novant facilities as well as the Carolinas Medical Centers system (which includes CMC-NorthEast in Concord) and Wake Forest University Baptist Medical Center to ensure appropriate and timely care for veterans.

Of the 21,000 visits to the Hefner VA emergency department last year (including repeat visits by the same veterans), she said only 10 percent or 2,100 visits qualified as actual emergencies.

In the future, Adams said that 10 percent can be provided access to those services in local medical centers on a fee-for-service basis.

When the transition is complete, she said the other 90 percent can be treated at primary care clinics with hours to be extended into the evenings. Primary care clinics in Winston-Salem, Charlotte and Hickory will also be expanded so that veterans who had been coming to the Hefner VA won't have to travel as far for services.

Outpatient services will include general mental health, medical and surgical specialty care, diagnostic imaging, dental care and ambulatory surgery.

As for the elimination of inpatient beds, Adams said there are only 14 general medicine and six surgery beds. The average census in the intensive care unit for the past year has been four patients.

"So it's not a large number of beds that we're talking about not being here at Salisbury," she said.

As part of the transition, the Mental Health and Long Term Care Centers of Excellence will continue to provide inpatient services.

When asked about veterans' concerns, Adams attributed them to "the fear of the unknown." The plan ensures that veterans will get the health care they need, she said.

"We want it to be very seamless for the veterans," she said. "We want them to have the best health care."

As for the cost of veterans' inpatient services at private medical centers, Adams said it will be paid as long as the patients are referred by the VA. Emergencies would also be covered, she said.

Adams said no timeline has been set for the transition. "We want to make sure we have communicated well with the community," she said.

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