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Veteran healthcare backlog fix fails

Posted at 6:39 PM, Nov 24, 2015
and last updated 2015-11-24 21:39:15-05

When the Veterans Affairs healthcare scandal made national headlines and Contact 13 exposed long wait times and backlogged care here at home, Congress and the VA came up with a fix--allow veterans to go outside the VA to get care in their communities.

Sounds good but we found the fix that was supposed to fast-track access to healthcare, is failing our veterans.

The Choice Program is based on a simple idea. When the VA can't provide an appointment in 30 days, or a vet lives too far from a clinic, they can choose to get care outside VA walls. But we've heard from many veterans who say the government they served is letting them down. 

"It should be here and now it's kind of here," explains Navy veteran Brett Mikijanis about the damage to his arm.  "And like I said, that's a flex."

Brett tore his bicep helping a friend move furniture. 

"It sounded like a piece of celery snapping."

In unbearable pain, Brett rushed to the VA emergency room. Doctors told him it was serious, and he should see an orthopedic specialist "STAT"  but the VA couldn't get him an appointment within 30 days.

"They released me with orders to call a number on my release, tell them that I need urgent care," says Brett.

Brett says that number was for the Choice Program. And that's where his woes began.

"They told me it takes 5 to 7 days for the VA computer to talk to the Choice Program computer."

A week later, Brett called Choice again.

"They told me they had got the referrals from the VA and that they had to send off to Washington. And that it would take another 5 to 7 days."

All the while, his arm is getting worse, and he's getting no care.
 
"When I was in the service and they said, 'Ok you need to go to Iraq.' We didn't get to tell them, 'Ok, I'll get back to you in 5 to 7 days.'"

More time passed with more problems when Choice told him information was missing and he had to answer all the same questions all over again. To make matters worse, as a tradesman working in hotel restoration, Brett makes a living with his hands. The clock on a proper recovery was ticking away. 

Brett says doctors told him, "the longer it goes the harder it will be to repair, if not impossible,"

"It's basically a run-around," says Tony Marshall a Service Officer at the VFW who helps veterans navigate the system. 

"You go to the VA and they send you to Choice," says Tony. "Choice sends you back to the VA. And it can go on for two or three months before you get any kind of an answer, if you get an answer at all."

Contact 13 learned it's not just the Choice Program that's problematic. There are at least seven options for veterans to get care outside the VA.  Each has its own set of rules, requirements and red tape. 

We took veterans' concerns to Southern Nevada VA Director Bill Caron.

"The multiple lanes for VA in the community occurred over time," says Caron. "And I think at some point you hit this tipping point and the confusion starts to create a lack of coordination."

Exactly what Brett ran into when he called Choice, yet again, after waiting nearly four weeks for help. 

"She was sorry. There was nothing she could do. She was still waiting for the referrals from the VA," says Brett.

"Tremendous undertaking," explains Caron. "Has it gone as swimmingly and as smoothly as we'd like? No. absolutely not."

And that's frustrating for Congresswoman Dina Titus who serves on the House Veterans Affairs Committee.

"It just shows you that there's so much confusion in the bureaucracy that prevents people from getting that care that they need."

We told Rep. Titus about the care Brett couldn't get.

"Not only is it not humane because now you've suffered longer, but it's not good economic sense either," says Titus. "Because its going to cost more now to deal with the problem than if they had addressed it initially."

Nearly eight weeks after his injury, Brett finally saw a specialist who had more bad news.  His bicep was not only torn, it was shredded. One of the worst cases the doctor has treated in his career.  While Brett faces months of recovery and an uncertain future, he has a message for leaders.
  
"I want them to start taking care of what they promised they would do."

The VA recently presented lawmakers with an action plan that includes consolidating all Care in the Community programs into a single system called the New Veterans Choice Program.

That will take Congressional approval, more money and who knows how much time before veterans see improvement.  We'll be keeping tabs on the progress.