BEND, OR -- "Our veterans aren't getting access to care in the timely manner that Congress wants them to get access to care."
Over a year after allegations of long wait times, falsified records and distant care options at VA centers across the country flooded the news, Congressman Greg Walden spoke to KBND news about moving forward, and the problems with change.
Walden met with Central Oregon veterans in his Bend office just as recent problems with the implementation of Oregon's own VA programs, aimed at reducing wait times and getting local service, have been causing local concern. Right at a time when several state legislators have been calling for more accountability, Walden and a slew of concerned veterans continued the discussion.
Last year, scandal swept the nation when it was found that the Phoenix, Arizona, Veterans Affairs Health Care System had falsely the listed wait times veterans were experiencing to get care, making care look far more adequate than it was. The lack of medical response was found to have caused the deaths of 35 veterans, and inconvenienced thousands. In subsequent investigations nationwide, similar problems surfaced across the country -- long wait times and the lack of nearby health care.
What started as an investigation ended with a U.S. House of Representatives vote in 2014 to implement H.R. 3230, a law implementing veterans programs. For Oregon, one, the Patient-Centered Community Care Program, is aimed at finding community-based health professionals to service veterans. The Choice Program, meanwhile, since November 2014 has given veterans who have waited over 30 days or live more than 40 miles from a VA clinic the option to seek treatment from non-VA providers.
But since that rollout, Central Oregon has been facing its own problems with implementation of the three-year temporary programs. According to local VA advocate Dick Tobiason, so far, it's been far from smooth.
Tobiason spoke with KBND about his concerns, the chief of which is the lack of accountability statewide. Through the Oregon VA program, those enrolled in the Choice Program are issued cards and are then eligible to negotiate their health care to within a 40-mile distance "as the crow flies" -- not within driving distance. But Tobiason says success can't be measured, as the system has not been making information public.
"Get the VA to tell us -- what's going on with performance?" Tobiason asks. "What are the performance indicators, how much money is being spent ... what's the reduction with wait times?"
Reimbursements have also been difficult for some veterans. The Portland VA reports that for refunding under the Choice Program, veterans must be enrolled in an active VA participant, have medical documentation of an emergency and have received health care within the past 24 months.
Since the two programs were implemented, Tobiason says he hoped to see disabled veterans avoid the inconvenience of traveling to the Portland VA, and get their care locally. At first that outcome looked promising. Back in November of 2014, Central Oregon's St. Charles Medical Center announced the hire of Wendy Rudy, a veteran, as a service liaison. And at the time, Tobiason hoped to see the local effect of the $10 billion dollars being used nationwide to pioneer the programs.
But currently, he says he's seeing more of the money being spent on new medical centers rather than on local care. "We don't need to build more Denver Medical Centers with five times overpriced costs," Tobiason says. "We don't need to build facilities; we need to take care of veterans and use the money for doing that instead of building these empires."
It's a concern shared by Sunriver Representative Gene Whisnant, Bend State Representative Knute Buehler and Bend State Senator Tim Knopp. The three Central Oregon legislators recently sponsored House Joint Memorial 14, which would petition Congress and other government agencies to make the Oregon VA release information on program success, and ramp up efforts to make care local.
The measure prompted testimony at the Oregon House Veterans Services and Emergency Preparedness Committee on Thursday, March 26. It goes in-depth into concerns voiced by Oregon veterans, including concerns that "rural veterans often have to drive several hours, sometimes in hazardous road conditions, to receive medically necessary treatment or procedures."
Tobiason was one of the advocates to testify for the program. But according to him, his concerns reach beyond what the measure would address. Tobiason says part of the problem he's been seeing is the two programs are working separately, instead of being merged into one. But one of his biggest concerns: they are only test programs, and so far they've been expensive.
"Why are they temporary?" Tobiason asks. "If we can make them work, why can't they become permanent? What happens at the end -- would you discontinue them? Crazy."
Walden disagrees with Tobiason on that note. According to the Congressman, the transition period is important, and he expects the pilot programs to be extended. "You have to test it before you roll it out," he says.
The concerns piling up didn't surprise Walden at Monday's meeting. "That's why I pulled together this meeting, because I've been hearing this for months now," he says.
So far there are several major miscommunications within the VA he's picked up. Veterans should have been eligible for the Choice Program if they couldn't get help within 30 days, but some VA workers have gone with 30 business days, dragging out the process. And with the law being interpreted as 40 miles "as the crow flies," driving distance has been less factored into the picture.
Refunding has also been a problem, as some veterans have had to pay unnecessary costs after the services they received were miscategorized. James Tuchschmidt, the Washington D.C. Acting Principal Deputy under the Secretary for Health, was at the Bend meeting and says that is a mistake.
"We don't want veterans paying collections because it's something we should have done and haven't paid," Tuchschmidt says.
But when it comes to progress, Walden's views end on a positive note. The representative is expecting to deal with legislation continuing the programs in the House Veterans Committee, after which he hopes to modify less successful parts of current legislation. It hasn't been perfect, he says, but it has been a lot of work.
"You're talking millions of veterans and a short time to roll it out," Walden says. "And the VA has worked on it, but clearly they've missed the mark in some areas, and the statute has missed the mark in some areas."
Photos by Junnelle Hogen