The U.S. Department of Veterans Affairs failed to meet its goal for thousands of Maryland VA medical providers to schedule appointments on time during the period between Aug. 1 and Feb. 28, according to data the government gave The Associated Press.
About 8,800 of more than 303,000 appointments completed during that period at VA clinics and hospitals in Maryland didn't meet the agency's goal of seeing patients within 30 days, the data show. The failure rate at Maryland facilities was 2.9 percent, or roughly 1 in 34 visits. That's slightly worse than the national rate of 2.8 percent, or 1 in 36.
Veterans' experiences can vary greatly depending on the VA facility in question and their knowledge of the system, according to Mike "Mad Dog" Sater, assistant adjutant with the Maryland chapter of Disabled American Veterans, who often assists Carroll County veterans in their efforts to get care through the VA Maryland Health Care System. He said that at the three Maryland VA facilities most used by Carroll veterans — Baltimore VA Medical Center, often called "Green Street" by veterans; Loch Raven VA Clinic; and Fort Detrick VA Clinic — timely appointments are rarely a problem for those qualified, at least when he is involved.
"I have been in the VA health care system for a long time, so for lack of a better word, I know how to work the ropes and how to make the phone calls," he said. "As far as it goes at the local VA here in Maryland, once you get into the system, it's usually a two-week wait."
According to the data however, veterans without Sater's experience in Carroll County and elsewhere in Maryland are having a harder time. Of the three facilities Sater mentioned, Loch Raven VA Clinic was ranked lowest, with a failure rate of 3.5 percent, or 708 out of 19,975 appointments delayed for at least 31 days. In the entire state, however, the facility with the longest wait times was an outpatient clinic in Glen Burnie, near Baltimore, with a failure rate of 8.1 percent and 789 of its 9,733 total appointments delayed at least 31 days between Sept. 1 and Feb. 28.
None of the Maryland facilities approach the failure rates of the most delayed VA facilities in the country, such as the Hopkinsville VA Clinic in Hopkinsville, Ky. — which had a rate of 19.6 percent — but the VA Maryland Health Care System is making efforts to reduce wait times. Spokesman R. David Edwards said the VA is aggressively adding staff throughout its Maryland system, which includes six outpatient clinics, hospitals in Baltimore and Perry Point, and the Loch Raven VA Community Living and Rehabilitation Center in Baltimore.
Since August, when Congress gave the VA an additional $16.3 billion to attack the problem, the Maryland system has hired 13 new primary care providers and is recruiting nine more, Edwards said in an email.
In another effort to curb delays nationwide, the Veterans Access, Choice and Accountability Act that gave the VA its extra funding also provided some veterans a Choice Card, an ID card that could allow them to seek private medical care outside the VA system. Those eligible had to have enrolled in the VA Health System prior to Aug. 1 or left the military during the past five years after having served in a combat zone, according to Edwards.
"That is only for veterans that cannot get an appointment within 30 days or live more than 40 miles from a VA facility," he said. "It's a great initiative. If we ever get backed up in a clinic and we get over 30 days, it gives us that flexibility to go into their local community."
According to the AP, 46,000 veterans nationwide made private-sector appointments through the program between Nov. 5 (when veterans began receiving the ID cards) and March 17, a small portion of the 4.7 million appointments the VA system sees each month.
One reason for the slow progress of the Choice program might be that eligible veterans are simply unaware that it exists. Former Army Spc. Julien Husselbaugh, of Taneytown, who left the service in 2011 and has been enrolled in the VA Maryland Health Care System since 2012, said he had neither heard of the Choice program nor received an ID.
"They don't reach out to people enough. How am I supposed to know about this if nobody has ever released that information?" he said. "I have been down to the [Baltimore VA Medical Center] multiple times since November. How hard would it have been for someone at the VA to tell me about that?"
In general, Husselbaugh said he found the expectation that veterans learn the ropes of the VA Health System on their own to be baffling.
"They give you a thick handbook, then they expect you to know everything. It's like a Bible almost," he said. "They should have a rep that sits you down; they should call it 'exit counseling,' telling you what you are entitled to: 'This is where you need to go; this is how to get your benefits.' "
In Carroll County at least, the county commissioners recognized the need for local guidance for veterans who did not know where to start when it comes to navigating the VA system. After the formal creation of the Carroll County Veterans Services Council in July, the county became the first in Maryland to hire its own Veterans Services Officers to help veterans sign up for benefits.
Even after these efforts, keeping veterans informed is a major difficulty, according to Carroll County Commissioner Doug Howard, R-District 5, who was instrumental in forming the Veterans Services Council.
"The hardest challenge has been communication, finding vets, letting them know what we do and then getting information back to them," Howard said. "The Veterans Services officers can provide a wide range of information, but the challenge is it's only when [veterans] are in front of them that they can learn about new things."
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Even with knowledge of the Choice program, Husselbaugh would not have qualified — all of his appointments for the treatment of scoliosis have been made within 30 days thus far, and Taneytown is within 40 miles of all the nearest facilities. Still, he said, the ability to be seen at a closer facility could be of great benefit to veterans in Carroll County, especially those who might be suffering from PTSD.
"Somebody that is in a depressed state, they are not going to want to drive two hours to get help. That's not going to happen. They will want to drive 10 to 15 minutes at the most," he said. "For Westminster, they should have a VA place where people can come in like the regular hospital and check in there."
The idea of bringing a new VA facility to Carroll County is not a new one, and both Howard and Sater have expressed support for the idea in the past. Right now, Howard said there is a slow-moving but ongoing dialogue between the VA and Carroll County concerning the possible use of the Access Carroll clinic in Westminster as such a facility.
"As you can imagine, it is a very complicated process," he said. "However, we have had the head of the [Baltimore VA Medical Center] facility come out and tour Access Carroll. They are taking this very seriously, and I don't like taking no for an answer when it comes to the veterans."