- Associated Press - Thursday, April 9, 2015

HONOLULU (AP) - Delays for medical appointments at Veterans Affairs facilities are shorter than the national average across much of Hawaii, but that’s not true of outer islands.

At the Hilo VA Clinic on Hawaii’s Big Island, for example, 5.4 percent of appointments were delayed at least 31 days, compared to 2.8 percent nationwide.

The percentage of appointments delayed up to 60 days wasn’t much better, with 4.4 percent facing such waits, compared to 2 percent nationwide.

The situation reflects, in part, the challenges of providing health care in an island state and in rural areas, where it’s more difficult to recruit doctors.

“We’re adjusting and trying to keep it in line with the others,” said Wayne Pfeffer, director of VA Pacific Islands Health Care System. “They’re smaller clinics, so if you lose a doctor or nurse, you have to really work hard to fill that void.”

The Associated Press examined six months of appointment data at 940 VA hospitals and outpatient clinics across the U.S. to see how things might have improved since a scandal over delays and a cover-up led to the resignation of VA Secretary Eric Shinseki and prompted lawmakers in August to pass the Veterans Access, Choice and Accountability Act.

The statistics show that since the summer, the number of vets waiting more than 30 or 60 days for non-emergency care has largely stayed flat. The number of medical appointments that take longer than 90 days to complete has nearly doubled.

In Hawaii, fewer veterans are calling with complaints about medical wait times, said Ronald Han, director of Hawaii’s Office of Veteran Services. When wait times were spiking over the summer, Han’s office was fielding many more requests for help, he said.

“You can have the best metrics in the world, and if the veteran’s not happy, I’m going to go with what the veteran’s talking about,” Han said. “But I have no reason to doubt the numbers that are coming out, because of the number of calls coming in.”

The delays are related to a shortage of doctors, officials say. Hilo has three primary care physicians on staff, and if one is out sick for a few days or on annual leave, that prevents some appointments from being scheduled, said Craig Oswald, Pfeffer’s assistant.

Veterans say the amount of time they’re waiting for doctor appointments is improving, but many continue to have problems enrolling in the system to begin with.

Also, the validity of the data coming out of the VA Pacific Islands was recently thrown into question. The VA Office of Inspector General released a report in late March that revealed that a supervisor was manipulating data to make it seem like the staff was processing claims more quickly than they actually were.

Some of the electronic files that were altered were for claims in which veterans were changing the status of dependents, which could have resulted in delays for veterans accessing benefits, according to the report.

Cummins Kameeiamoku Mahoe III, a Vietnam Veteran who lives on Maui, faced such a delay. He got married in February 2012, and sent in paperwork to add his wife as his spouse within weeks of the wedding. But his change in marital status - which should have resulted in higher benefits payments - wasn’t acknowledged by the VA until March 2015, when he received a letter stating he would get retroactive payments dating back to the marriage, he said.

“In our case, not having that difference of money back in 2012, ‘13 and ‘14 was not a hardship for us, but I do know that there are veterans that every single penny is important,” Mahoe said.

Several veterans on the Big Island faced long delays getting approval for hearing aids.

“Our biggest problem is getting veterans benefits, not getting the care after it’s approved,” said Dave Carlson, commander of the American Legion for Kailua-Kona.

It took five years for Carlson’s benefits to begin, and he’s been working for nine years to help a World War II veteran get back into the system, he said.

“This guy is now 90 years old, and almost totally blind, and they can’t get him in the system,” Carlson said.

The regional VA is planning to spend $6.5 million to add 115 positions to its staff this year, and is currently in the process of bringing 59 people on board, Oswald said.

“Recruiting is always kind of a challenge in the Pacific,” Oswald said. “Whether it’s our cost of living, whether it’s our remote location, whether it’s the professional life that’s available in those communities, or whether it’s family concerns.”

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