Director's Quarterly Letter - Tuscaloosa VA Medical Center
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Tuscaloosa VA Medical Center


Director's Quarterly Letter

Memorial Wall

October 2019

Medical Center Director John Merkle
John F. Merkle, FACHE
Medical Center Director


For previous Director's Messages, click here. 


Dear Veterans,

At Tuscaloosa VA Medical Center, we are continuously striving to meet our Veterans needs, now and into the future. We’ve had many successes over the last quarter, which help us reach our goals of providing timely access to quality care.

In June, we began implementing the MISSION Act.  MISSION is an acronym, which stands for “Maintaining Internal Systems and Strengthening Integrated Outside Networks.” Through this Act, VA has made many changes in several key areas including: streamlining and improving community care, establishing a new urgent care benefit, expanding caregivers eligibility, strengthening VA’s workforce, and strengthening VA’s infrastructure. Through the MISSION Act, VA has additional opportunities to enhance our high-quality health care to our nation’s Veterans. Additionally, about 8% of Veterans were eligible for the Choice Card Program, but now about 40% of Veterans are eligible under the MISSION Act. I want emphasize that the MISSION Act is not about privatizing VA. It is about strengthening and improving VA’s high quality health care system.

On June 20, we held a job fair and the turnout was simply amazing. We had more than 500 people come out to talk to our Human Resources staff about job openings. With such a turnout, it really showed me that Tuscaloosa VA is a place that people want to work, and it made me extremely proud to see people in such large numbers show interest in joining our team. We are continuously using tools such as the All Employee Survey to better meet the needs of our staff, which in turn will better serve our Veterans.

                                                             2019 Job Fair             2019 Job Fair

Speaking of job fairs, on July 11 two of our vocational rehabilitation specialists (Aaron White and Dr. Mary Watson) participated in the McDonald Hughes Job Fair held in the community. The Veterans’ Job Fair was a huge success!  Approximately five of our own Veterans were transported by our vocational rehab staff and two of those had potential job offers. One Veteran was offered a cook position with Baumhower’s Restaurant and starting pay is $15.00/hour.  There were also other Veterans not working with us in our CWT program; however, our staff were still on hand to help and provide guidance to those Veterans despite them not enrolled in our program.  Mr. White and Dr. Watson assisted those Veterans as well by helping connect them to employers, helping to prepare them for when they approach the employers in attendance, reviewing their resumes, and providing information about our services for follow-up and how Compensated Work Therapy (CWT) can assist in maintaining employment in the event they are hired by the companies. 

In July, we were notified that our facility has received a score of 100 on the Health Equality Index survey and was designated a "Leader in LGBTQ Healthcare Equality" in the HEI 2019 Report. This is great news and shows our facility has made strides to ensure our LGBTQ Veterans receive the care they need and we are a leader in this area. Research shows that LGBT Veterans expect to experience discrimination in VHA facilities which may prevent engagement in care. Research also shows that due to stigma, stress, and discrimination, LGBT Veterans as a group experience higher rates of several health conditions compared to non-LGBT Veterans, including higher risk for suicide. Therefore, VA is working to reduce minority stress and engage sexual and gender minority Veterans in order to provide health care that addresses their needs.

On July 26, Voluntary Service held a luncheon for the summer student volunteers. I want to thank Voluntary Service for managing a great program this year as well as the parents of each student volunteer for ensuring they met the daily requirements. To be accepted into this program, the students had to commit to a standard we uphold here at the medical center for our volunteers. This speaks to their character and commitment to always seek out new challenges in order to learn and grow as individuals. We hope the students enjoyed it as much as we did.
Student Volunteers  Student Volunteers  Student Volunteers Student Volunteers

Also in July, we started our Green Gloves Initiative, which encourages all VA staff to do their part in creating a clean and safe environment. Staff are encouraged to help by locating the Green Gloves stations throughout the facility, looking around for items that do not belong, and using the gloves to safely pick up and discard litter.
Green Gloves Initiative

In August, we began communicating plans to become a smoke-free campus on October 1. As I’m sure you have heard, every VA medical center around the country went smoke free on this date. This policy change coincides with additional VHA efforts to help us become the provider of choice for Veterans. I know this is going to be a very tough transition for our smokers, but we have no choice but to follow our science and continue to do what is right medically for everyone. Change is never easy, but this isn’t the first time a tough challenge like this has presented itself. Some of you may remember when patients were allowed to smoke on the units. Some of you remember when policy changed to where acute psychiatry patients were no longer allowed to smoke while admitted. We have faced tough challenges before and finally after a time of adjustment, the new way became the norm. That too, will happen with this new policy.

Also in August, we held a Strategic Planning Summit. This was an opportunity for our services to discuss their accomplishments from the past year, areas identified for improvement and their plans for the coming year. We took many ideas raised over the two days and will implement into a facility plan. We have a tremendous work force of dedicated managers and front line staff as was evident during these briefings. All staff should be proud of what we have accomplished in the past year and the great things we will accomplish in this coming fiscal year.

In September we held a provider fair where we welcomed local providers to the medical center to learn about the MISSION Act and how they can join our network of providers that can treat our Veterans. We explained how they can sign up to be part of the network Veterans can choose from and how the process works. We also have an Information Center in the lobby of Bldg. 1 where Veterans can come and talk to Community Care staff about any questions they have regarding community care appointments and billing questions.

And lastly, September is Suicide Awareness Month. I hope all of you have seen the public service announcements that we worked with Coach Nick Saban to record, including one on Veteran suicide. Just as Coach Saban said, one Veteran suicide is one too many, and unfortunately about 20 a day take their own lives. About 14 of those 20 are not enrolled for VA Care.

We must do anything and everything we can to help get these Veterans the care they need. At Tuscaloosa VA, our Suicide Prevention program is staffed by one Suicide Prevention Coordinator (SPC) and one Suicide Prevention Case Manager. The SPC maintains a list of Veterans at high risk of suicide, and places a patient record flag in each high risk Veteran’s electronic record. The list averages approximately 20 Veterans. The flag is active for 90 days, during which time Veterans receive increased mental health contact, to include suicide risk assessment and safety planning. After 90 days, the flag status is reevaluated, and will be continued or inactivated. A minimum of five outreaches are conducted per month, outside of the Tuscaloosa VA campus, and these are focused on increasing suicide prevention awareness. Tuscaloosa VAMC maintains mail contact with all high risk Veterans for one year after they are identified as high risk. The Suicide Prevention program also responds to consults from the national Veterans Crisis Line, for Veterans within the Tuscaloosa VAMC catchment area. We need everyone to make a commitment to ending Veteran suicide. As Veterans, we must make a commitment to help our fellow Veterans who remain in any way we can and continue to set an example of our American values. As we have done in the military we need to confront those Veterans who are not living to these values. Be their buddy. Buddy teams should not be a lost concept as a Veteran. Through the buddy system, we can ensure our fellow Veterans remain with us and have fruitful lives until they are called home.

In closing, I want to thank all of you for your support. We have tremendous support from our Veterans, our Veterans service organizations and community, and we understand we are all in this together, with the same goal.



Director, Tuscaloosa VA Medical Center