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UPDATE: BAY PINES VA POLICY SAYS TAKE ALL OFF-
CAMPUS EMERGENCIES TO ANOTHER HOSPITAL --
However, new agreement allows non-veterans to
be treated if they fall ill on VA grounds.
Background on this story (with backlinks) is
here...
http://vawatchdog.org/07/nf07/
nfJUL07/nf072707-3.htm
For more information on the troubled Bay Pines
VA facility, use the VA Watchdog search engine...click here...
http://www.yourvabenefits.org/sessearch
.php?q=bay+pines&op=ph
Today's story here...
http://www.sptimes.
com/2007/07/27/Southpinellas/VA
_s_usual_reply___No.shtml
Story below:
-------------------------
VA's usual reply: 'No'
Bay Pines policy says to take all off-campus emergencies to another
hospital.
By WILLIAM R. LEVESQUE, Times Staff Writer
ST. PETERSBURG - A former Pinellas paramedic said Thursday that she and
her colleagues knew better than to take nonveteran patients to the Bay
Pines VA Medical Center emergency room.
"If you brought them, you got turned away," said Stacie Smith, 35, a
paramedic from 1996 to 2003. "It got to the point that, if you had a
non-vet, why call to ask them if you couldn't bring them there?"
Her recollection was confirmed Thursday by officials at the Department
of Veterans Affairs and Pinellas County. They said the VA emergency room
always directs paramedics to take critically ill nonveterans to other
hospitals unless they suffer a health emergency on Bay Pines' property.
The county and the VA had previously said that they had a verbal
agreement allowing paramedics to take critical nonveterans to Bay Pines,
if it was the closest emergency room. In detailing that pact, they made
no distinction between patients on or off VA land.
On Thursday, the Pinellas medical director, Dr. Laurie Romig,
backtracked, saying no such agreement ever existed. Only "discussions"
were held, she said.
Bay Pines officials blamed miscommunication for a June 26 incident in
which paramedics were told by the facility to take a Bay Pines worker,
Mark A. Surette, to a hospital three miles away. Surette, 51, collapsed
during a heart attack on VA property, 200 feet from the Bay Pines
emergency room.
Surette later died at St. Petersburg General Hospital. Officials have
said it is impossible to know if the delay contributed to his death.
Romig is investigating paramedics' response.
On Thursday, the VA and Romig signed an agreement saying paramedics
could take seriously ill nonveterans to the VA emergency room without
seeking prior clearance - only if they fall ill on Bay Pines property.
"Typically, that's how it works, if it's not a veteran," said VA
regional spokesman John Pickens.
Romig and Craig Hare, an emergency medical services division chief for
Pinellas, declined to discuss whether they are satisfied with the
agreement, which means a nonveteran who falls ill even a foot off VA
property can't be taken to Bay Pines' emergency room.
"We're happy that when patients are in physical proximity, they accept
and stabilize them," Hare said.
Smith, the former county paramedic, said she recalled one 1998 incident
in which an 86-year-old woman suffered a stroke across the street from
Bay Pines. Paramedics sought permission to take her to the VA emergency
room and were refused, she said.
The woman later died. The VA refused to discuss her case.
Also Thursday, the county released additional audio recordings to the
St. Petersburg Times of communication among paramedics who responded to
Surette's heart attack. The county hadn't previously released them
despite a public records request by the newspaper.
The VA said that a doctor turned away Surette because he didn't realize
the man had collapsed on VA property. Hare disputed that claim.
"They were fully aware of the patient's condition, and they were fully
aware that we were on their campus," Hare said.
Newly released recordings also cast doubt on the VA's assertion.
"We can see the ER," one paramedic said. "We're like one building away
from the ER. But you want us to transport to St. Pete General or do you
want us to transport to the ER here?"
An unidentified voice responds, "It has been confirmed he is not a vet."
U.S. Rep. C.W. Bill Young, R-Indian Shores, said he has requested that
the VA provide its written policy on when it will accept seriously ill
nonveterans at its emergency rooms around the nation.
So far, Young said, the VA tells him such a policy exists, but it can't
provide him with a copy. A national VA spokesman could not be reached
late Thursday.
"They're searching," Young said. "I suspect it doesn't exist. There
should be a policy for this reason: A VA hospital should not become a
general hospital. But in the case of a life-threatening situation, any
medical facility, government or not, should be available to save the
life of a human being."
A June 2007 Bay Pines memo detailing medical rules notes unequivocally,
"Persons with emergent/urgent care needs shall be admitted without delay
whether or not they are eligible for VA care."
But Pickens said that only refers to nonveteran patients who show up or
are taken unannounced to the VA emergency room. The memo, he said, does
not refer to paramedics calling to seek permission to take nonveterans
there from off VA property.
Smith, the former Pinellas paramedic, and the county confirmed that the
VA goes to lengths to determine if a patient is a veteran when
paramedics call seeking permission to take someone to Bay Pines from off
its property.
The VA requests the last four digits of patients' Social Security
numbers and part of their name, which they can use to determine whether
they are veterans.
If patients are confirmed to be veterans, paramedics are often free to
transport them to Bay Pines, officials said.
If not, the patient, regardless of condition, is diverted elsewhere, she
said.
"If you're not a veteran, I couldn't have taken you to the VA hospital
even for a bloody nose," said Smith, a Tampa resident. "And you always
had to call. It was like getting an invitation to someone's house."
The VA said earlier this week that paramedics didn't have to call to get
permission to go to its emergency room. But both the county and Smith
said that isn't true.
Paramedics never take a patient to any emergency room without calling
the hospital, they said.
Confusion exists even among some Bay Pines employees about when they can
use the VA emergency room.
Roger Curry, 60, a gardener at Bay Pines' cemetery, said workers at the
cemetery aren't allowed to visit the emergency room for work-related
injuries and must drive to the VA's James A. Haley Medical Center in
Tampa.
Curry said workers who are also veterans sometimes visit the emergency
room rather than drive to Tampa.
But they go as veterans, he said, incurring some cost. In those cases,
they don't file worker's compensation claims.
Asked if he would be taken to the Bay Pines emergency room if he had a
serious medical problem, Curry said, "It hasn't happened yet, and I
don't know."
Pickens, the VA spokesman, said those cemetery employees would be seen
by Bay Pines emergency room if they required urgent care. But he
confirmed that, otherwise, they must visit Haley because their health
records are kept there.
"It's a completely insane way of doing things," Curry said.
Times staff writer William R. Levesque can be reached at (813) 226-3436
or levesque@sptimes.com.
-------------------------
Larry Scott --
