Delays and inequitability still plague VA health care

Since 05-21-03

By Deborah Funk
Navy Times staff writer
26 May 2003 Issue

Department of Veterans Affairs officials have taken steps to improve how they manage health care, but too many veterans still wait too long for care and travel too far to get it, according to congressional investigators.

The General Accounting Office said VA remains challenged to ensure timely appointments and equitable access to care, including nursing home and long-term care, and to modernize its disability programs to process claims faster and more accurately, according to GAO testimony offered May 8 to the House Veterans Affairs Committee.

VA's goal is to process a basic compensation claim in 100 days. Despite progress in recent years, it still takes 220 to 250 days to process a claim, depending on its complexity, said Disabled American Veterans spokesman David Autrey.

Often, a veteran sees that a claim was incorrectly denied at the regional level, then appeals to a higher level. The appeals board agrees and returns the claim to be processed correctly at the regional office  where it returns to the pile of backlogged claims,  Autrey said.

On another issue, VA must provide nursing home care to veterans with service-connected disabilities rated 70 percent or higher or who need nursing home care because of a service-connected disability, the GAO said.

But other veterans may get such care only at VAâ's discretion. Policies and practices vary among VA networks, leading to inequitable access, the GAO said.

These veterans who need long-term nursing home care may have access to that care in some networks but not others,  the GAO said. This is significant because about two-thirds of VA's current nursing home users are recipients of discretionary nursing home care.

Veterans age 85 or older are most likely to need nursing care. They number about 640,000 now but are expected to swell to more than 1 million by 2012 and remain at that level for more than 10 years, the GAO said.

A separate GAO report to be released May 22 shows veterans are being placed on waiting lists at more than one-third of VA facilities.

Moreover, most facilities either lack or offer limited respite care, home-based primary care, geriatric evaluation and adult day health care, according a news release from Sen. Bob Graham, D-Fla., senior Demo-crat on the Senate Veterans Affairs Committee.

Most VA facilities don't offer the range of services Congress has mandated, he said.

The VA system must be more responsive to those who are using it, including the nearly 10 million veterans over age 65, Graham said in the release.

To be sure, by moving more to community-based care in recent years, VA officials have taken care closer to the veterans. But the May 8 GAO testimony found that excessive waiting times for outpatient health care continue, and many veterans travel great distances for care.
----------------------------------------
Submitted,
SCPO Don Harribine, USN(Ret)
NCPOA
NAVetsUSA