Larry Scott (former E-5) served four-plus years in the U.S. Army with overseas tours as a Broadcast Journalist at AFKN HQ, Seoul, Korea and AFN Lajes Field, The Azores, Portugal and a stateside tour as a Broadcast Journalism Instructor at the Defense Information School (DINFOS). Larry was decorated four times including the Joint Service Commendation Medal with Oak Leaf Cluster. He was awarded DOD's First Place Thomas Jefferson Award for Excellence in Journalism. After the Army, Larry went back to radio news, working in Indianapolis as a News Anchor on WIFE Radio and then in New York City as a News Anchor on WNBC Radio. He receives VA compensation for a service-connected disability and uses the Portland, Oregon/Vancouver, Washington VA facilities for healthcare. Today, Larry resides in Southwest Washington and operates the veteran's help website YourVABenefits.org. To contact Larry Scott email larry@yourvabenefits.org.
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What is happening at the Portland VA hospital is not an aberration. It is happening at all VA hospitals in the country, to a greater or lesser extent. Budgets that have not kept up with the number of veterans seeking and qualified for health care are crippling the VA system from within.
Veterans wait longer and longer for appointments and needed surgeries. The wait at the pharmacy in many facilities is so long you can read an entire Tom Clancy novel. The overworked staff members feel the stress at almost the same level as the veterans.
More veterans are coming home from the Middle East in need of care. The latest wounded toll in Iraq is over 7,100 and more than 17,000 troops have been evacuated from Iraq and Afghanistan for medical care not directly associated with combat. What will they come home to?
Most VA hospitals handle these problems quietly. They “push out” appointments and surgeries while keeping the staff and funding crunch in mind. In Portland, the problem was not handled quietly. A simple letter brought to light this appalling situation.
Now what do we do? Veterans must get to those who control the purse strings. Our elected representatives hold those strings, and they’ve got them tied in a knot. Let your representatives know that this constant under-funding of the VA is not acceptable. Let them know you vote. A veteran’s call to his United States Senator’s office this week received the following response from a Senate staffer: “Delaying surgeries happens all the time. It’s just the way the VA works.” Really? Well, that doesn’t work for me! Vote your own best interests. Vote for those who support full and mandatory funding for VA health care benefits.
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October 8th, 2004
[Have an opinion on this article? Go to the Discussion
Forum to sound off.]
Opinion By Larry Scott
Last year the VA's CARES (Capital Asset Realignment for
Enhanced Services) Commission poked and prodded VA facilities around
the country. The 16-member traveling commission was tasked by VA
Secretary Anthony J. Principi to identify "the demand for VA care
and projecting into the future the appropriate function, size and
location of VA facilities." This simple statement by Principi in
his acceptance of the CARES Commission decision points out a flaw
that could affect VA planning for the next twenty years.
In simple form, the national CARES report recommended closing three
full-service VA hospitals, and building many local and regional
clinics. Please read the CARES report to find out how it will impact
services in your area, as it has a state-by-state breakout.
The problem with CARES
is easily seen in its name. It is concerned with "Capital Assets,"
and millions of dollars have been spent on a study deciding how
to spend billions of dollars on facilities. A careful reading of
the CARES report brings to light what could be seen as an overwhelming
interest in real estate rather than health care. While much thought
is given to construction and consolidation of VA facilities, you
won't find any mention in the CARES report on how to staff and fund
the necessary health care programs to be housed in current and new
facilities.
Could this be seen as the VA is looking for ways to consolidate
its facilities, while failing to seek more funding to hire the medical
personnel to staff those facilities? One veteran summarized the
mood of many when he told me, "CARES doesn't." An alternate name
has been proposed for CARES: Can Anyone Really Envision this Stuff.
The Portland, Oregon/Vancouver, Washington VA facility, where I
receive my care, is a case in point. In two previous pieces for
Military.com (Sep.
7, 2004 and Sep.
22, 2004) I detailed the enormous problems caused by under-funding
at the Portland VA. Now, the CARES report recommends changes that
will only exacerbate these problems.
From the Portland/Vancouver CARES report: "Our demand for
care has been significant the last few years. We have had some of
the largest waiting lists in the country, in spite of implementing
advanced clinic access, direct clinic access, evening and weekend
clinics. Up to 1200 new patients apply for care each month. The
number of unique patients we treat increased 17% this past year.
