- Associated Press - Thursday, April 9, 2015

BILLINGS, Mont. (AP) - Veterans seeking care at Montana’s largest VA hospital experience more long delays than the national average despite pledges by senior officials to cut down on wait times.

One in 20 patients at the Fort Harrison VA hospital in Helena must wait a month or longer to receive care - nearly twice the national rate. Long waits have continued despite pledges by senior officials to cut down on delays and a huge infusion of cash from Congress to help tackle the nationwide problem.

The Associated Press examined waiting times at 940 VA hospitals and outpatient clinics across the U.S. to see how things have changed since a scandal over delays led to the resignation of VA Secretary Eric Shinseki and prompted lawmakers in August to pass the Veterans Access, Choice and Accountability Act.

Figures for Montana show the overwhelming majority of veterans received care at the state’s VA clinics within the monthlong timeframe agency officials set as their goal.

Yet, the data suggest there has been little progress - and even some steps backward - at Fort Harrison, the state’s largest VA facility. With 48 acute care beds and a wide range of specialty care not available at clinics in other cities, Fort Harrison is depended on by veterans across the state.

Montana has one of the highest per capita populations of veterans in the country - roughly 100,000 people, or about 10 percent of the state’s residents. Its predominantly rural makeup presents an added challenge: Many veterans travel hundreds of miles to reach the nearest VA clinic or the hospital at Fort Harrison.

Since the beginning of September through February, more than 2,200 patient appointments at Fort Harrison have been delayed at least 31 days. Care was delayed for at least two months in 536 of those cases, and for three months or more in 275 cases.

Almost 47,000 appointments were completed at the hospital during the period.

The trend for delays of at least a month stayed relatively flat, hovering around 5 percent of all appointments. But the number of longer delays over the period almost doubled, from 34 waits of three months or more in September, to 63 in February, the most recent month available.

Nationwide, an average of 2.8 percent of appointments during the period were delayed for a month or more.

Roger Hancock, Montana American Legion commander, told VA Secretary Robert McDonald during a March 30 visit to Helena that veterans, particularly those with mental health issues, cannot wait for treatment.

“We had a mom bring her son to Fort Harrison here, and he was threatening suicide and was given a 30-60 day appointment out,” Hancock said. “We need to get these people in, and we need to lead them to acute care, whether Fort Harrison has capability or not, we need to send him somewhere immediately.”

McDonald said the Montana VA was working to contract with more psychiatrists and recruiting and hiring more doctors who specialize in mental health as well as primary care doctors, particularly in rural areas of the state.

In response to concerns about long waits for care, the VA began releasing statistics in May on the timeliness of medical appointments at about 1,000 facilities. In August, Congress gave the VA an additional $16.3 billion to attack the problem by hiring more doctors, opening new clinics and expanding a program to make it easier for vets to get private care.

So far in Montana, few patients have opted for private doctors, according to Montana VA spokesman Randy Martin. He said less than 1 percent of eligible appointments have been outside the VA system through the so-called Choice program.

“What’s most important is that our patients receive our care within a clinically appropriate time. And the numbers show over those … months, they didn’t change dramatically,” Martin said. “It takes a while for the trend line to go in a positive direction, but the options that are available to our patients, our veterans, have increased over that same period of time.”

The VA spent almost $650 million and treated 35,200 unique patients in Montana 2013, the most recent year for which figures were available.

It is difficult to quantify exactly how things have changed since Shinseki’s May resignation because the VA introduced a new method for measuring wait times at the end of the summer.

VA officials say their using a new methodology is more accurate, but its adoption also meant that around half of all patient appointments previously considered delayed are now being classified as meeting VA timeliness standards. As a result, recently published wait times can’t be compared with data the VA released last spring.

___

Baumann reported from Helena. AP writer David B. Caruso contributed to this report.

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