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MailTribune.com
  • Local veterans, clinic staffers struggle with staff shortages

    Frustrations rise for the both the veterans seeking disability assistance, and for the staff members charged with providing care
  • Erica Yohner really didn't want to mess with a disability claim.
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    • An audit of SORCC in White City, conducted May ...
      Total appointments: 10,452
      Scheduled within 30 days: 10,157
      Scheduled within 14 days: 9,993
      Took more than 30 days: 295

      Average wait times for established patients:
      To get primar...
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      An audit of SORCC in White City, conducted May 15 through June 3, showed:
      Total appointments: 10,452

      Scheduled within 30 days: 10,157

      Scheduled within 14 days: 9,993

      Took more than 30 days: 295

      Average wait times for established patients:

      To get primary care appointment: 2.78 days

      To get a specialty care appointment: 1.63 days

      To get a mental health appointment: 1.82 days

      Average wait times for new patients:

      To get primary care appointment: 48.10 days

      To get a specialty care appointment: 88.10 days

      To get a mental health appointment: 56.56 days
  • Erica Yohner really didn't want to mess with a disability claim.
    The 37-year-old Operation Iraqi Freedom veteran put off submitting a disability claim for more than two years after her 2007 discharge from the Army.
    By the time she was ready to take advantage of Department of Veterans Affairs benefits resulting from disabilities sustained during her tour of duty along the Iraqi border with Iran in 2005, she was dealing with migraine headaches.
    What should have been a fairly simple process at the VA's Southern Oregon Rehabilitation Center and Clinics in White City, however, turned into one of the many grueling tales that exploded into a national furor and led to the resignation of former Veterans Affairs Secretary Eric Shinseki last month.
    In a review of operations this spring released days after Shinseki's departure, the VA gave SORCC mixed reviews. It showed 97 percent of its patients were given appointments in 30 days or less. But it ranked the facility third-worst in the nation in waits new patients endured to see specialists (88 days), and seventh-worst nationally for new patients to get access to mental health services (561/2; days).
    Yohner, who has the highest priority for scheduling because she is considered 100 percent disabled, can identify with those whose waits lasted interminably.
    "I have had some positive experiences, but to be honest, I feel like most of my time out there is horror stories," Yohner said. "I've been receiving health care but never had a long-term primary care provider. In four years, I've had three primary care doctors. I'd go see them once, and then they'd leave, and I'd have to wait and get another."
    Her first primary care provider sent her to Roseburg for MRI work.
    "They were talking about sending me to Portland for speciality work and then my doctor in White City decided to quit," she said.
    A year passed before Yohner was assigned another primary care physician, who left three months later. Without a doctor, she had to wait.
    Yohner dealt with her debilitating migraine pain — two or three times a week — by sitting in a dark room for long periods.
    "I have four girls, and the two older ones were really helpful," said Yohner, whose daughters range in age from 5 to 18. "My mom helped out, too, so I was lucky to have a good support system."
    Earlier this month she tried to reach a doctor at SORCC, but couldn't get through.
    "My latest doctor had quit, and I couldn't get anyone to pick up," Yohner said. "You push the (phone) buttons at the primary clinic ... and hope they pick up."
    Delays throughout the massive VA system led to intense national scrutiny and promises for reforms.
    "It's going to change, it has to change," said SORCC spokesperson Anna Diehl. "Not simply because it's been mandated by the upper echelon because of the attention we've gotten. It has to change, not just to meet needs of current veterans, but all those veterans coming back from Afghanistan and Iraq."
    While SORCC's staff has grown in recent years, the additional help hasn't kept pace with the demand for its services. The thinly stretched staff make do, or, in some cases, move on.
    "The morale has definitely taken a hit," Diehl said. "It's demoralizing when you're in the trenches and know you're doing a good job with resources you're provided. A mentor of mine once told me, 'No matter what agency or corporation you're working for, there are never enough resources, you're always going to need more.' "
    Alice Thomsen knows a bit about demoralizing moments. She was in Beirut, Lebanon, during 1983 when a terrorist bomb killed 241 Marines sleeping in their barracks.
    Thomsen, an Army nurse from 1980 to 1989, moved to Medford from Milton-Freewater last September. She soon discovered things were different in White City than Walla Walla, Wash., home to the VA hospital closest to Milton-Freewater.
    "I figured I'd be able to walk in and pretty much go into any of the clinics, having had my record transferred," said Thomsen, who is considered 100-percent disabled with post-traumatic stress disorder. "Normally, when you transfer you can set up an appointment in 30 days; here it took an act of God."
