Carney says clinics, Choice card not working for vets

MILLSBORO – If the Veterans Affairs community-based outpatient clinics can’t be adequately staffed with medical professionals, and veterans have difficulty using a program designed to give them non-VA treatment options, Congress and VA should consider easing program rules and getting rid of the clinics altogether, Rep. John Carney said Monday.

“The reason for having the CBOCs (community-based outpatient clinics) was to bring care closer to the vets, so they didn’t have to travel all the way up to Elsmere,” Carney said, referring to the VA hospital in Wilmington, where more specialized treatments are available. If they’re not working, he said, “Should we think about doing away with them?”

The VA clinic in Georgetown has been particularly vexed with staffing shortages, leading to excessive wait times for treatment over the past year, as reported by VA. Several vets told The News Journal during a well-attended, Carney-sponsored benefits event for veterans at American Legion Post 28 in Millsboro that the clinic has only one full-time doctor, a primary care physician, to deal with thousands of patients, and recently lost its only psychiatrist.

They also complain, as have thousands of vets nationwide, that the Veterans Choice program introduced last year and trumpeted as a simple route to non-VA care for those facing long waits for care or who don’t live close to a health care facility, is useless for those who have specialized needs. The Choice card rules state that if a veteran lives within 40 miles’ driving distance of a facility – even a community-based outpatient clinic, or CBOC – they don’t qualify for Choice, even if that facility doesn’t offer the care they need.

“I’m concerned that [CBOC understaffing is] eliminating the possibility of our vets using the card, and yet not delivering the service that we had anticipated,” said Carney, a Democrat. “The alternative would be to do away with the 40-mile limit. If it’s not working, we ought to change it, and create some flexibility.”

Choice also needs to be expanded, vets and advocates said, because of the difficulty some Delaware veterans who are referred to Wilmington have in traveling there from downstate. Many are aging, can’t drive, have no one to drive them and have to rely on a free shuttle bus that VA runs from Georgetown to Wilmington four times a week. More limited service is provided by groups such as the nonprofit People’s Place in Milford. Either way, the ride is long.

“I see old people waiting there at Georgetown – World War II vets – and getting on that bus,” said Patrick Moonan of Millsboro, a disabled Army veteran who gets some medical care at the clinic. “This is the way a World War II veteran is treated? Spend eight hours to go to a doctor’s appointment? Something’s wrong.”

“The fact that these people are here today to ask for help is a disgrace, and it’s shameful to this country,” said Judy Mangini of Lewes, who wants to “give every veteran a card that they can use at any doctor’s office, any medical facility and any hospital. And it needs to be done.” Mangini’s husband Paul is a Navy veteran who served in the Vietnam War.

VA, while cash-strapped and under the gun to more expeditiously serve veterans more than a year after the scandal over excessive wait times for appointments erupted at the Phoenix VA hospital, isn’t likely to agree to eliminating CBOCs. Carney agreed that even if officials determined that closure made sense, a legislative solution would be challenging. But even in a highly partisan House, he said, “It is an area where I think Democrats and Republicans can work together.”

The VA, the nation’s largest integrated health care system, operates more than 1,700 hospitals and other facilities. More than 800 of these are CBOCs, such as the six operated by the Wilmington VA Medical Center.

In February, the Georgetown clinic had the nation’s 10th worst average for patients waiting more than 30 days for treatment out of 940 facilities nationwide – a figure that saw a dramatic improvement in May, according to VA’s figures.