At Hearing, Veterans Discuss Wait Times as Plan Advances

PASADENA — Georgia Hernandez says her father’s medical care at VA clinics in recent months had been mired by long wait times for appointments that left him with no other option than to seek care at a Houston hospital.

It was there that doctors discovered George Barraza, a Vietnam War veteran, had liver cancer and that he was suffering from hepatitis C and cirrhosis. After doctors ran several tests and sent Barraza and his daughter back to the VA, they were told to come back two months later, but Barraza died before his appointment.

“He served honorably in both the Army and the Air Force in Vietnam,” Hernandez said Thursday at a hearing of the state Senate’s Veteran Affairs and Military Installations Committee. “I just don’t think he was taken care of in the way he should have been.”

Hernandez was among several who testified before the committee at the Port of Houston in Pasadena. Committee members collected information from veterans and state officials who work with the veteran community as they prepare to task the Texas Veterans Commission with assisting veterans in obtaining medical services and filing complaints for long wait times.

Legislators have proposed that the veterans commission be directed to expand its “strike force team” — created in 2012 to reduce a backlog of disability claims — to set up a hotline for veterans looking for assistance in setting up medical appointments with the VA.

With the commission “uniquely positioned” to carry this idea out because of the strike force’s existing infrastructure, committee chairwoman state Sen. Leticia Van de Putte, D-San Antonio, said it’s likely the proposal would move forward.

The proposed strike force team expansion comes in response to a nationwide investigation of scheduling practices at VA medical facilities — including six medical centers, 20 outpatient clinics and 36 community-based outpatient clinics in Texas — following allegations by several whistleblowers that staffers at federal clinics were instructed to manipulate scheduling documents to falsely report shorter wait times for veterans seeking medical services.

In a recent audit, the VA determined that several clinics in Texas are among those with the longest average wait times in the country. The VA’s clinic in Harlingen topped the list for average wait times for new patients seeking specialty care at 145 days. Several other Texas clinics have been designated as needing “further review” of their scheduling practices.

Van de Putte, the Democratic nominee for lieutenant governor, said the state’s leadership is on the same page in terms of giving the commission the green light despite the cost to the state. Expanding the veterans commission’s duties would require authorization from Gov. Rick Perry, Lt. Gov. David Dewhurst and House Speaker Joe Straus.

Also Thursday, Perry announced that the state has reached agreements with health facilities to provide care for veterans who cannot get timely treatment from the U.S. Department of Veterans Affairs and has asked federal officials to approve the plan.

The veterans commission has been directed to provide a cost estimate for implementing the extended strike force. During the hearing, Thomas P. Palladino, executive director of the commission, said taking on this new role would take a toll on the operations of the existing strike force team — which is focused on disability claims — if the state did not appropriate additional funding to the agency.  

Van de Putte said the price tag is expected to be much lower than the $1.5 million utilized to create the strike force team in 2012 because it would likely only require six or seven additional staffers.

After getting the cost estimate from the veterans commission, state leaders are expected to authorize the proposal to extend the veterans commission’s duties in about a week. The veteran hotline is expected to be running within a month.

The extended duties for the commission would, at first, be financed through the commission’s existing budget in order to set personnel in place as soon as possible to begin assisting veterans. Lawmakers would then ask for an emergency appropriation for the commission to cover any costs that went beyond the commission’s existing budget.

Sen. José Rodríguez, D-El Paso, said the price for helping Texas’ veterans should not be seen as a burden to the state’s coffers.

“If we’re serious in helping our veterans … the state is going to have to bite the bullet,” Rodríguez said, adding that if the state could provide additional funding for border security, it should be able to send an appropriation to set up the strike force teams.

During the hearing, lawmakers also considered other ways in which the state could help veterans obtain medical services. But Texas is limited in what it can do at the VA’s clinics because it cannot provide additional medical professionals to ease the high patient-to-doctor ratio at the facilities.

Sen. Donna Campbell, R-New Braunfels, questioned whether state officials would support calling for block grants from the federal government to provide veterans with medical services locally through a fee-basis program.

“I think the whole system is broken. I don’t like it,” she said, adding that the VA should be “decentralized.”

But Jim Richman, director of claims representation and counseling for the veterans commission, said the VA system already has a fee-basis program in place that’s not effective because the funding allowed per veteran is insufficient. Also, he said, doctors are unwilling to participate because the VA only pays out 80 percent of what medical services may cost, with reimbursements taking nine to 12 months to be processed.

Richman said the excessive wait times at federal clinics are a “symptom of the disease.”

“The disease is the number of vets versus the number of doctors,” Richman said. “It’s gargantuan.”

This story was produced in partnership with Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.