Not much has changed with wait times
An Associated Press analysis of wait times at 940 VA hospitals and clinics from Sept. 1 to Feb. 28 found that the number of veterans waiting more than 30 or 60 days for non-emergency care has largely stayed flat. It also showed:
- Nearly 894,000 appointments completed at VA medical facilities failed to meet the system's timeliness goal, which calls for patients to be seen within 30 days.
- Nearly 232,000 of those appointments involved a delay of longer than 60 days — a figure that doesn't include cancellations, patient no-shows, or instances where veterans gave up and sought care elsewhere.
- Of the 75 clinics and hospitals with the highest percentage of patients waiting more than 30 days for care, 12 are in Tennessee or Kentucky, 11 are in eastern North Carolina and the Hampton Roads area of Virginia, and 11 are in Georgia and southern Alabama.
- The number of appointments delayed by more than 90 days jumped to nearly 13,000 in January and more than 10,000 in February, compared to an average of around 5,900 the previous five months.
- At the VA's outpatient clinic in Jacksonville, Florida, 7,117 appointments involved a wait of more than 60 days. There were more vets experiencing extended delays at that one clinic than in the entire states of New York, New Jersey and Connecticut combined.
- The VA's most chronically delayed outpatient clinic, located in Virginia Beach, Virginia, reported improvement. In September, 24 percent of its patient visits were delayed by at least 30 days. By February, that had fallen to 11 percent.
Thousands of area veterans waited more than a month for medical care since last summer, while wait times at VA facilities nationwide have stagnated despite a $16 billion infusion of federal funds intended to expedite care for those who have served in the military.
This is according to an I-Team/Associated Press analysis that shows wait times reported monthly by the U.S. Department of Veterans Affairs have not improved from September 2014 to February 2015.
The numbers show that the Dayton and Cincinnati VA medical centers — and their clinics in Springfield, Middletown, Hamilton and Richmond, Indiana — generally had a smaller percentage of patients waiting more than 30 days for appointments than the national average.
The Lima clinic and VA medical center in Columbus, however, were among those that exceeded the national average.
The number of veterans waiting one or two months for an appointment went from 931 across the region in September to 519 in February. But the number waiting more than two months grew from 119 to 214; more than half of these were at the Cincinnati VA.
George A. Bell, 81, has sought medical treatment at the Dayton VA since the 1950s. The Miami County man called Monday to set up an appointment for an examination of a lip scar that he said was cancerous in the past.
“I’m afraid the skin cancer is coming back in that area,” he said.
The Dayton VA booked him for a May 7 appointment, he said. That’s been his typical wait time for the three or four times a year he may visit the medical center, the Coast Guard veteran said.
“Because of the new regulations, they try, but you’re still looking way down the road,” he said.
Rodney L. Taylor, 70, a Marine Corps veteran who served in Vietnam and described symptoms such as diabetes and heart disease that medical authorities have linked to exposure to Agent Orange, said he usually can get scheduled at the Dayton VA within days.
“Most everything I can get in eight to 10 days,” the West Carrollton resident said. “If I’ve got something a little more serious than that I can walk in any time to the emergency department.”
Dayton VA Medical Center director Glenn Costie, who served as an interim director at the VA medical center in Phoenix last year after allegations surfaced that some veterans died while waiting for care at the Arizona facility, said VA facilities in Ohio, and specifically Dayton, have “always done very well when it comes to managing our wait times.”
“The veterans served by the Dayton VA have always enjoyed some pretty good access,” Costie said. “Whether it’s here at Dayton or the outpatient clinics in Lima and Richmond and Springfield and Middletown, we actively manage that for our veterans.”
The clinic in Richmond will move to a new location and nearly double in size next week. The VA has assigned an additional primary care team — a doctor, two nurses and a clerk — to three teams already there, Costie said.
Few choose ‘Choice’
The number of patients served annually in the VA system has grown from 4.5 million in 2002 to 6 million in 2013. During that same period, outpatient visits have soared from 46.5 million to 86.4 million annually; patient spending has grown from $19.9 billion to $44.8 billion.
Very few veterans, meanwhile, are taking advantage of a new program that makes it easier to get care outside the VA system instead of face long waits or lengthy drives. Between Nov. 5 and March 17, according to VA officials, only about 46,000 patients had made appointments for private-sector care through the Veterans Choice Program.
In Ohio, only 339 veterans have taken advantage of that option, despite the fact that 8,584 have qualified because they were facing wait times of more than 30 days, and 667 qualified because they live more than 40 miles driving distance from a VA center. Ohio’s VA centers serve more than 228,000 veterans.
The VA loosened rules on getting care outside the VA system last year amid public furor over concerns that veterans were facing long delays for care. Previously, veterans could only go outside the system for procedures the VA didn’t offer.
American Legion of Ohio service director Suzette Price said the VA rushed out cards in the mail to every veteran in Ohio for the Choice program, but didn’t explain it very well. She suspects that is one reason few veterans have used the program. Another reason, she said, is that the private sector often can’t get veterans in for an appointment much faster.
