Wait times worst in U.S.

The Denver Post - - FRONT PAGE - By David Migoya

Wait times for med­i­cal ap­point­ments at vet­er­ans fa­cil­i­ties in east­ern Col­orado and the Den­ver area are among the worst in the na­tion, U.S. Depart­ment of Vet­er­ans Af­fairs data show. Front Range vet­er­ans have seen lit­tle im­prove­ment in the three years since a na­tional scan­dal erupted over the prob­lem.

The av­er­age wait for a pri­mary care ap­point­ment at just the Den­ver VA Med­i­cal Cen­ter has grown to more than 18 days as of July 1 — three times higher than those at the main VA fa­cil­ity in Phoenix, where the prob­lem was first ex­posed in 2014, and nearly four times the na­tional av­er­age.

The wait­ing pe­riod in Den­ver had been half of what it was in Phoenix, ac­cord­ing to VA data re­leased this month.

Through­out the 13 hos­pi­tals and clin­ics that make up the East­ern Col­orado Health Care Sys­tem, the av­er­age wait for a pri­mary care ap­point­ment as of July 1 was more than 12 days. Only Amar­illo, Texas, and Palo Alto, Calif. — both smaller than ECHCS — were worse.

In all, though, nearly 13.5 per­cent of all the ap­point­ments at the ECHCS had longer than a 30-day wait, fed­eral data show — worst in the na­tion — even though the VA in 2011 said its goal was for each vet­eran to be seen by a doc­tor within 14 days.

Navy vet­eran Al Mon­toya of Den­ver said he has be­come ac­cus­tomed to wait­ing up to three months to see a pri­mary care doc­tor at the Den­ver fa­cil­ity.

“It’s not al­ways like that for ev­ery­thing, but pri­mary care takes long­est,” he said. “It does no good to com­plain, and I know they’re do­ing the best that they can. They’re very good peo­ple here.”

The na­tional wait-time av­er­age is 4.9 days, and about 5.8 per­cent of all ap­point­ments across the coun­try had longer than a 30-day wait, ac­cord­ing to VA data.

In May, the VA re­ported that more than 92 per­cent of all com­pleted ap­point­ments in east­ern Col­orado were han­dled within 30 days, but that was the low­est in the na­tion. The av­er­age was nearly 97 per­cent, data show.

“Not much has re­ally changed here since what hap­pened in Phoenix,” said Randy Proc­tor, an Army vet­eran who said he has been vis­it­ing the VA cen­ter in Den­ver for 30 years. “Some ap­point­ments aren’t so bad, but if it’s den­tal, that’s the worst. It takes a long time.”

“Deeply trou­bling”

Col­orado con­gress­men as­sailed the agency for its con­tin­ued — and wors­en­ing — is­sues over vet­eran care, es­pe­cially af­ter the VA bat­tled other con­tro­ver­sies such as the mas­sive de­lays and cost over­runs in con­struct­ing a new $1.7 bil­lion fa­cil­ity in Aurora, which is ex­pected to open in the spring.

“I find this deeply trou­bling and I will be dis­cussing it with (VA) Sec­re­tary David Shulkin,” said U.S. Rep. Mike Coff­man, R-Aurora, who is a mem­ber of the House Com­mit­tee on Vet­er­ans’ Af­fairs and the Armed Ser­vices Com­mit- tee. “Ad­di­tion­ally, I will be spend­ing time … at the VA to find out why our vet­er­ans in the Rocky Moun­tain re­gion are not re­ceiv­ing the timely care that they need and have earned through their mil­i­tary ser­vice.”

Con­gress­man Ed Perl­mut­ter, D-Ar­vada, said he was sur­prised wait times were still an is­sue here.

“Clearly, we need to be con­tin­u­ously fo­cused on how to re­duce vet­eran wait times, and I plan to take an­other look at the is­sue,” he said. “Den­ver’s wait times shouldn’t be above the na­tional av­er­age.”

In Jan­uary 2015, not long af­ter the wait-time scan­dal came to light in Ari­zona, the av­er­age wait time at the Den­ver fa­cil­ity for a pri­mary care ap­point­ment was just 7.5 days, records show. Phoenix was 14 days.

Worst in La Junta

The cur­rent back­log for ECHCS is worst in La Junta, which showed av­er­age wait­ing pe­ri­ods of more than 24 days, up from about three days in 2015.

ECHCS of­fi­cials on Thurs­day said crit­i­cal short­ages in med­i­cal per­son­nel — doc­tors, physi­cian as­sis­tants and li­censed prac­ti­cal nurses — make it dif­fi­cult to keep up with the grow­ing de­mand Col­orado has seen from an in­creas­ing vet­eran pop­u­la­tion. And some­times it’s sim­ply be­cause vet­er­ans would rather wait for a fa­mil­iar face.