Eighty-eight percent of these were Priority 1-6 veterans. Every
new primary care patient generated 2.5 specialty care consults and
30% required a mental health referral." (emphasis mine)
The above statement is a very short list of the problems facing
the Portland VA. But look below at the solution proposed by the
CARES report.
From the Portland/Vancouver CARES report: "As part of our
CARES planning, we have proposed moving most of our Primary Care
operations off the Portland campus to satellite clinics in the metropolitan
area using the vacated space for expansion of specialty care. Oregon
Health & Science University (OHSU) leases two inpatient wards from
us with net revenue of $1,017,326 per year. We would reopen these
as acute hospital wards if we had adequate nursing staff." (emphasis
mine)
CARES proposes building more clinics (a total of four, at last count)
at a cost of millions of dollars. Where is the money to staff these
clinics? It doesn't exist. It's not in the budget. The Portland
VA can't even support the space it has now. Notice that the neighboring
OHSU hospital leases two inpatient wards from the VA. This is because
there is no money to staff these wards. So, instead of serving veterans
who desperately need health care, the Portland VA uses these empty
wards to generate income. Someone should get the "Shame On You Award"
for this decision.
This concept of "consolidation" might seem a good plan to some.
The idea is to save money and provide better healthcare services
to veterans. Unfortunately, these two concepts do not work hand-in-hand
in this instance. Here's a look at what "saving money" did to one
program at the Portland/Vancouver VA. One CARES report refers to
this specific case of "cost cutting" and concludes it is a success.
You decide.
Once upon a time, the Vancouver, Washington VA facility had a program
called CARS (Chemical Addiction Rehabilitation Section), which had
in- and out-patient services for veterans seeking help with alcohol
and drug problems. Many of those in the CARS program lived at the
Vancouver DOM (domiciliary). Also, many veterans took advantage
of the Vocational Rehabilitation program to get needed job skills.
Guess what? CARS has been dismantled and the DOM has been closed.
All this in the name of "consolidation," as put forth by the CARES
report.
Veterans in the Portland/Vancouver area who qualify for the DOM
program are now sent to the DOM at White City, Oregon, nearly 300
miles to the south. While they do receive needed help with medical
and/or addiction problems, the Vocational Rehab portion of their
care has run into problems. The White City/Medford area of Oregon
has a historically high rate of unemployment, running as much as
9.2% since the DOM consolidation. Basically, there are no jobs for
the veterans coming out of the DOM program. So, they come back to
Portland/Vancouver and start a job search, a project that could
have been handled concurrently with their care if the Vancouver
DOM had stayed open. This, at best, is an unnecessary hardship on
many veterans.
And, what of the personnel who so ably staffed the CARS program
for many years? They (the ones who didn't resign or retire) have
been moved to other positions in the Portland/Vancouver VA. Mostly,
they are pushing paper. They are not counseling veterans who need
an alcohol and/or drug abuse prevention program. Many of these counselors
hold multiple degrees and all are certified. Now, they fill out
forms and answer phones. Again, all in the name of consolidation.
The CARES report is final, and Secretary Principi has accepted it.
Consolidation of VA facilities is a given. Untold millions, or even
billions, will be spent to build local and regional clinics. But
no money has been allocated to staff these new facilities. And there
is no money to staff the newly available space created at existing
VA facilities that are not being closed. Even though I have outlined
the difficulties CARES implementation will cause at the Portland/Vancouver
VA facilities, the story is the same all over the country.
Fiscal Year 2005 is here. There is no budget. The VA will continue
to curtail spending. The hiring freeze at the Portland/Vancouver
VA, and others, will continue, perhaps into next spring. Secretary
Principi has requested a 5.8 percent increase in the VA
budget submissions for 2005. But most of that increase is NOT
for health care -- the requested health care increase is 1.9 percent.
This cannot even begin to pay for increased costs in supplies, fuel
and other tangibles. What this means is that FEWER real dollars
are being requested for healthcare in 2005.
A PLEA TO VA SECRETARY PRINCIPI: Sir, please reconsider your
priorities. Those who have served the United States of America deserve
adequate health care. The VA has suffered because of gross under-funding.
Ask for the necessary funds to provide the health care you are tasked
to provide. As a political appointee, I know you answer to your
political patron, the President of the United States. Perhaps a
little chat is in order. Just a reminder of all the promises to
"support our veterans"...
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