MARINA, California -- The recipe for the Army's newest partnership in Monterey County involved many ingredients and cooks.

A mouthful of a name (Major General William H. Gourley Veterans Affairs-Department of Defense Outpatient Clinic), two congressmen (Sam Farr and Jimmy Panetta), two grand openings (Oct. 14, 2016 hosted by Farr and another on Aug. 3), $100 million, and 150,000 square feet later, the second Army and VA combined treatment facility welcomed its first patients Aug. 14.

The California Medical Detachment of the Presidio of Monterey will serve an estimated 4,200 patients, the spouses and children of all military assigned to PoM and the Naval Postgraduate School.

"We basically took the same great pediatrics and family medicine staff, the same great care, and put it in a great new building," said Maj. Ben Ingram, CalMed chief medical officer. "We're in a great location, right around the corner from the commissary, not that far from Fort Ord housing."

Active duty military treatment stays at CalMed's clinic on the Presidio.
Ingram said. "We're also close to a shopping area with a lot of fast casual dining."

The nuts and bolts of creating a clinic serving both VA and the military was daunting. Besides the patient populations, differences extended to the different software systems and the VA-issued access cards CalMed personnel needed.

Running logistics for the Army side was Maj. Dan Coulter, CalMed deputy commander for administration.

"Working interagency with the VA partners and our own folks, who were used to operating in a fashion for so long, in standing up the clinic made for interesting dynamics," he said. "Information technology was one of the big challenges we faced."

Ashley Lomeli, clinical systems trainer for CalMed, brought her previous work experience at VA to the process.

"I was able to be at meetings and help with the cross talk," she said. "VA and Calmed were talking about similar services and work, there's just different terms."

Both health care groups had to maintain care at old locations and welcome patients at the new clinic on Aug. 14.

"I think the biggest challenge was making sure the mission at the Presidio and the clinics didn't suffer while we were getting this operation up and running," said Lt. Col. Brian Lanier, CalMed commander. "It's been a lot of work by our team to put a good DoD face on Gourley clinic."

He replaced Lt. Col. Bill Soliz June 15 and, as he said, "I got to oversee the sprint to the finish.

"I thought it was a very exciting prospect to come in here and deal with the challenges that came with this," Lanier said. "The VA people we've interacted with have been amazing partners. They're keeping the long game in mind and we have the opportunity to do something here in model of care that the rest of the country can build upon."

The pediatric clinic provides primary needs ranging from acute visits to well visits such as sport physicals, immunizations and overseas screenings.

The family medicine clinic assigns each patient with a team of health care providers to receive improved access, coordinated services, and better continuity of care.

The joint facility also features an on-site pharmacy, laboratory, and X-ray. Two-way video telehealth is available from specialists at Madigan Army Medical Center, Joint Base Lewis-McChord, Washington.