Michelle Peppers has only been with HBPC a short 4 months and came amid a time of growth and many changes. There was an issue with the local Mountain Home CBOC contract that did not allow HBPC patients to get ancillary care at the CBOC (labs, Xray, EKG, etc.). This situation was at an impasse for a few months. Then a HBPC patient who had a relatively urgent cardiac issue, needed Cardiologist consultation. The veteran wanted to stay within VA but could not drive to Little Rock, did not want to see a local cardiologist, and was denied a telemedicine visit at the CBOC due to the contracting issue. By the end of the following week, Michelle Peppers had worked with all the key individuals to provide a tele Cardiology visit in the home utilizing the ECHO device. The FIRST in the entire NATION, as I understand! Within the following week, Michelle was instrumental with a team of others in rectifying the contracting issue, and HBPC patients were allowed access to care at the local CBOC. This is just one of the many examples of the challenges encountered with the growth and expansion of a service line. Michelle has been phenomenal at solving every issue that is presented within her influence respectfully and with the best interest of veteran patients at heart. Michelle Peppers is an Extraordinary Nurse and person in general. She demonstrates every VA ICARE core value and inspires others to do the same. Michelle Peppers deserves the DAISY Award to recognize her commitment to one of the most vulnerable patient populations. Just because it hasn't been done before hasn't stopped Michelle from innovatively meeting veterans' needs where they most need it.