El Paso Veterans Affairs system nation's worst

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El Paso Veterans Affairs system nation's worst
El Paso health care needs 'radical changes'
By Chris Roberts / El Paso Times
Article Launched: 04/06/2008 12:00:00 AM MDT

Copyright 2008
The El Paso Veterans Affairs Health Care System is the worst in the nation, according to an internal performance survey, the El Paso Times has learned.

Reported problems at the El Paso VA involve patient care, outreach, technology, medical equipment and supplies, and staff morale that apparently resulted in threats of "mass resignations. " The situation prompted a visit Friday from U.S. Rep. Bob Filner, D-Calif., chairman of the House Committee on Veterans' Affairs.

Asked whether he thought the El Paso VA was failing local veterans, Filner answered, "No question."

The El Paso VA is not providing the level of customer service it should, system Director Bruce E. Stewart said late Friday, but it has made recent improvements. And, in some cases, the way the El Paso VA answered survey items gave a wrong impression, he added.

Although Filner said he saw reason for optimism after meeting with top El Paso VA staff, including Stewart, he said he told them he would conduct a congressional hearing if things did not improve in the near future.

"It seemed clear to me that the culture of the place needed some radical changes," Filner said in an exclusive interview with the El Paso Times. "There wasn't a service orientation. "

Filner said the problems in El Paso also are symptoms of a systemwide culture that doesn't put veteran care first, but all too often focuses on cost-cutting.

He said the present funding mechanism -- which doesn't provide enough money to get through a year without supplemental budgets -- is a major stumbling block for the department.

The Department of Veterans Affairs Web site lists more than 70 health-care systems, which can include other types of treatment centers.

"He (Filner) has been leading the effort around the country to make sure we're doing a better job taking care of veterans," said U.S. Rep. Silvestre Reyes, D-Texas, who asked Filner to make the trip and also attended the meeting Friday.

Congress has put together the largest budget in the department's history, Reyes said.

The additional money, Stewart said, is allowing him to hire more than 100 people, which will significantly improve the overall quality of care provided by the agency.

The survey -- which measured clinical quality, access and patient satisfaction -- scored the El Paso VA at 71.4, while the national average was 81.3, according to a letter to Reyes from Susan P. Bowers, VA Southwest Healthcare Network VISN 18 director.

The letter, dated Feb. 29, was provided by Reyes' office in response to an El Paso Times request for information on the survey, which was concluded last fall.

"This is the lowest aggregate score in the country, and is (an) area of significant concern," wrote Bowers, who was at the meeting Friday.

A 1.9 percent decline in visits from 2006 to 2007, reported by Bowers, is an indication some veterans are giving up on the El Paso VA, Reyes said.

However, Bowers praised Stewart for consistently approving "the immediate recruitment of any physician position as soon as there is an indication that the position will be vacated," and added that "many of the problems noted existed when Stewart assumed responsibility as the director."

El Paso veterans advocate Ron Holmes, who attended the meeting, said he has worked with three El Paso VA directors. He said he and another veterans advocate were promised a more-direct way of passing along problems veterans are experiencing.

"Let's wait and see," Holmes said Saturday. "I would like to say we've got new people, and we're carrying baggage from the last group."

A long-standing problem for the El Paso VA has been it's "front door" -- the telephone system.

During the past two years, Bowers wrote, hold times on the system have dropped from an average of more than two hours to fewer than 15 minutes.

A new phone system, which is installed and being debugged, Stewart said, will provide VA officials with the data they need to identify bottlenecks.

That will include finding out why veterans are calling so that staffers can be allocated in a way that allows more calls to be answered by humans instead of recordings, he said.

Regarding a complaint that a "large" backlog of patients are waiting for outside consultant visits because of slow payments or nonpayments by VA, Bowers said no "significant issues" have been brought to the attention of the financial department, although she added, "there have been isolated instances of problems in individual cases" that were quickly resolved.

Although Bowers acknowledged that there have been delays making appointments in specialty areas such as eye care and urology that "are short staffed internally as well as in the community," she wrote that nearly all primary-care appointments for new and established patients are completed within 30 days of the desired date.

An extended-hours program requested by Reyes to allow for walk-in patients who can't leave their jobs during the day was "designed to fail," in part due to inadequate publicity, according to a summary of complaints provided by Reyes' office.

Veterans also were required to get appointments rather than simply walk in.

Bowers wrote that the after-hours clinic was not set up for walk-ins "because of the level of staffing that would be required to make that a safe and effective model. Essentially, all areas of the clinic would have to be open during that time if (the El Paso VA) were to adopt that model."

But both congressmen said Bowers' response illustrated the problem.

Rather than detailed explanations of why the programs won't work, they said they wanted to see proposals -- including requests for more money or other resources, if necessary -- that would make them work.

"Maybe two days a week they could open at 10 a.m. or 11 a.m. and stay open late at night," Filner said.

Filner said he asked Bowers to rewrite her response with a focus on what can be done to improve things, and both congressmen said they planned a follow-up meeting in the near future.

"Being rated lowest in the nation was a huge embarrassment, and I think they're committed to changing," Filner said, but he added, "It doesn't change with one meeting."

Chris Roberts may be reached at chrisr@elpasotimes. com; 546-6136.

In accordance with Title 17 U.S.C. Section 107, this material is distributed without profit to those who have expressed a prior interest in receiving the included information for research and educational purposes. Reference: http://www.law. cornell.edu/ uscode/17/ 107.shtml

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