    Before any appointments, she had to go through an obligatory orientation.
    "They said it would be 30 days, when I signed up the first of October," Thomsen said. "It took until the end of January."
    She has since accessed several clinics, but again she discovered a less-than-flattering difference.
    "They've got an attitude — because this is primarily an alcohol and drug rehabilitation center — and treat everybody as if they have an alcohol and drug problem. They want to take you off any medications that you might have been on previously with any narcotics in them."
    She was removed from her long-term medicine regimen that had been tested in trials for migraine patients.
    "Being a nurse, I pretty well know what medications to take, when I need to take them and what works for my migraines so I can still function; cleaning house, grocery shopping or go for a hike."
    Veterans who learn how the system works tend to find palatable results, said Rod Evans, executive director for Veterans in Recovery in Jackson County.
    Evans, a VA patient himself with 100 percent disability, has dealt with the White City facility since moving down from Portland in 1999. He's quick to point out that SORCC is not a hospital, but a stand-alone domiciliary with rehabilitation clinics.
    "I've had nothing but good experiences with the VA," Evans said. "But it's a whole other ball game when it comes to eligibility, enrollment and being seen for the first time."
    There is nothing new when it comes to challenges veterans or staff face, he said.
    "One of the things we've been trained as veterans is to hurry up and wait," Evans said. "That's been the model for a long time."
    Evans is among the 100 percent disabled due to feet, ankle and back injuries, as well as his participation in drug and alcohol recovery.
    "I was open to what the providers suggested," he said. "My primary care doctor suggested this or that for my treatment team. By following recommendations and suggestions — man, my life has been great."
    Broader societal and cultural elements encouraging entitlement come into play as well, he said.
    "That's the biggest problem I've found in working with veterans," he said. "It's the 'I want what I want and I want it right now' attitude. There's some selfishness and self-centeredness."
    But even for those veterans who've had a long-term relationship with the VA, things can go sideways.
    Ron Schutz is a retired Cal Trans highway supervisor who now lives in Grants Pass. He has had a series of disagreements with the VA, most recently over a 74-year-old SORCC doctor's evaluation that he said led to a reduction in his monthly disability payments.
    His injuries go back to his service days, 1962-65, when he was injured in an off-duty auto accident near Edwards Air Force Base. Schutz has received varying levels of disability payment for his injuries and was receiving $1,400 monthly before he was evaluated by the doctor at SORCC on behalf of the Veteran Benefits Administration at the end of 2012. The outcome of that evaluation led to a $197 monthly reduction in Schutz's benefit check.
    He has since filed a complaint with the VA. The outcome is pending.
    Despite the turmoil swirling at the department's highest levels and day-to-day difficulties on the ground, the VA continues to have staunch supporters.
    In a letter to the Mail Tribune written in late May, White City resident and Vietnam veteran Dennis Mower expressed support for the embattled institution.
    "It has been my experience in human nature that one can do excellent work or deeds, but one slip or mistake, (and) all other past work or deeds is wiped away," Mower wrote. "Forgiveness is given, but murmurs still will continue."
    The sheer number of veterans desiring medical service is staggering, he suggested.
    "These people are performing an impossible job on a daily basis," Mower wrote. "Because of our overwhelming numbers, we have to wait to be seen or to have our needs met. Of course we all complain about how long it takes for the VA to get to us. But come on, there are so many of us and so few of them."
    Naturally, pressing needs should be addressed first, he wrote. "But finger pointing is not a solution. These services are a gift (whether timely or not), and not a right."
    Even so, as the VA struggles with ongoing internal reports of deficiencies, veterans continue to look for help to cope with pain and injury from their service years.
    Yohner said she resorted to going through Congressman Greg Walden's office to expedite the multiple-year eligibility process.
    "The last time I saw a primary care provider, a year ago, the doctor was required to fill out a seven-page questionnaire before they could even see the patient," she said. "This is an important issue and no one is fixing it. My frustration level with this system is high and I feel helpless to fix it. There are so many promises being made, but no one is actually doing anything to fix the problem."
    Reach reporter Greg Stiles at 541-776-4463 or business@mailtribune.com. Follow him on Twitter @GregMTBusiness, friend him on Facebook and read his blog at www.mailtribune.com/Economic Edge.
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