Why are they allowed to sell U.S. Veteran gear and flags that are made in China?

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1 Bene-Travel How come travel pay mileage changed? I believe National standards are set to determine travel reimbursement. 50 miles has been taken off each trip? We have a dashboard that is used which connects with Bing Maps to determine the mileage for claims utilizing distance for each claim. The distance calculated prior to the use of the dashboard may have been different than what is being calculated now. You may check with the travel clerk who can provide additional information re. the mileage and difference. Canteen Products Champ VA Customer Service Why are they allowed to sell U.S. Veteran gear and flags that are made in China? Champ VA works perfect for my wife for the last 16 years. Why not use this system for all Veterans and put an end to all the VA Medical Problems? Would it be possible to include sensitivity training for VA employees? I think understanding that we are customers and Veterans would make a friendly, more tolerant environment for all. The Canteen has about 40% of its items made in the USA. The Canteen is currently working on getting more vendors on board providing the availability of "Made in the USA" products. We are also working with our Concessionaire Vendors to provide more "Made in the USA" products as well. As provided under the Veterans Access, Choice and Accountability Act, VA will carry out the Veterans Choice Program which will allow eligible Veterans who meet certain qualifications to seek care outside VA. As implementation guidelines are finalized, Veterans will be notified. Currently all employees receive sensitivity training during newcomers orientation. We have expanded our New Employee Orientation from 3 days to 5 days in order for us to provide an immersion in the patient-centered culture. Additionally, special training on the Veteran Experience is provided to all employees throughout the year. Along with training we have deployed TruthPoint, a Veteran s experience assessment in our primary care clinics and inpatient areas. Thru this Veterans are asked to share with us the real time experience with the appointments and inpatient stays. In this way we are able to identify areas of challenge and address them immediately. These initiatives are ongoing and an important priority as part of VA staff's reaffirmation of our ICARE core values.

2 Front Desk Staff Receptionist at the various clinics are checking Veterans in and talking on the phone. Why can't certain individuals be designated for phone service and the others for check in? We have problems with the dual role now. Geriatric Services Why is the Geriatric Clinic not at the hospital? Please call. We are looking at expanding the use of our Call Center which will allow us to have the clerks at the desks focus on treating the Veterans that are presenting to clinic. Geriatrics Primary Care will be located in all of the primary care clinics. We are exploring the possibility of having some primary care clinics located at the medical center in the future. Handicapped Parking Hiring Veterans Side loading vans are using regular handicapped parking. Why aren't their more Veterans in the upper management of the VA in Washington DC and around the country. At the request of the U.S. District Court Judges, Side-loading enforcement has been suspended until such time as an understanding at the court levels can be reached on the proper enforcement code. We expect this issue to be resolved in the next few months at which time enforcement will resume. We are not able to address this question on a national level, however, we can report that over 41% of our local workforce are Veterans. Laughlin The Laughlin Clinic has been promised to open for the last four years. Now we understand it will only be for Primary Care and labs, no x-rays, etc. The latest information is the elevator is not be enough for disabled Veterans, what gives? Opening the Laughlin Outreach Clinic has been challenging due to a number of contracting issues relating to the lease and required construction build-out. We have since; however, secured a new construction contract and are just about complete. The lease is on hold pending Certificate of Occupancy from Clark County Building Department. The one issue pending is a resolution of a county code on an Americans with Disabilities Act (ADA) accessibility issue with the clinic s ramps. An independent assessment of ADA/Architectural Barriers Act Accessibility Standard (ABAAS) compliance is in progress.

