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    Saturday, March 23, 2019-8:57:56P.M.






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Bureaucracy, physician shortage cause delays in medical care for Pacific island veterans

HAGÅTÑA — It takes between 37 and 75 days for veterans in the Pacific islands to receive medical attention and mental health care from defense facilities, the Government Accounting Office said, confirming the veterans’ perennial complaints about delayed services.

“These delays were similar to some GAO had identified in previous work pertaining to veterans’ access to care nationwide,” GAO stated in a report released Friday.

These services are provided by the Department of Veterans Affairs Pacific Islands Health Care System or VAPIHCS to approximately 50,000 veterans who live Hawaii, American Samoa, Guam and the Northern Mariana Islands.

These services are provided by the Department of Veterans Affairs Pacific Islands Health Care System to approximately 50,000 veterans who live Hawaii, American Samoa, Guam and the Northern Mariana Islands.

GAO found that some of the veterans experienced delays related to the processing of their enrollment applications, contacting them to schedule appointments and completing comprehensive mental health evaluations.

An analysis of sample group showed that veterans sent by VAPIHCS for specialty care referrals to Veterans Choice Program waited for an average 75 days.

Those who were referred Department of Defense treatment facilities waited from 37 to 47 days.

“GAO found VAPIHCS did not always manage referrals to the military treatment facility in a timely way and there was inconsistent guidance describing the roles and responsibilities of the VAPIHCS staff involved in the process,” GAO said.

The bureaucratic delays were compounded by an acute shortage in medical professionals.

“GAO also found that VAPIHCS faces challenges recruiting and retaining physicians,” GAO said.

VAPIHCS has 100 budgeted physician positions but as of October 2017, there were 17 vacancies.

“Some of the challenges VAPIHCS faced are unique to the Pacific Islands, such as the availability of only one local medical school from which to recruit, along with travel burdens and a high cost of living that may discourage physicians from relocating there,” GAO said.

“Other challenges were similar to those GAO has previously identified as faced by VA medical centers across the country, such as differences in interpretation of hiring and recruiting policies,” GAO said.

 VAPIHCS officials said they use several strategies to help recruit and retain physicians, including VHA strategies used by other VA medical centers such as financial incentives and an educational debt reduction program. Although they described limits to the success of some of these strategies, they have not evaluated their effectiveness, GAO said.

“Without completing an evaluation of its strategies, VAPIHCS may not be optimizing its resources to improve its hiring efforts and may continue to struggle with physician shortages,” GAO said.

Guam’s delegate to Congress Madeleine Bordallo said despite progress made on the health care for Pacific island veterans, the GAO report revealed that “more needs to be done” to improve Veterans Affairs services.

“Our veterans deserve better,” Bordallo said.

“It is unacceptable that some of our veterans have to wait an average of 75 days for care when utilizing the VA Choice Program, or 47 days when going to a DOD facility. This report is also helpful as I continue advocating in Congress for better care and services for veterans who sacrificed much for our island and nation.”

Sen. Frank B. Aguon Jr. said he understands that  Guam Community-Based Outpatient Clinic is not to blame for the inconsistencies found in the GAO report.

“We know that the Guam CBOC has more patients than medical professionals and their support staff are overworked,” said Aguon, a veteran and a candidate for governor. “We know that the VA and the VAVHA leadership could do more, but chooses to do nothing.  What we need now is for the Congresswoman to be firm with the VA and the VAVHA leadership; and press the issue of adequate, accessible, and timely care for all veterans on Guam and in the Pacific islands.”

In August 2015, the Guam Legislature adopted a resolution requesting the U.S. secretary of Veterans Affairs to conduct a system-wide audit of the scheduling and access management practices at the Guam Community Based Outpatient Clinic; and if necessary, provide recommendations to improve services to Guam’s Veterans. 

The Veterans Health Administration, within the Department of Veterans Affairs, operates one of the nation’s largest health care systems.

In fiscal year 2016, VHA provided care to about 6.9 million veterans and obligated about $65 billion for their care through 170 VA medical centers and 1,082 clinics nationwide.