National legislation could beef up Cape Girardeau Veterans Affairs facility

In the wake of allegations of long wait times and secret waiting lists at Veterans Affairs hospitals, national legislation has been proposed that could help service members in the Cape Girardeau area.

If passed, the bill would authorize the VA to lease 26 new walk-in health facilities in 18 states and spend $500 million to hire more doctors and nurses. One of those proposed facilities could be in Cape Girardeau.

Sarah Feldman of U.S. Sen. Claire McCaskill's press office said the project is authorized in legislation recently introduced by U.S. Sen. Bernie Sanders, I-Vt., but has not yet passed. It was announced Thursday that Sanders and Sen. John McCain, R-Ariz., are teaming up on a joint VA bill, not yet introduced, that also will include the project.

In the VA's fiscal year 2015 budget request, the proposal includes leasing approximately 43,000 square feet, including 290 parking spaces, for a community-based outpatient clinic in Cape Girardeau to support the John J. Pershing VA Medical Center in Poplar Bluff, Missouri. This would replace the existing lease on the 8,000-square-foot facility at 3051 William St. that expires in 2016.

"The proposed lease would enhance existing VA outpatient services in the Cape Girardeau area by addressing wait time, utilization, space and parking gaps," the proposal description says. "The project will include an expansion of specialty care, rehabilitative services, primary care, mental health, ancillary services, women's health, home health services, and space for Veteran Services Officer(s), and Veterans Benefits Administration."

Sgt. Joseph Adams of Dexter, Missouri, poses for a photo while serving one of his three military deployments to Afghanistan and Iraq. (Submitted by Joseph Adams)

Specialty services in the proposed project are oncology, rehabilitation medicine, homeless services, mental health clinic, opioid substitution program, psychology, substance abuse clinic, primary care, radiology, general surgery, orthopedics and urology.

Right now, U.S. Sen. Roy Blunt said in a media conference Thursday, the VA's goal is to decrease wait times to 14 days for each patient. As failure to meet that goal continues, offering veterans more health-care options may be the answer.

Blunt said one proposal in the Senate would allow veterans who live 40 miles from a VA facility or have waited more than 14 days for an appointment to access any facility that is Medicare-qualified and will accept veterans at the Medicare rate. He said if people have alternatives, the VA might start meeting its 14-day goal.

On the front lines

U.S. Army Sgt. Joe Adams said if he made an appointment at the VA Medical Center in Poplar Bluff, it would probably be a month before he could see someone.

Adams, who served three tours in Iraq and Afghanistan and is a recent Southeast Missouri State University graduate, said the VA's quality of care has always been good and for veterans, it's basically free, but the wait times are "pretty crazy."

The time it takes to see a physician in the VA health-care system has come under fire, with allegations of secret waiting lists and veterans dying while waiting for care. It resulted in the recent resignation of Secretary of Veterans Affairs Eric Shinseki and much posturing by members of Congress.

A letter Blunt received last week from the VA Heartland Network said the Poplar Bluff VA facility has 14 patients who have waited more than three months for service, St. Louis has 26, Columbia has 19 and Kansas City has 12. The network has nine hospitals, one health care center and 51 community-based outpatient clinics in Missouri, Illinois, Kansas and Indiana.

In light of these and other wait times around the country, a nationwide audit of the VA was conducted and the results are expected to be released this week.

Adams said he's found VA's care to be quite good, but there have been times when he's been stuck between a rock and a hard place.

" ... And I knew I could go to the VA for it, but I'd have such a long wait," Adams said.

When he's been referred to the VA in St. Louis, for example, the VA would pay the mileage.

He said he's observed that the Poplar Bluff facility seemed geared more toward older veterans than younger ones and women. His girlfriend, who is also a soldier, said more services are available at her home facility in Columbus, Ohio, for women and those who have served in Iraq and Afghanistan.

At times, Adams said, he's had to use "alternate routes to get stuff done." After each deployment, he was allotted a certain number of days of Tricare, which provides civilian health benefits for military personnel, retirees and their dependents, including some members of the reserves.

When the former Dexter, Missouri, resident returned from Afghanistan in 2011, he was having sleep issues and waited about four months before the VA was able to get him into a sleep study.

"I've actually filed disability claims. I'm just waiting to hear back. That was two or three months ago," Adams said Thursday.

Retired U.S. Marine Master Sgt. David Larson of Jackson, who served from 1972 to 1993, said he's hasn't been to the VA hospital in Poplar Bluff, but has used the outpatient clinic in Cape Girardeau at least three times, mainly for physicals and blood tests. "And those three times, they've provided me with good service," Larson said.

"They tried to get me to go to the hospital in Poplar Bluff," Larson said, but he declined because he wasn't sure he wanted to travel that distance and "get stuck down there."

Additionally, he said, he's in a unique position because he's covered through TriWest insurance, which covers active and retired service members and their families. The VA still wants to see him once a year to "make sure I'm still around" and keep his records up to date.

Benefits from the VA include free immunizations and lab tests. If he had a blood test at a private facility, it would typically cost $250. Additionally, he went to a hospital a couple years ago, and, including an emergency room visit, tests and an overnight stay, the bill was about $25,000. However, "I wound up paying out of my pocket less than $2,500 out of that $25,000. The rest of it was picked up by TriWest," he said.

However, the consensus among veterans he's talked to, not just from this area, is the VA is "pretty bad when you have to fear the people who are charged with taking care of your medical needs more than you fear being on the battlefield."

"That is the feeling of a lot of veterans that I've talked to," Larson said.

Michael Spies, also of Jackson is retired from the Army and National Guard with 21 years of service. The medical corpsman said in an email Saturday that he has experienced no difficulties in arranging appointments or with the care at the Cape Girardeau clinic or Poplar Bluff hospital.