“Vet­er­ans want to come to us,” ECHSC Chief of Staff Dr. Ellen Man­gione said. “They can go else­where, but they choose us.”

The sys­tem cur­rently has a 16 per­cent va­cancy rate — there are 336 physi­cians — even though it of­fers some pri­mary care doc­tors as much as $200,000 a year in salary and ad­di­tional train­ing.

“It’s a chal­lenge to keep up with the de­mand,” as­sis­tant di­rec­tor Josh Prid­gen said. “The mar­ket­place has be­come very com­pet­i­tive.”

The Den­ver fa­cil­ity has im­proved in one key area: the av­er­age wait for a men­tal health ap­point­ment has dropped from nearly 20 days in 2015 to fewer than nine days to­day, data show. But that is still more than dou­ble the na­tional av­er­age.

The num­ber of sched­uled ap­point­ments in the ECHCS has grown by 41 per­cent in2 K years to 91,278, data show, while those in Phoenix have risen by 48 per­cent to 102,363.

“I know the Golden clinic has been a bright spot in pro­vid­ing an­other op­tion for vet­er­ans, and I be­lieve the new med­i­cal fa­cil­ity will be too, but we need to shorten these wait times for our vet­er­ans mov­ing for­ward,” Perl­mut­ter said.

The av­er­age wait at the Golden clinic was more than seven days in 2015. To­day, it is about five days, data show.

Den­ver in­sid­ers chal­lenged the ac­cu­racy of VA’s na­tional num­bers, say­ing pa­tients are bet­ter off to­day than three years ago. How­ever, they con­cede that hir­ing med­i­cal pro­fes­sion­als re­mains a prob­lem at fa­cil­i­ties in Col­orado Springs and Pueblo, where the num­ber of pa­tients on wait­ing lists is larger than Den­ver.

“That’s to do with not enough avail­able peo­ple want­ing to work for the VA,” said Bernie Ro­goff, a vol­un­teer vet­er­ans ad­vo­cate who serves on a pa­tient-care team at the Den­ver cen­ter and is a board mem­ber of United Vet­er­ans Com­mit­tee of Col­orado. “They are dis­torted (wait­time) num­bers. Pri­mary care wait­ing times are likely five, at most seven days, and there ain’t noth­ing wrong with that.”

Since the scan­dal broke in 2014, av­er­age wait times at the Carl T. Hay­den Vet­er­ans Af­fairs Med­i­cal Cen­ter in Phoenix have im­proved dra­mat­i­cally, to six days for a pri­mary care ap­point­ment. Re­gion­ally, about 7 per­cent of all ap­point­ments in Phoenix were out­side the 30-day win­dow.

“VA fa­cil­i­ties learn from each other by shar­ing in­for­ma­tion and best prac­tices,” Sch­abert said. “But ul­ti­mately, ev­ery VA health care sys­tem is unique in a num­ber of ways, in­clud­ing the de­mo­graph­ics of its vet­eran pop­u­la­tion, the geog­ra­phy it cov­ers, the num­ber and size of clin­ics and the num­ber and cer­ti­fi­ca­tions of its health care pro­fes­sion­als.”

The 2014 scan­dal

The wait-time scan­dal broke in 2014 with al­le­ga­tions that VA hos­pi­tals in­ten­tion­ally fal­si­fied records to make it ap­pear pa­tients were be­ing seen promptly when, in fact, they were placed on long wait­ing lists. Some vet­er­ans in Phoenix died wait­ing to see a doc­tor.

Find­ings from en­su­ing in­ves­ti­ga­tions caused the cre­ation of the Choice pro­gram, which of­fers vet­er­ans fed­er­ally paid med­i­cal care out­side the VA when wait­ing times ex­ceed 30 days or the drive to a VA med­i­cal fa­cil­ity is more than 40 miles.

Congress on Mon­day ap­proved a $2 bil­lion fund­ing shift to cover Choice ex­penses de­spite ob­jec­tions it took money away from other VA pro­grams.

Through May and since its in­cep­tion in 2014, the VA has is­sued more than 108,000 Choice pro­gram au­tho­riza­tions to more than 49,000 vet­er­ans in Col­orado, a VA spokesman said.

Man­gione said she knows it’s a chal­lenge to im­prove, but she won’t give up.

“Am I wor­ried about im­prov­ing?” she asked be­fore tak­ing a long pause to re­spond. “Other than ev­ery morn­ing re­al­iz­ing there’s a vet­eran be­hind ev­ery one of those num­bers, I’m ab­so­lutely fo­cused on do­ing a bet­ter job.”

Daniel Bren­ner, Spe­cial to The Den­ver Post

Pa­tients wait for their ap­point­ments Thurs­day at the Den­ver VA Med­i­cal Cen­ter.

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