3 Lost ID Card I was on hold for eight solid hours over two days looking for my lost VA ID card. After making the 14 mile trip, my ID was right under the counter at Enrollment. Why was this not given to a manager. Medical Records Patient Advocates Who do I talk to about the destruction or loss of my records, and who, regarding lack of treatment including referral time schedules? Who is a Veteran supposed to voice their concerns when the Patient Advocates is unable to assist? We sincerely apologize that your ID card went unoticed but are pleased to hear that you were able to recover your card. Unfortunately; due to the volume of workload, your card was missed. You may contact the Release of Information (ROI) office to discuss the destruction/loss of your medical records. There is an ROI office located at the medical center and four primary care clinics. If you believe there is information in your VA medical records that is inaccurate, you should submit a written request to amend your record to VAMC, Attn: Chief, HIMS, 6900 North Pecos Road, North Las Vegas, NV You should provide a copy of the document that contains the inaccurate information, and your written request should indicate what is inaccurate and what you are requesting us to do to correct the information. If you are not able to connect with the patient advocates, you can go on line to MyHealtheVet and, through secure messaging, connect to your provider team. You can also voice your concerns using Electronic Inquiry Routing and Information System (IRIS): https://iris.custhelp.com/app/ask/session/l3rpbwuvmtm5otk yndg0oc9zawqvejezdey1vww%3d - See more at: er_concerns.asp#sthash.eyntvs59.dpuf Physical Therapy Is physical Therapy limited to hospital only? Preventive medicine? Physical Therapy is provided in both inpatient (hospital) and outpatient settings. Preventive medicine with regard to physical functioning involves lifestyle choices including exercise and diet

4 Police & Security To facilitate a more open and welcoming environment, would it be possible for the Police and Security guards to adopt a more neutral dress, for example, blazers. It would still allow them to be armed. Provider Pay Provider Turnover Respite Care I have encountered a few "It's not my job" mentality, why? Why must doctors take a pay cut to work here? I think the VA doctors are leaving due to the computer system, Can you help? When will the Respite Care open in this hospital and nursing home. I am in need of Respite Care. VA Regulations (VA Handbook 0730) maintain the uniform requirements for all VA Police officers. On September 18, 2014, VA published new Annual Pay Ranges for Physicians and Dentists of the Veterans Health Administration which will greatly enhance VA flexibility to recruit, develop, and retain highly qualified providers to serve our Nation's Veterans. The Las Vegas market is challenging for recruitment and retention of providers as Nevada ranks 46th in physicians/capita. While individuals leave for many reasons, the VA computer system is not generally a shared reason for leaving. On September 18, 2014, VA published new Annual Pay Ranges for Physicians and Dentists of the Veterans Health Administration which will greatly enhance VA flexibility to recruit, develop, and retain highly qualified providers to serve our Nation's Veterans. The Community Living Center is in the process of opening. Services will be implemented over a period of time as we have to hire staff to support the services. The Community Living Center will provide services to those who need care to enable them to get back on their feet and go home. Respite services is projected to be available in the latter half of 2015.

5 Service Animals Why do we not have an area for Service Animals with the little green bags for waste and water We currently do not have an area set aside for Service Animals. However, there will be an area designated on the east available? I heard we had one but nobody seems and west ends of Building 1 for Service Animals. Please keep to know where it is. checking with our information counters for more information. SES Removal Has the new authority to remove bad VA SES employees from the payroll been used? Do you think more VA services should be taken care of by the private sector? Suggestions 1. Implement Veteran Mentor Program - Volunteers. 2. Implement local Nurse Call Lines. 3. Paper vice computer satisfaction surveys. 4. Clinic Directors need to be more visible. 5. Improve Volunteer Program. 6. Need signs at every exit, "If you unhappy with your service, ask for... or call Implement Customer Service training for everyone, it has gone away in the era of self-service. 8. Cross train employees for efficiency. 9. Partner with organizations like VFW, DAV, AMVETS, US Vets, Vet Courts, etc. 10. Employees Stand down for training (just like military when there is a mishap or serious event). 11. Hire Veterans - reach out to them. On August 7, 2014, President Obama signed into law The Veterans' Access to Care through Choice, Accountability, and Transparency Act of The act grants the Secretary of Veterans Affairs authority to remove VA Senior Executive Service individuals whose performance or conduct warrants removal or transfer the individual to a General Schedule position at any grade the individual may be qualified. The authority has not been used locally nor we are not aware of any situation nationwide where the Secretary has used the authority. Thank you for your suggestions. 1. We do use volunteers as mentors in the Vet to Vet Peer Support Program. 2. thru 4. Noted. 5. We constantly strive for improvement and welcome your feedback on how we can better serve our Veterans and our volunteers. 6. thru 8. Noted. 9. VA Voluntary Service partners with Veteran Service Organizations. These organizations make up the majority of membership on our VAVS Committee which provides guidance and feedback to Voluntary Service. 10. Noted 11. VA Southern Nevada Healthcare System (VASNHS) strives to hire Veterans whenever possible. Currently, 41.83% of our workforce are Veterans, while 41.33% of all new hires in Fiscal Year 2014 were Veterans. We utilized all legal appointing authorities for Veterans to include the Veterans Employment Opportunities Act of 1998 (VEOA), Veteran Recruitment Appointment (VRA), 30% or More Disabled Veteran authority, and Disabled Veterans Enrolled in VA Training Program.