"I have found the staff at both facilities to be caring and very professional," Spies wrote. "The only real difficulties I had with the VA concerned my claim for service connection of the stage-three renal cancer I was stricken with as a result of service at Camp Lejeune, North Carolina, which was repeatedly denied and required appeals over the course of seven years until the President signed the 'Care for Camp Lejeune Veterans Act' [in 2012]."

"I also have some thyroid issues and did see a endocrinologist for a second opinion and there was no indication the treatment I was receiving from the VA was not appropriate. I am a medical corpsman and may have a bit more knowledge than the average patient and I have yet, at this time, to see any need to leave the VA system. An alternate treatment system might prove a good solution in larger areas where the patient base is larger than in the Southeast Missouri area, such as Sen. McCain's idea of issuing a treatment card to veterans to allow them to see private physicians," Spies wrote.

Official words

Angela Smith, public affairs officer/congressional liaison at the Poplar Bluff VA, said wait times depend on what services are available and how soon. Veterans also may have to be referred to other VA facilities for different types of care.

"The John J. Pershing VA Medical Center is working with VA Central Office as they continue a nationwide audit to ensure a full understanding of VA's scheduling policy and continued integrity in managing patient access to care," Smith said in an email to the Southeast Missourian. "We are also systematically reviewing capacity at the medical center and each of our community-based clinics in an effort to maximize our ability to provide veterans medical appointments when and in the manner they want them. If we find situations where we are not able to increase capacity, we are authorized to increase the use of care in the community through non-VA care. No veteran should have to wait for the quality health care they have earned and deserve. This is our top priority."

The Poplar Bluff facility serves 29 counties -- 24 in Missouri and five in Arkansas -- with clinics in Farmington, Cape Girardeau, Sikeston, West Plains and Salem (two days a month), Missouri, and Paragould and Pocahontas, Arkansas, two days a week.

It offers primary and specialty care, mental health, telehealth, acute care (hospital), long-term (nursing home) care, short-stay (rehab) care and urgent care services to approximately 20,000 veterans -- more than 500 every day, Smith said. But it does not offer surgery for things such as gall bladders.

Generally, in an emergency, Smith wrote, veterans should proceed to the nearest emergency room. It's also recommended that veterans contact their primary care team within 72 hours, if possible.

If additional services are needed, veterans are referred to another VA facility, such as St. Louis or Columbia, Missouri, or Marion, Illinois. Sometimes the facility obtains the needed services for veterans at a local non-VA facility. "We developed these relationships so that we can provide our veterans with a complete range of services to meet their health care needs," Smith wrote.

The Poplar Bluff and Marion VA Medical Center underwent an audit recently. Smith wrote that those results are expected to be revealed by the national office "very soon."

"We will follow the instruction that comes as a result of this nationwide review," she said.

Beth Lamb, public affairs specialist at the Marion VA Medical Center, said the review, conducted at her facility by VA employees who were not connected to the Marion hospital, came up with no significant findings.

The Marion VA covers most of Southern Illinois, parts of western Kentucky and southeastern Indiana. This includes 53 counties and about 43,000 veterans, Lamb said.

Patients can see a primary-care provider within 11 days. The wait at Marion VA for specialty care -- cardiology, neurology, podiatry and audiology, for example -- is 19 days on average, Lamb said. Evansville, Illinois, has the largest clinic outside the hospital and Paducah, Kentucky, even provides a podiatrist.

Lamb said veterans in emergency situations are advised to go to the nearest emergency room, or the Marion VA's emergency room.

The number of days a veteran waits can fluctuate depending on how many doctors "we have on board," she said. If a physician leaves, for whatever reason, it could change that access.

Déjà vu

This is not the first time VA problems have been revealed. Problems have arisen in the past at various hospitals around the country. Locally, after a 2010 Southeast Missourian investigative series on the family of Iraq veteran Lucky Sands, the newspaper ran several stories on veterans facing problems with everything from benefits to health care.

More than a year after Sands' death, Cynthia Herath, Sands' mother, received a letter from the VA telling her that after "careful and compassionate consideration, a decision has been reached on your claim."

After that, Sands' daughter, Ceylon, would receive $488 a month in Dependency and Indemnity Compensation, a death benefit for the loss of her mother, the Missourian reported in February 2011.

Charles Phillip Jestus, who sustained serious health problems from exposure to Agent Orange in Vietnam, died in December. In a March 2011 story, the Missourian reported Jestus accrued tens of thousands of dollars in medical bills, many of which the VA refused to cover. He acknowledged being treated outside the VA health care system, which can affect VA coverage. Jestus said his treatment involved emergency care, leaving him little choice.

In the article, Jestus contended the VA health system at times had complicated his medical condition with overcrowded facilities, uncaring health care providers and a "chain of command" system of paperwork that left him buried under a mountain of debt and mental stress.

Joseph Mohorc Sr., senior vice commander of the VFW in Chaffee, Missouri, and district quartermaster, helps veterans navigate through the maze of VA benefits. When contacted Friday, Mohorc was driving, so his son, Joseph Mohorc II, VFW Post commander and district junior commander, answered questions.

The elder Mohorc has served 32 years in the military, starting in the Army in Vietnam and in Iraq and Afghanistan as a member of the National Guard. Answering for his father, Mohorc II said new disability claims can take six months to a year to be completed, but if it's not for a new returning soldier, it could take "even longer than that."

Disability could cover hearing loss, post-traumatic stress disorder, injuries or anything that pertains to that injury, as long as it's related to military experience.

rcampbell@semissourian.com

388-3639

Pertinent address:

3051 William St., Cape Girardeau, Mo.

1500 N. Westwood Blvd., Poplar Bluff, Mo.