Arkansas VA hospitals' leaders assess goals, struggles

Long wait times for services still an issue

Margie Scott, director of the Central Arkansas Veterans Healthcare System, speaks Friday at John L. McClellan Memorial Veterans Hospital in Little Rock.
Margie Scott, director of the Central Arkansas Veterans Healthcare System, speaks Friday at John L. McClellan Memorial Veterans Hospital in Little Rock.

Days after U.S. Veterans Affairs Secretary David Shulkin warned the nation of the "critical condition" of the federal agency, VA leaders in the state outlined their facilities' strides and shortcomings.

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Dr. Catina McClain talks Friday at McClellan Memorial Veterans Hospital in Little Rock about efforts to meet federal Veterans Affairs goals. Margie Scott, Central Arkansas Veterans Healthcare System director, is at left.

Central Arkansas Veterans Healthcare System Director Margie Scott spoke on Friday about the Little Rock facility's improvements, its struggles with medical staffing and its continued focus on stemming the state's rate of veteran suicides.

Scott's news conference, and a similar one in Fayetteville on Friday, are part of a nationwide effort to make the public aware of efforts to improve VA services. They follow a similar address by Shulkin on Wednesday, in which he said chronic problems across the U.S. include long waits for appointments with care providers.

"We want to be accountable. Our goal is to be the most trusted organization, and we know we have work to do, but we're here and we're committed to make that happen," Scott said.

One area of success officials in Little Rock cited was this year's decreased rate of veteran suicides. Four veterans have committed suicides so far this fiscal year, officials said, the lowest rate the agency has ever seen.

One tool recently employed by the agency for suicide prevention has been the Recovery Engagement and Coordination for Health, Veterans Enhanced Treatment program.

Rolled out six months ago, the Reach Vet program identifies veterans who may be facing the highest risk of suicide. Using dozens of screening parameters -- like past suicide attempts, being male, being over 65, being white, having a history of substance abuse and being single --the algorithm determines the top 0.1 percent of those facing the highest risk.

Using this data, health care providers can intervene early with services such as missed-appointment follow-ups and individualized care plans.

According to federal figures, 20 veterans take their lives daily across the nation, while only six of those 20 had sought VA services. According to Scott, those figures show that improvements are needed in expanding access to more veterans.

Just under 150,000 veterans live within the Central Arkansas Veterans Healthcare System's 47-county footprint, and 67,640, or 45 percent, are enrolled for VA care, according to the hospital's figures.

Officials want that number to be higher, they said, but they continue to face a barrier in their own public perception.

Last year, the VA Office of Inspector General released a report detailing how central Arkansas VA employees had previously altered patients' wait times to make it appear veterans weren't waiting as long to see doctors.

Similar problems were revealed nationwide after dozens of veterans died while awaiting treatment in Phoenix, resulting in the ouster of former VA Secretary Eric Shinseki.

"It has been a challenge to overcome the difficulties that [Central Arkansas Veterans Healthcare System] may have had with [regards to] access, or some of the other facilities may have had with regard to access in the past," system Chief of Staff Catina McClain said.

Improving that perception by ensuring each patient's needs are being met during each visit has become another area of focus, officials said.

"If you can't get in the door and be seen when you need to be seen, we have failed and we will be accountable for this," Scott said.

Wait times for new patients remain high in Little Rock, with a 24-day wait for primary care visits and 10 days for mental health services. But officials stressed that same-day service is available for urgent care needs for existing patients.

McClain said one difficulty in lowering wait times is the VA's continued struggle with employee retention in Little Rock's competitive medical field. The local competitors, she said, offer higher salaries, bonuses and benefits than the federal hospital can.

"The market competition creates for us a tremendous challenge. One of our biggest challenges is maintaining and recruiting nurses, surgeons, anesthesiologists ... the list can go on and on," she said. "And it's critical that we get the right person. We want someone dedicated to the profession who is interested in providing the best thing for our patients."

Elsewhere in Arkansas, wait times for primary care VA visits for new patients can be as high as 33 days in North Little Rock and 30 days in Hot Springs, officials said. For mental-health related visits, wait times are as long as 45 days in Searcy, and 33 days in Pine Bluff.

More information on patients' wait times at VA facilities is available at www.accesstocare.va.gov.

VA officials on Friday also revealed more than $22 million of facility upgrades at the Little Rock branch to be completed this summer.

Those improvements include a $15 million operating center, which expands the facility's ability to conduct complicated surgeries; a renovated $2.9 million dialysis unit, with a patient capacity increased from 19 to 24; and a new $4.8 million ear, nose and throat, eye and dermatology clinic.

Later in the year, the agency also plans to open two new community-based outpatient clinics in Mena and El Dorado.

In Fayetteville, a 20-bed substance abuse and mental health treatment center for veterans is set to open by the end of the year on the grounds of the Veterans Health Care System of the Ozarks in Fayetteville, Director Bryan C. Matthews said Friday.

In addition, the center is drawing up plans to open a 15-bed acute care mental health center on its grounds, Matthews said.

Information for this article was contributed by Doug Thompson of the Northwest Arkansas Democrat-Gazette.

Metro on 06/03/2017

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