VA Faces Long To-Do List from Flagstaff Vets
Lost medical records. Months-long waits for administrative approvals. Prescriptions that couldnt be filled. The veterans complaints piled one on top of the other, so swiftly that officials from the Northern Arizona VA Healthcare System were barely able to respond.
The setting was an early January town hall at the Flagstaff VA clinic where veterans were invited to speak directly to leadership with the Department of Veterans Affairs northern Arizona base in Prescott.
The hour-and-a-half long event seemed an almost cathartic opportunity for veterans to vent their frustrations with the system intended to care for them into old age. From their comments, it became clear that as the Department of Veterans Affairs begins massive reforms after last years wait time scandal, improvements will have to encompass everything from clinic receptionists to medical staffing to prescription services in the northern Arizona system.
For their part, VA officials say those national reforms are in fact already touching this region and will soon result in visible changes at the Flagstaff VA clinic. The clinic has almost finished hiring an additional primary care team, has received extended funding to send veterans to outside specialists and has a new attitude toward making processes more efficient, M. Keith Piatt, chief of staff at the Northern Arizona VA Healthcare System said in an interview with the Daily Sun. Many of the changes, Piatt said, can be directly tied to 2014s Veterans Access, Choice, and Accountability Act, signed by President Obama in August.
Wait Times
Waiting times for appointments, which were at the root of the scandal that rocked the Phoenix VA and immediately rippled outward, have plagued Flagstaffs clinic as well. In May, the clinic was one of 112 facilities flagged for further review after a nationwide audit of appointment scheduling. The issue was also a major complaint brought up by veterans at this months meeting.
Attendees talked about waiting weeks or months to see a doctor for everything from bronchitis to a torn meniscus to an annual physical. When Dan Bernardo tried to schedule an appointment for a biannual physical, he couldnt get an appointment for five months, said the Vietnam War veteran. That was after the nurse forgot to schedule the appointment when he first approached her four months before. When another Vietnam veteran, Simon Sandoval, called to schedule an annual physical last year, he said he was told the wait was three months.
Those experiences should be getting fewer and fewer, VA officials said. Since June, wait times to see a primary care physician at the Flagstaff clinic have been reduced from 45 days to potentially one day if a patient is willing to do the appointment via teleconference, VA spokeswoman Mary Dillinger wrote in an email. For new patients to see a provider, the wait is 32 days. That should continue to improve as the clinic finishes hiring a second primary care team, made possible thanks to the $18 billion allocated to the VA under the 2014 Choice Act. The act also establishes a Veterans Choice Fund that will pay for veterans to see outside doctors if the VA cannot schedule them within 30 days.
Coordinating Care
In rural northern Arizona, the VA contracts with two private healthcare companies to provide veterans access to specialized health care that the VA cant provide here.
But several veterans at the open house said the coordination between the VA, the private healthcare companies and the individual practitioners is still clunky and flawed, resulting in lost records, long wait times and delayed care.
Clinton Jones has been wrapped up in the back-and-forth between the VA and outside providers for months. The Marine veteran who served in Iraq and Afghanistan has had to stay at a friends house for the past seven months because he cant climb the stairs to his third-floor apartment due to a torn meniscus and complications from a broken hip bone.
Unbeknownst to him, Jones broke his hip jumping out of a helicopter in Afghanistan 10 years ago. The bone that regrew is thicker and doesn’t fit as well into his hip socket, Jones said. It took years for the VA to correctly diagnose the service-related injury and now he has spent four months being transferred from doctor to doctor in search of the correct hip surgeon in Flagstaff. When his paperwork needs to be transferred from outside providers back to the VA, Jones said it often seems to disappears in transit, forcing him to go back and carry over the documents himself. The process almost drove Jones to suicide six months ago.
“It’s like you get hurt and you have this great place called the VA that is supposed to help guys when they come back,” Jones said. “But then the place thats supposed to help them doesnt really care and bounces them around just to get them out of their hair.”
Despite veterans struggles going between the VA and outside providers, the VA is likely to pursue more of those contracts in the future, Piatt said.
He explained that its hard for the VA by itself to establish an integrated healthcare system in the more rural areas of the country.
We now have a chance to reconfigure the way we do business and look at what are best options veterans. If its providing care at local doctors office rather than have them drive to VA clinic then that’s the right thing to do, he said.
Changes Afoot
But instead of seeing this period as one of opportunity for the VA to change the way it does business, Robert Heinrich believes now is the worst time for a veteran needing to access the VA healthcare system. Heinrich, who was also at the VA open house earlier this month, has struggled to get the prescriptions he needed, faced a 109-day wait for his first doctors appointment at the VA clinic in Flagstaff and miscommunication between the VA and outside providers that forced him to wait months to get neck surgery.
We’re having this huge change of the system and an extreme influx of veterans coming into a system that has no leadership that is trying to get that leadership with new people in charge, the Navy veteran said. I think the majority of people there want to help veterans, but bureaucracy is tying everyone’s hands.
Piatt shared those concerns. The VA has always faced a challenge in getting needed care to everyone it serves, but its workload has increased in recent years with incoming veterans from Iraq and Afghanistan and the wave of Vietnam veterans that are starting to experience more health problems, he said.
Its that confluence, all of the sudden that real intensity of need and the VA was caught a little flat-footed, Piatt said. Its difficult for any enormous system to turn on a dime, what the crisis over the last year has done is furnished us an opportunity to reevaluate our services, look at the most efficient ways we can provide the most care to most eligible veterans and put it in a place where its easier for veterans to get that care.
The town hall itself was part of the VAs effort to improve its outreach to veterans. Northern Arizona VA Healthcare System officials started the open houses in September and will be traveling to different parts of northern Arizona on a quarterly basis, said Dillinger said.
After the meeting in Flagstaff, VA officials followed up with 30 veterans to help resolve issues they brought up at the event, she said.
Despite his frustrations with the VA, Heinrich acknowledged that the situation is starting to look up.
I’m seeing improvement slowly. (VA officials) coming up here (to Flagstaff) and showing face is a start but there’s a lot that needs to be done here, Heinrich said. I’m grateful for anyone within the system who is trying to change it and not reinforcing the old system.
Tags: Veterans News
