The Goldendale Sentinel - Headlines & History since 1879

By Shelby Taylor

VA health services for county still struggling


VA Portland

SHINING EXCEPTION: The VA Clinic in The Dalles is the only VA health outlet in the area fully staffed and with virtually no wait times.

It is well known that veterans may utilize state and federal funded programs to pursue primary care, mental health, surgeries, and other basic health care appointments. But how efficient is the heathcare these veterans are receiving? Unfortunately, the average wait time near Klickitat County is more than three times the national average. Veterans are experiencing delays in care primarily due to staffing issues, though one local facility in The Dalles has been well staffed and running smoothly in recent years.

The most common locations near Klickitat County for veteran health care are: Yakima, The Dalles, and Vancouver, Wa. Both the Dalles Clinic and the Vancouver Clinic are part of the VA Portland Health Care System. This means veterans must go to Portland for additional emergency services. The Yakima Valley Vet Center and Yakima Community Based Outpatient Clinic (CBOC) are part of the VA medical center in Walla Walla. Commonly, veterans in this area will pursue the Dalles clinic location.

The Veterans Health Administration consists of over 1,700 sites of care serving 8.76 million veterans each year, according to its website. But serving this large a number of veterans poses difficulties in effectively maintaining efficient programs. The Department of Veterans Affairs release online patient access data where veterans may check the efficiency and quality of their local VA provider.

By using this data, veterans can compare destinations with the national statistics for veteran services near Klickitat County (see chart).

Even though the Vancouver area handles ten times as many veterans' appointments than Yakima, each region repeatedly falls below the national averages. The national average for veterans being scheduled within 30 days is over 90 percent. While the Portland area is still below this, both Vancouver and Yakima fall almost 10 percent lower than the national standard. More importantly, the average wait time for primary care near Klickitat County is more than three times the national average. Specialty care also needs improvement, with Yakima's wait time being six times longer than than the national statistics, though they exceed in mental health times, being five times faster.

Though the efficiency of these Washington and Oregon facilities need improvement, there is business being done to motivate our progression towards quality care and shorter wait times. U.S. Rep. Jaime Herrera Beutler represents the Southwest Washington's 3rd district and has been highly active in veterans' affairs. The congresswoman has highlighted the delayed veteran care as being contributed by a high turnover rate of employees, lengthy hiring process, and staff vacancies in the area.

Merely two months ago, in April, Herrera Beutler proposed and passed a legislative directive that requires each VA region to collect data on the number of medical staff who were hired, how many have left, their reasons for leaving, the care and capacity for severely disabled veterans, and how many homeless veterans are receiving care.

"We continue to see major holes in the VA system-particularly with hiring and retaining staff that provide care. The VA insists they are correcting these problems, but it's happening too slowly for Southwest Washington veterans who need quality medical care. It's important that Congress advances these accountability measures I've authored to give the VA more tools to provide better services to our military heroes," said Herrera Beutler.

These collected statistics will allow the VA to identify the issues within the system hindering their ability to promptly provide quality care for veterans. One way that these steps have been implemented by the VA Portland Health Care System is by training and retraining employees who are responsible for scheduling patients to help eliminate any confusion during scheduling procedures.

Since the bill was passed last year, the VA has also begun collecting data from exit surveys that summarize the principle reasons explaining their departure and a detailed plan of how the VA will address the issues causing providers to leave. The first report, each being submitted every six months, has shown varying details for employee's reasons for leaving. According to Amy Pennington, the congresswoman's communications director, this data can be broken down by provider type: physicians tend to leave due to management and lack of respect; registered nurses have left for normal retirement; and physical therapists often attend additional schooling.

When the next report is released, the VA will better be able to address the staffing issues of the Health Care System and determine if the newly implemented training programs have benefited the employee turnover rate.

In addition to this bill, the congresswoman has also been directing her focus to the delays in the hiring process. When the VA has a new position opening, the applicant may get through the interview process, but then have to wait through the credentialing process which can take four to six months alone. Often, this delay in hiring results in applicants finding other healthcare opportunities with faster hiring processes.

This lengthy process wastes the time of the individuals applying and impacts the functionality of the facilities, many of which need additional staff as soon as possible. The high turnover rates and lengthy hiring process combined, result in a vacancy rate of over 20 percent. The VA does not currently collect data on these hiring process time statistics. This has resulted in the congresswoman's provision that passed the full House on May 19, 2016. This provision requires the VA to include the percentage of staff, per category, that leave each facility, along with the average time it takes to fill each of these vacancies so that the VA may take additional steps to improve this hiring process.

While the next report is anticipated, there have been other programs introduced to assist with the current wait times of veterans. The VA Portland Health Care System has opened weekend clinics, instituted walk-in clinics, and greatly increased the use of telemedicine. Telemedicine enables veterans to talk to specialists at other locations via electronic communication, reducing the need for veterans to travel long distances, and doubling the care veterans receive. Daniel Harrigstad, the Public Affairs Officer of the VA Portland Health Care System, says the clinic has also hired 131 additional clinical staff to assist in meeting Veteran Care since 2014.

One facility that does occupy the maximum Primary Care staff possible is The Dalles location in Oregon. The facility has been consistently well staffed since its recent remodel and expansion in 2012 which nearly tripled its size from 1,272 square feet to 3,520 square feet. The clinic as also has a full time social worker, utilizes telemedicine, and hosts a full day clinic once a month to assist veterans transitioning to the VA Health Care System, according to Harrigstad.

One area that not only The Dalles clinic needs to work on, but the entire VA system as a whole, is their phone services. Many veterans nationwide are experiencing difficulty having their phone calls answered or returned. The entire VA system has 900 full time employees that receive 27 million calls a year at a total of just 8 call centers. Veteran's must use this national phone system for questions and information regarding their care. This process can be long and even unsuccessful. Many veterans encounter busy signals, are directed to incorrect facilities, leave messages that are often not returned, and even have calls dropped after being told to call back at a less busy time. The VA is currently working to implement online self-service options with a new updated website that will allow veterans to access needed information to reduce the need for phone inquiries. Many have also suggested there be a call back option so that their dropped phone calls may be returned instead of forgotten.

Though there are many improvements to be made within the VA Health Care System, there has been strong support and initiatives from people such as Herrera Beutler who have taken the matter strongly to help fix and improve the care for veterans. "It's my job to make sure the men and women who have sacrificed to serve and defend our country receive the care they've earned," said Herrera Beutler.


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