Monday, July 04, 2005

Report on V.A. Healthcare Crisis

Report on V.A. Health Care Crisis for Veterans
By: Col Dan

This report provides a snapshot of what is happening across the nation. It indicates how the VA budget shortfall is hurting veterans care and shows why we need more than the $975 million; besides for ease of passing a quick emergency supplemental we should match the Senate. Ranking Democrat on the House Veterans Affairs Committee, Congressman Lane Evans (D-IL), and his staff conducted this research.

Snapshot of How VA Budget Shortfall is Hurting Veterans' Access to Safe and Timely Care across the Nation.

The VA claims that by shifting funds dedicated to replace old equipment and conduct maintenance the department can address its budget shortfall and meet veterans' demand for timely, high-quality health care. The following snapshots from across the nation reflect the stark reality of the budget shortfall on veterans' access to safe, high quality care.

*The 3 surgical operating rooms at the White River Junction VAMC in Vermont had to be closed on June 27 because the heating, ventilation, and air conditioning system was broken and had not been repaired due to the siphoning of maintenance funds to cover the budget shortfall.

*The VAMC in San Antonio could not provide a paraplegic veteran with a special machine to help clean a chronic wound because the facility did not have the equipment dollars.

*The VAMC in Lebanon, Pennsylvania, closed its Geriatric Evaluation and Management Unit which does extensive case management to help elderly veterans increase their functioning and remain at home.

*The Community Based Outpatient Clinics (CBOCs) needed to meet veterans' increased demand for care in the North Florida/South Georgia VA Healthcare System have been delayed due to fiscal constraints. The Gainesville facility has made progress in reducing its wait lists, but as of April there were nearly 700 service-connected veterans waiting for more than 30 days for an appointment.

*VA Medical Centers in VISN 16, which includes Arkansas, Oklahoma, Mississippi and Louisiana and part of Texas, have stopped scheduling appointments for many veterans who are eligible for care, pending available resources.

*Even though the VA Palo Alto, California, Health Care System has used $3 million in capital funds for operating needs, as of March 1 more than 1,000 new patients had to wait more than 30 days for a primary care appointment. A third of these new patients had to wait more than 3 months. More than 5,000 patients had to wait more than 30 days for a specialty care appointment. Roughly 1,400 had to wait more than 3 months.

*The replacement of the fire alarm system at the Loma Linda VAMC in California won't be done this year because the facility is using most of its capital funds to cover operating expenses.

*The White River Junction VAMC in Vermont struggling with a$525,000 shortfall in its prosthetics budget.Because the FY 2005 budget is inadequate, the facility has not been allowed to hire 3 additional mental health care staff and 3 additional Registered Nurses for the ICU. Nurses in the ICU have been forced to work double shifts, which this Committee has found to be an unsafe patient practice.

*Even though the San Diego VAMC expects to exceed its goal in medical care cost collections, it will divert $3.5 million of non-recurring maintenance funds to partially cover operating expenses, and has delayed filling 131 vacant positions for 3 months. The facility has a waiting list for patients of 750 veterans.

*Because the Iowa City VAMC had to shift maintenance funds and equipment funds to cover a FY 2004 million shortfall of $3.2 million in medical care expenses in FY 2004, the facility is facing severe infrastructure problems and a larger shortfall of $6.8 million in FY 2005 that puts patient care and safety at risk. The facility wanted to spend $950,000 in non-recurring maintenance funds last year to prevent a mechanical failure of the electrical switcher, which would close the facility, but was required to use those funds to cover a budget shortfall in medical care last year. As a result in FY 2005, the VA must divert $1.5 million of medical care funds to maintain the key electrical switchgear forthe hospital.

Recently, a motor failed on a hospital bed, which the VA planned to replace but couldn't because of the shortfall, causing a fire with the patient on the bed. Fortunately the patient was able to get out of the bed safely, but the facility was forced to expend $700,000 of medical care dollars to replace all the beds, which thanks to the diligence of VA staff lasted 7 years beyond their life expectancy. The facility could not use capital funds to replace the very old beds because the money had already been siphoned off to cover medical care.

To bring the shortfall down to $6.2 million the facility has delayed hiring staff for 4 months. The deliberate short staffing of nurses on the psychiatric ward - as a means to correct the budget shortfall -- has forced the VA to cut the beds available for treatment in half.

*As a result of cost cutting measures to make up for the shortfall in FY 2005, the Portland, Oregon, VAMC is delaying all non-emergent surgery by at least six months. For example, veterans in need of knee replacement surgery won't be treated because of the budget shortfall.

Since FY 2002, the Portland VAMC has had to use its equipment and non-recurring maintenance funds to cover medical care expenses. For FY 2005 the facility needed $13 million for medical and clinical equipment but only received $2 million.

The facility is reducing staff as a cost-cutting measure and is now short at least 150 hospital staff, including nurses, physicians, and social workers. As a result of budget cuts for staffing, the VA has cut the number of medical beds available to care for veterans.Veterans in need of outpatient psychiatric treatment at the Portland facility are on a waiting list because of the budget shortfall.

*The Biloxi, Mississippi, VAMC has diverted maintenance dollars to meet operating expenses for the past two years but the facility will not be able to balance its budget without reducing staffing levels at a time when the Gulf Coast Veterans Health Care System has approximately 100 new veterans seeking enrollment each week.

*Fifty percent of all the veterans receiving home health care through the San Antonio VAMC will now have to fend for themselves. This cost-cutting measure means that some 250 veterans, including those with spinal cord injuries, will no longer be provided this care.

*The VA Connecticut Healthcare System is facing a major budgetary challenge of sending veterans to non-VA facilities for hospitalizations because the VA has a shortage of beds to care for veterans and staff.

*Due to the budget shortfall, the VA facility in Bay Pines, Florida, has been forced to put veterans who have a service-connected illness or disability rating of less than 50% on a waiting list for primary care appointments. As of late April, some 7,000 veterans will be waiting longer than 30 days for a primary care appointment.


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