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SUNDAY FOCUS: VETERANS ACCESS TO HEALTH CARE Making progress A year after VA facilities came under fire for delayed health care for veterans, SORCC wait times are improving By Tony Boom for the Mail Tribune MailTribune.com By Tony Boom for the Mail Tribune Posted Aug. 9, 2015 @ 12:01 am By Tony Boom for the Mail Tribune Posted Aug. 9, 2015 @ 12:01 am --> BY THE NUMBERS Wait times for veterans' medical appointments at the Southern Oregon Rehabilitation Center and Clinics in White City have improved over the last few months. Com... » Read more X BY THE NUMBERS Wait times for veterans' medical appointments at the Southern Oregon Rehabilitation Center and Clinics in White City have improved over the last few months. Completed appointments at SORCC in June 2015: Total appointments: 12,039 Appointments completed in 30 days or less: 11,733 (97.46%) Appointments completed in over 30 days: 306 (2.54%) Avg. wait for primary care appt.: 2.24 days Avg. wait for specialty care appt.: 4.60 days Avg. wait for mental health appt.: 1.01 days   Completed appointments at SORCC in May 2015: Total appointments: 10,049  Appointments completed in 30 days or less: 9,833 (97.85%)  Appointments completed in over 30 days: 216 (2.15%) Avg. wait for primary care appt.: 2.08 days Avg. wait for specialty care appt.: 5.06 days Avg. wait for mental health appt.: 0.94 days   Completed appointments in April 2015: Total appointments: 12,156 Appointments completed in 30 days or less: 11,917 (98.03%) Appointments completed in over 30 days: 239 (1.97%) Avg. wait for primary care appt.: 2.05 days Avg. wait for specialty care appt.: 6.02 days Avg. wait for mental health appt.: 1.96 days   Completed appointments at SORCC in March 2015: Total appointments: 11,910   Appointments completed in 30 days or less: 11,574 (97.18%) Appointments completed in over 30 days: 336 (2.82%) Avg. wait for primary care appt.: 3.01 days Avg. wait for specialty care appt.: 7.74 days Avg. wait for mental health appt.: 5.39 days   Completed appointments at SORCC in February 2015: Total appointments: 9,465 Appointments completed in 30 days or less: 9,249 (97.72%) Appointments completed in over 30 days: 216 (2.28%) Avg. wait for primary care appt.: 2.28 days Avg. wait for specialty care appt.: 6.34 days Avg. wait for mental health appt.: 2.82 days   Completed appointments at SORCC in January 2015:  Total appointments: 9,914  Appointments completed in 30 days or less: 9,640 (97.24%)   Appointments completed in over 30 days: 274 (2.76%) Avg. wait for primary care appt.: 2.61 days Avg. wait for specialty care appt.: 6.19 days Avg. wait for mental health appt.: 3.66 days » Social News p bs:newslist StartDate="20121121" EndDate="p bs:datecalc Months="3"" DateSort="1" UseObjects="1" ObjectClass="81" Taxonomywords="2325,665" ExactTaxonomyMatch="1" Image="1" Count="4" --> Statistics show wait times for medical appointments at the U.S. Department of Veterans Affairs' facility in White City have improved slightly in the year since Congress intervened in a nationwide scandal over delayed health care for veterans. Patients say they are pleased with the additional staff and improved scheduling at Southern Oregon Rehabilitation Center and Clinics, says the leader of a county veterans group. “They have made significant improvement out there," says Bob Huff, who chairs the Jackson County Veterans Allied Council. “Things have changed within the last year. I’ve seen a lot of satisfied people over the course of the last six to eight months, absolutely.” An April 2014 nationwide audit of scheduling practices and management at VA facilities was ordered by VA Secretary Eric Shinseki  after problems surfaced in Phoenix, Ariz., and elsewhere of off-the-books scheduling and mismanagement of resources. Shinseki subsequently resigned, and  Congress passed the Veteran’s Access, Choice and Accountability Act in August 2014, which has resulted in additional staffing to reduce wait times and improve performance. At SORCC, no evidence of off-the-books practices was found, but a VA official said the scheduling system was confusing and more training was needed. A Vietnam Army veteran, Huff is both an outpatient and a volunteer at the facility. He says he’s never had a problem, but the fact that SORCC is not a hospital can make it frustrating for others who need specialized services. Scheduling at the facility is now in good shape, he says. Korean War veteran Herbert Robb, 86, of Phoenix, who broke his hip and suffers from osteoporosis, says his experience with scheduling over the last year has been better than previous times. “A couple years ago you’d call and be put on hold 20 or 30 minutes. Now they will say ‘sir’ and then ask what you want,” says Robb. “The attitude has improved, but the need is still there for more medical and technical people. I’ve been treated very favorably." During June, SORCC completed 12,039 appointments in White City, 11,733 (97.46 percent) of which occurred within 30 days of the veteran’s requested date — a 0.46 percent improvement over the spring 2014 audit.  Getting veterans needed appointments with specialists has improved within the last six months, though VA officials acknowledge more can be done. In January, veterans waited an average 6.19 days to see a specialist, compared with 4.6 days in June. “Presently, there can be long waits in the Medford community," SORCC says in a prepared statement. "An example would be dermatology, where new patients can wait 9-12 months to be seen. It is what occurs in rural communities everywhere." Extra funding and more hours have helped the facility make appointments for primary care in a more timely manner. Average wait time to see a primary care worker in June was 2.41 days, compared to 2.61 days in January. “We were mandated to add hours by the VA,” says Monica Mortimer-Lamb, facility business manager. “Most of our providers now work 10-hour days so we can accommodate those additional hours.” Appointments available as early as 7:30 a.m. weekdays have been popular under the new schedule, which also includes Saturday morning sessions, says