6 Telephones Why is the phone system so difficult to call in and to receive calls on appointment reminders? There must be a better way. The new system for calling in goes to a call center. I spent 45 min, 25 min, 45 min Tuesday. Went to Patient Advocate, she spent 25 min on hold with phone center. It is terrible. Can t get appointments. When is VA going to fix phone system? I experience major frustration trying to make mental health appointment. Stop giving pills and cover up pain. Address problem. Can you create a better phone system? Forever waiting for representative. Our calls are very important to you. We are on hold a long, long time. Telephones When dialing (702) , it asks you to dial in your extension number which is usually unknown/do not have it. It is a with the operator, to get to the right destination. Why is that? We recognize that there are problems with our telephone system. We are working to maximize the capabilities of the system as well as bringing our staffing up to appropriate levels to handle the high volume of calls we receive. We are also working to establish a pharmacy call center to help alleviate the high volume of call center calls. The operators rely on the individual calling to provide sufficient information for them to be able to identify the correct telephone number for the caller. Additionally they rely on the accuracy of our electronic telephone directory which from time-to-time, may have some outdated information. Therapy Pool Where and when is the VA 600 million dollar hospital going to get a therapy pool for mobility challenged Veterans? We would love to have a pool at this facility. Funding has not been set aside for a pool or Veteran Recreation Center. To make this happen will most likely involve Veteran Organizations and private funding coming together to recognize the importance of this and raising/donating the needed financing. Therapy Pool Where is the therapy pool for the facility? When the hospital was designed the decision was made not to include a therapy pool due to liability issues. While the possibility of an "Endless Pool" was under consideration for a time, space/location became the issue. At this time there are no plans to have a therapeutic pool added to VASNHS campus.

7 Town Hall Please advise of next Town Hall meeting. Thank you for being part of the Town Hall meeting. We will certainly share the date of the next meeting once we are able to secure a date/time. Volunteers VSOs Waiting Time How can we speed up enrollment at Voluntary Service for people who want to volunteer. Some times it takes to long and we loose volunteers. Has happened several times. Since two individuals (names removed) as VSO representatives at the Nevada State Veterans Officer recently (August 2014) who will be knowledgeable at those two top positions for Vietnam Veterans? Why is there a day backlog for some specific clinics including Dermatology and Endocrinology? We have worked very hard to speed up this process. In September, 50% of those who were oriented were processed in one month or less and 85% were processed in two months or less. Ideally, we would like to see all our volunteers process in two weeks to one month, and we are making progress on that goal. Every member of the Nevada Department of Veterans Services office is knowledgeable and can represent all service men and women from every era. We certainly have challenges with waiting time for some of our specialty clinics due to capacity and demand. To help reduce waiting time, we are utilizing our Joint Venture partnership with the Air Force 99th Medical Group, providing non-va care in the community, have offered extended hours and Saturday clinics for some specialties, and continue to assess capacity and demand on an ongoing basis while we recruit for more providers.

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