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Report says average wait time at NH VA facilities is more than three weeks

New Hampshire Union Leader

June 09. 2014 9:40PM

A New Hampshire veteran with a mental illness faces an average wait time of 23 days or more for a first-time appointment at the three U.S. Veterans Affairs medical facilities that serve most New Hampshire veterans.

That data is contained in a much-anticipated audit (click here to view the full report) that outlines average wait times at 731 Veteran Affairs medical facilities across the country. The audit follows revelations that veterans have died while waiting for care at the VA hospital in Phoenix, Ariz.

Released Monday, the audit details some shenanigans — 13 percent of VA schedulers nationally were told by their boss to skew appointment dates in the system. Another 8 percent used a system other than the official VA system.

It also found some benchmarks were unrealistic.

“A 14-day wait-time performance target for new appointments was not only inconsistently deployed throughout the health care system, but was not attainable given growing demand for services and lack of planning for resource requirements,” according to audit findings.

New Hampshire veterans who seek VA medical care generally deal with one of three systems, based in either Manchester, Boston or White River Junction, Vt. Data showed the Manchester facility with shorter wait times, although it is the smallest of the three and the only one that does not include a full-service hospital.

At all three, either 99 or 98 percent of patients had their appointment scheduled within 30 days. Other specifics from the audit:

• The Manchester VA had the aforementioned average wait of nearly 23 days for a first-time mental health appointment, while waits extended out to an average of 39 days for a specialty clinic, or 20 days for a primary care appointment.

• The Boston VA Health Care System, which includes hospitals in Jamaica Plain, Roxbury and Brockton, Mass., had average waits of 26 days for an initial mental health appointment; 54 days for a specialty clinic and 60 days for primary care. The system said it saw 2,600 referrals from the Manchester VA last year.

• The White River Junction VA had average waits of 28 days for an initial mental health appointment; 53 days for a specialty clinic and 30 days for primary care. The clinic sees about 7,500 New Hampshire patients a year.

“The overall access data for us looks pretty good,” said Deborah Amdur, director of the White River VA.

She said the average wait times for mental health appointments don’t take into account a program, developed in White River, that embeds mental health providers in the VA walk-in, primary-care clinic. So a veteran going through a mental health crisis can get access immediately, she said.

She said scheduling specialty clinics can be a challenge. White River is hiring some specialists to reduce wait times. In other cases, it will pay the bill of a veteran who sees an outside specialist, Amdur said.

The audit flagged the Boston VA hospital in Brockton for further review, given what was found in the surveys of schedulers. Boston VA spokesman Pallas Wahl had no details on what the issue is, but said the Boston VA feels confident the process at the Brockton facility meets VA standards.

Wahl said the latest data show shorter wait periods at Boston.

The Manchester VA provided no comment on the data.

The VA said it is taking several steps to address the data. Veterans waiting longer than 30 days for an appointment will be given the option to continue waiting, reschedule if possible, or see a non-VA provider.

The VA said it will remove the 14-day performance goal and suspend all executive bonuses for this year.

The state’s two U.S. senators issued statements about the report.

U.S. Sen. Jeanne Shaheen, D-NH, credited the VA for canceling bonuses, which she called for, but she said more must be done, including regular audits.

U.S. Sen. Kelly Ayotte, R-NH, said no veteran should have to wait more than 90 days for an appointment, and veterans should have the choice to see a private provider if the wait is too long or travel too far.

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