Mortimer-Lamb. About 50 staff have been added to the VA's clinics in Southern Oregon, which include locations in Klamath Falls and Grants Pass. Most were in administration and none were primary care providers, says Mortimer-Lamb. Staff at the three clinics now total about 670. SORCC can pull in contract employees for certain areas of care when demand requires it, says Interim Director Barbara Oemcke. If the high demand continues, full-time employees could be added in impacted areas. Access to the appointment scheduling system has been limited to those employees who use it regularly, says Oemcke, to cut down on possible problems. Primary care providers, for instance, previously had access, but administrative staff members are more likely to be aware of resources available to help with scheduling, she says. Several other initiatives have been integrated at SORCC to help improve veterans' access to health care. Choice Program The nationwide Choice Program, signed into law in August 2014, allows veterans who cannot schedule an appointment at a VA facility within 30 days or who live more than 40 miles from a VA facility to seek care from other providers. Since the program was started at SORCC in November 2014, 2,933 appointments have been sent to other providers. "Choice was a huge new program. We have ongoing training for all staff related to that so everyone understands how the program works and so that veterans can access it,” says Mortimer-Lamb. Lead scheduler Ken Ishmael, a Choice coordinator, and an assistant help veterans who opt for Choice, Ishmael says. An outside provider, TriWest Healthcare Alliance, handles actual scheduling when veterans opt for Choice. Even with Choice, timely scheduling to see specialists may be difficult, as private-sector providers are in high demand in some areas, Ishmael says. “We have had feedback that we are compliant,” says Mortimer-Lamb of audits that have been conducted to determine how well Choice is working. Veterans tracking A program developed at SORCC to coordinate care when veterans are referred to other VA facilities or the private sector has been in place since late April. SORCC developed the program after learning of similar efforts in Walla Walla, Wash. “It had a lot of moving parts. It took a fair amount of time to put it together, writing the guidelines,” says Mortimer-Lamb. A team of three registered nurses, two nurse practitioners and four clerical staff support veterans as they move across health care systems. A three-month review is now underway to see where improvements might be made. Even though the program has not been in place long, veteran-reported issues related to coordination of care have decreased 49 percent in fiscal year 2014-2015 so far, when compared with 2013-14. The VA’s fiscal year runs from Oct. 1 to Sept. 30. Scheduling and training  More training has been given on existing software, some of which has been updated. A new, nationwide scheduling system, the first in 30 years, is under development. Ishmael will be glad to see the new scheduling program. He says the current screen has a DOS-like face. He anticipates the new program will have Windows-based software and will be much more like those used in primary care and specialist offices or medical facilities. “Right now it’s pretty cumbersome to use what we have,” says Ishmael. “It will be nice to get software that is easier to use and more friendly.” Schedulers and people in other areas also have received additional training, including updates to the current scheduling program. “We have a great deal of mandatory training that is required for all our staff,” says Mortimer-Lamb. “Every time a new program is rolled out, it comes with lots of training for staff.” Personnel who may not be performing as expected also receive attention. “We give them extra training if they are not up to par. That usually resolves the problem,” says spokeswoman Rhonda Haney. “We haven’t had to assign anything else. Everyone has been coming up to par and doing really well.” Kiosks Electronic kiosks have been installed at SORCC so veterans can check in, file travel claims, change their address and perform other tasks without having to wait in line for a staff member. SORCC drew nationwide attention last year when it was reported that 50 percent of schedulers felt they were told to falsify appointment data. The report was based on audit interviews done with just two schedulers rather than the nine called for under VA guidelines. No follow-up employee audit has been conducted, Haney says. All the scrutiny focused on VA facilities throughout the country means strides are being made in improving access to health care for veterans, officials say.  “When there is a lot of attention in the media, employees are concerned,” says Oemcke. “Out of that concern we want to make sure we are providing the best in care to veterans.” Tony Boom is a freelance writer living in Ashland. Reach him at [email protected]. By Tony Boom for the Mail Tribune MailTribune.com By Tony Boom for the Mail Tribune Posted Aug. 9, 2015 @ 12:01 am » Comment or view comments /* $( document ).ready(function() { // Jquery mobile is trying to style the button and leaving a blank gry button on top of a white button $("#viafouracoms .vf-comment-controls li.vf-right").html(' Submit '); });*/ » STAY INFORMED Email NewsLetter Sign Up Today Sign up for our newsletter and have the top headlines from your community delivered right to your inbox. calendar Connect with MailTribune.com Facebook Twitter RSS Back to top Reader Services Reader Services Home Subscriptions Subscriber controls Contact us Submissions Photos Events Letters to the editor Corrections Announcements Obituaries Story ideas Since you asked Alerts Email Alerts RSS Feeds Text Alerts Advertise Media Kit Home Products and services Ad rates Advertising contacts Propel Marketing Mail Tribune Daily Tidings The Nickel Shop Our Valley Blogs Mobile Site Stay Informed Email newsletter Sign Up Today Sign up for our newsletter and have the top headlines from your community delivered right to your inbox. 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