Working to reduce veterans' wait for primary care

By Megan R. Harrell
Star Staff

   The Mountain Home VA Health Center, Johnson City, is looking at ways to decrease the number of veterans waiting for primary health care. Director Carl Gerber spoke with area Veteran Service Officers yesterday to discuss possible solutions to the growing problem felt across the nation.
   Recent reforms in veterans' health care drastically increased the number of patients seeking care at VA medical centers. The veterans' benefits package put forth by the reform offers health care services to all honorably discharged veterans at a nominal cost.
   Gerber has highlighted the medical center's need for additional resources in order to begin reducing numbers on the waiting list. There are currently 2,700 veterans on the waiting list for primary health care. "Despite the fact that Congress has appropriated additional dollars, and it has put additional dollars in the VA budget, it is not enough money this year to account for the dramatic increases in pharmacy costs, health care, and the number of patients seeking care," Gerber said.
   The medical center was given a budget approximately 12 million dollars less than what costs were projected for the year, and has had to do its best to deal with the shortages. The medical center has already taken some steps to reduce the waiting list, and meet the budget shortfall through cost containment.
   The VA is looking at making constructional changes to its primary care clinics in order to better accommodate more primary care patients. The change could allow the center to care for an additional 2,000 patients.
   The center is working on other efficiencies such as a voice recognition device that allows doctors to dictate patients' charts. The software was purchased three years ago, and would increase the amount of time practitioners have to see patients. Gerber is also entertaining the idea of adding additional questions to the primary health care application, that will help in prioritizing veterans' needs.
   The patients with top priorities are those who are already in the VA hospital, those in the emergency room, and veterans who were in a primary care program in another region and move to the area. The triage of patients will help to make sure the center can continue to provide its primary mission of service to low income, service connected veterans.
   One of the main contributors to the backlog of veterans seeking primary health care is the lack of a separate pharmaceutical program at the medical center. The federal government does not allow the VA to serve as a pharmacy, and every veteran seeking prescription services has to do so through primary care enrollment.
   "The major reason veterans currently seek veterans' services is because they want to get their prescription medications. Unfortunately, the law does not allow us to act as a pharmacy, but it makes sense for us not to provide services to somebody who already has a doctor," Gerber said.
   Mountain Home Primary Care Director David Regan is trying to make the changes necessary to serve as many veterans as possible at the medical center. He has seen the program balloon under his leadership. "The trouble is that the rate of increase in health care dollars has not been able to keep up with the rate of increase in the number of patients seeking care," Regan said.
   Regan believes if Congress would allow the medical center to have a separate pharmacy provider, much of the backlog waiting for primary care would be eliminated. He stated that he would like to see Congress give the medical center more flexibility to spend money the way it deems necessary.
   Local lawmakers have voiced their concerns about the waiting list for veteran primary care. Sen. Rusty Crowe (R-Johnson City) spoke with Secretary of Veteran Affairs Anthony Principi to discuss the backlog of veterans seeking health care at the Mountain Home VA Medical Center. Sen. Rusty Crowe and Rep. Ralph Cole (R-Elizabethton) are both optimistic about Congress's willingness to deal with the problem.
   Principi has asked for more veteran relief in Washington, and has received some. There will be an additional 125 people hired across the nation to deal with the backlog of health care claims. The workers will be dispersed nationwide in the attempt to provide better care for veterans.
   According to Congressman Bill Jenkins' office, the 2002 federal budget set 51.8 billion dollars aside to deal with veteran affairs. The proposed budget for 2003 includes 56.8 billion dollars for veterans benefits and services. A portion of this federal funding will go toward reducing the backlog at VA centers.
   Crowe, chairman of the State Joint Select Committee on Veteran Affairs, noted that the backlog of veterans seeking primary care is not a new occurrence. "This has been a continuing problem over the years, but we do know now that the help is in the budget, and we are looking at a good situation for veterans," Crowe said.
   Rep. Cole believes the government is to blame for the waiting list and that Mountain Home Medical Center leadership is doing the best it can with the funding available. "All of the services provided by the government depend entirely on funding in the last few years. The VA Center has suffered from cutbacks in funding from Washington," Rep. Cole said. "It is one of the best VA centers in the country and we are fortunate to have it."