- Associated Press - Thursday, April 9, 2015

LANSING, Mich. (AP) - The chronically long waits for care that have infuriated patients at Veterans Affairs hospitals and clinics in some parts of the country are a lot more rare in Michigan, and the handful of facilities that struggled with delays over the summer have been successfully chipping away at the problem.

The AP examined waiting times at 940 VA hospitals and outpatient clinics nationwide from Sept. 1 to Feb. 28 to gauge whether things have improved since a scandal over delays prompted federal lawmakers to pass a law last summer providing an additional $16.3 billion to hire more doctors, open more clinics and expand a program that lets veterans receive private-sector care.

The review found that, nationally, the number of delays was not getting smaller. It also found deep geographic disparities in how long vets had to wait for treatment. Many delay-prone facilities are clustered in a handful of Southern states, while long waits were relatively rare in the Midwest.

At Michigan’s busiest VA hospital, the John D. Dingell VA Medical Center in Detroit, more than 99 percent of medical appointments were completed within the department’s timeliness standard, which calls for patients to be seen within 30 days.

Only three VA facilities in the state performed worse than the national average over the six month period examined by the AP, and there was at least a little improvement lately in all three.

At the VA hospital in Ann Arbor, an average of 3.4 percent of appointments took more than 30 days to complete between September and February, but that percentage was down to 2.4 percent in that last month. That’s better than the national average of 2.8 percent.

One contributing factor in Ann Arbor’s delays is that it offers many high-demand specialized services that most other facilities in the region do not, including neurosurgery and interventional cardiology, facility spokesman Derek Atkinson said.

The facility is trying to address demands for all kinds of care and boost the administrative support needed to keep such a large facility running smoothly, he said, adding that the facility has been approved to hire 120 new staff including “doctors, nurses, social workers, pharmacists, psychologists and the necessary administrative support.” Of 108 of those positions currently being recruited, one-third of those openings have been filled, Atkinson said.

The VA clinic in Grand Rapids had struggled with a higher-than-average number of delays, but the facility closed late last year and was replaced by a new clinic 10 miles away in Wyoming, Michigan. By February, only 1.7 percent of appointments were failing to be completed within 30 days.

The VA’s small Marquette clinic, which is part of the Iron Mountain patient service area, had a relatively high rate of delays - 3.6 percent - but its rate improved in every month except one during the six-month period.

Brad Nelson, a spokesman for the Oscar G. Johnson VA Medical Center in Iron Mountain, said it’s hard to recruit doctors in such rural areas, and January was the first full month that the Marquette clinic was fully staffed for the period analyzed. He also said the clinic has worked on lowering wait times by promoting telemedicine and a program allowing visits in certain cases to non-VA providers but paid for by the VA.

Telemedicine and other technology also helped facilities that already had low rates of delayed care, such as the Bad Axe Community Based Outpatient Clinic - it had just one appointment that took 31 days or longer to complete. The clinic, which opened in 2010, has capacity for another 245 veterans to enroll.

Sen. Debbie Stabenow has been an advocate for opening more VA facilities such as the Bad Axe clinic. Asked about the rates of delayed care at Michigan facilities, she said it’s encouraging to see Michigan doing better than other states, but the job is not done.

“I will continue to work with the State of Michigan, our veterans service organizations and the VA to address the many challenges we face in meeting the needs of our veterans,” she said.

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