But she said VA secretary Robert McDonald — who was appointed last summer after Eric Shinseki was forced out — has invested in needed technology. She is optimistic things will improve.
“These changes take time,” she said, noting that Ohio veterans are fortunate in the quantity and quality of VA care available compared to other states.
The analysis of wait times found that the issue is more pressing in the South. The outpatient clinic in Hopkinsville, Kentucky, for example, has the highest percentage of delayed appointments of any VA clinic in the country. Nearly 20 percent of its 5,377 completed appointments from September to February involved a wait of longer than 30 days.
Many restrictions
Paul D. Cameruchi, 66, who has sought treatment at both the Dayton VA and the VA hospital in Columbus, said the reason many veterans haven’t participated in the Veterans Choice Program is because few are eligible based on restrictions of how far you have to live from a VA treatment facility, or the availability of services.
“The whole state is just about covered and there’s no way anybody can qualify for it,” said Cameruchi, a Columbus resident who was an Army infantry platoon sergeant in Vietnam. “It’s like a Catch-22.”
Costie said veterans who qualify for health care outside the VA but haven’t chosen it take that route because they are “very happy” with the government health agency in Dayton.
“They seem satisfied with the wait times that we manage for them and they’d rather wait for the care the Dayton VA provides versus trying to introduce themselves to an outside provider they don’t even know,” he said.
Dayton VA spokesman Ted Froats said only nine veterans have gone outside the Dayton VA for care of the 295 who have qualified for the Choice program. He said this is one reason local wait times haven’t moved much.
“If eligible veterans decided they’d rather be seen elsewhere, our wait times would certainly decrease,” he said. “But we’re much happier with the present outcome: While we are working diligently to decrease wait times across the board, the numbers show that 97 percent of our veterans are determining that we are literally ‘worth the wait.’ ”
Max Kinman, a malpractice attorney in Mason who represents veterans with claims against the VA, said the VA offers top-notch care in treating war wounds for recent veterans, but falls short at treating vets with lifestyle and aging issues. He said the VA should let veterans choose whether they want to get all of their care in the private sector, paid for by the VA, instead of only when the VA can’t deliver.
“The VA could fix it by allowing them to go see private physicians, but they don’t do that,” he said.
Wait times vary
Ohio’s VA hospitals received $43.5 million this year of the $16.3 billion Congress appropriated last year to cut down on wait times. Ohio VA officials say they have spent $10.1 million but expect to spend it all, primarily to hire clinical staff and expand clinic space.
“Patient wait times are a function of both the demand for services and the supply of providers to deliver those services, both of which can fluctuate,” said Denise Kerr, spokeswoman for the VA in Ohio.
The seven local VA centers saw their number of appointments rise and fall monthly, and their responses varied.
Roughly 1.9 percent of veterans at the Cincinnati VA waited more than 30 days for an appointment in February, compared to 1.1 percent at the Dayton VA. Long wait times were rare at the Springfield Community Based Outpatient Clinic, but thousands of veterans waited more than a month for an appointment at the Chalmers P. Wylie VA in Columbus.
And the Lima clinic skyrocketed from nearly no long waits to dozens of patients waiting months for care.
Froats said the Springfield and Middletown clinics have short wait times because they’re fully staffed. Once a primary care provider and nurse practitioner are hired in Dayton and a physician is added in Lima, he said “we expect to see capacity exceed demand for primary care services at all our facilities.”
Costie meets with top staff every morning to discuss keeping local wait times below the national average.
“When you’re already ahead of the curve, there’s realistically only so much further you can improve in a relatively short amount of time,” Froats said. “That said, we are continuing to focus on this issue for our veterans.”
Veterans have long seen varying access to doctors from one facility to the next. Last week, the U.S. Department of Veterans Affairs Office of Inspector General released an inspection looking at how long it took veterans entering the VA system to get initial appointments with their primary care physician at the Dayton VA and affiliated clinics in the fiscal year ending in September 2014.
The report noted that veterans in Lima waited an average of 75 days to get an appointment at the Lima VA clinic in February 2014, but the wait at the Middletown clinic was only 9.6 days in September 2014 — though Middletown veterans were waiting a month in October 2013.
Getting a first-time appointment at the Dayton VA took between 11 and 19 days, and between 10 and 24 days in Springfield.
Kerr said Cincinnati — like the Portsmouth VA, which had the highest percentage of patients waiting more than a month in Ohio — saw times increase along with the number of job vacancies. She said the number of veterans across Ohio seen in fewer than 30 days has increased since November.
“Despite the positive trend … (the VA in Ohio) continues to work on enhancing access by hiring additional providers, optimizing clinic efficiency and fully utilizing non-VA care options aimed at providing veterans with greater access to care,” she said.
Deputy Secretary of Veterans Affairs Sloan Gibson acknowledged that in some parts of the country, the VA is perpetually a step behind rising demand.
“I think what we are seeing is that as we improve access, more veterans are coming.”
Associated Press reporter David Caruso contributed to this report.
About the Author