Bluefield Daily Telegraph, Bluefield, WV

Local News

June 17, 2014

Beckley VA wait times may be longer than national audit reports

BECKLEY — Wait times reflected in the national audit of the Beckley Veterans’ Affairs Medical Center aren’t what they seem to be, according to a health benefits adviser employed there.

Although the national audit numbers released June 9 show new patients waiting an average of 39 days to see a primary care physician at the Beckley facility, Gavin VanHoose said he has seen at least two veterans who waited for health care for six years and eight years.

One veteran was wrongly denied coverage because of his length of time served in the military and another was wrongly denied because of his assets.

“Veterans deserve to know,” VanHoose said.

He said he knows five veterans who were denied coverage and they have since passed away, even though they were actually eligible for health care the entire time.

“I’ve found hundreds of delayed veterans who were eligible but were denied their benefits. I have found veterans from 10 years back that were wrongfully denied and had to file for Service Connected Disabilities to access the hospital.”

He said possibly more than 1,000 have had health-care benefits delayed due to having assets in savings accounts at banks, but he said their income would have been low enough to make them eligible.

VanHoose said many employees there who handle enrollment do not always use the most up-to-date guidelines, i.e. financial restrictions or net worth.

These veterans, under the most updated guidelines, would be eligible for coverage, he said, but the staff turns them away.

When Chief of Health Administration Services at Beckley VAMC Allen Moye was questioned by The Register-Herald about these allegations, he said, “The eligibility and enrollment guidelines have not significantly changed since 2003.”

However, according to an enrollment expansion (Public Law 110-329) that took effect June 15, 2009, income thresholds were increased for “Group 8” to allow additional coverage for veterans who were previously denied enrollment.

Veterans are grouped based on priority. For example, groups one, two, three, four and six do not have to submit to financial eligibility guidelines because they are automatically enrolled. These are veterans who are extremely disabled, were a prisoner of war, earned a Purple Heart for being wounded in battle, among other qualifying factors.

The remaining groups — five, seven and eight — must submit to eligibility requirements, such as income and net worth.

VanHoose said the additional funding from the change June 15, 2009, allowed thousands of additional veterans to receive coverage from the VA because of the increased income thresholds.  

VanHoose is a veteran himself, an aviation electrician in the Navy for four years. After his service, he became employed at the Beckley VAMC in Health Administrative Services (HAS).

Soon thereafter, a Rural Health Initiative grant was implemented in 2010, which allowed him to reach out to veterans directly to let them know what types of coverage they are eligible for and the services available to them.

VanHoose started working in this program in 2012 and says he quickly began noticing problems in the system.

“Without that initiative, I would have never had the opportunity in the first place to have the updated training.”

That training revealed to him how many veterans were being wrongly denied health care coverage based on their assets, time in service and more. He then took his complaints to senior officials.

He filed a complaint in late January of this year with the Department of Veterans Affairs Office of Inspector General alleging gross mismanagement, violation of rules and legal and policy violations. That was before issues like those became national news in April.

His complaint stated, “This facility has been ‘Rejecting Eligible Veterans’ and continues to do so even after we have brought attention to the appropriate staff.”

He continued, “One veteran even passed away when we attempted to contact his residence to notify him of his eligibility for the VA Hospital.”

Since filing that complaint, he has found four other veterans who also died without being notified of their eligibility.

He received a confirmation letter from the Office of Inspector General, alerting him that a case had been opened based on the information he submitted, but he said he has yet to hear further since February.

In many instances, VanHoose said he would notify a veteran he or she was eligible, only to see them turned away after arriving at the hospital.

He cited computer system error for some of the delays, when the data was not property transmitted to the Health Eligibility Center (HEC) in Atlanta for over a year in 2012.

Moye confirmed that preliminary applications are processed in Beckley and final approval must come from the HEC, but he said he was “unaware of any issues”  about transferring applications between Beckley and Atlanta.

When VanHoose first started working at the VA, he said there were more than 8,500 veterans’ files listed as “in-process” but after a computer update Feb. 12, 2013, that number is down to 4,000; the others still remain “in-process.”

Moye reiterated that wait times that were released nationally are “reflective of what we’ve seen historically here.”

“Those numbers jive with the internal audit, so I’m not sure what they’re talking about,” Moye said. “We’re committed to serving veterans, our nation’s heroes.”

VanHoose said he fears that veterans are being turned away for coverage because if the hospital’s patient load increases, so does the amount of wait time, which reflects poorly on the hospital overall.

“If the facility doesn’t meet the appropriate wait-time measures, senior officials’ bonuses are going to be affected,” he said.

He said he has tracked the errors back 10 years, but the rate has increased he says over the last five years due to the Rural Health Initiative reaching thousands of veterans and the 10 percent enrollment expansion from 2009.

He decided to speak up because, “As a veteran myself, I kept thinking, ‘What if this was me?’”

For a veteran who has been denied coverage, VanHoose encourages him or her to contact the Beckley VAMC’s Enrollment Coordinator for a second look at his or her eligibility status.

“I have nothing to gain in coming forward. I only want to make sure every veteran has the opportunity to receive the benefits they were promised by our country.”

•••

Another veteran, John Hurt, who utilizes the Beckley VAMC for his health care, said he has had issues at the facility as well.

He served 21 years in the Marines and Army and confirmed, “They do pad those numbers on that wait time.”

Hurt said after his initial appointment was delayed to begin with, he had to wait nearly four hours to be seen by a doctor, and the doctor’s visit only lasted 15 minutes.

His wife also visited the doctor and he said all of her prescriptions were changed, which made her unstable and shaky, and when they tried to get in touch with the physician, he could not be reached.

He also has concerns about the way prescriptions must be filled at the VA, instead of mailed via home delivery.

“I had to stay longer, which was inconvenient, and I had to pay for it, where my ExpressScripts delivery to my home is free.”

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