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Omaha VA hospital officials look to new initiative, more staff

The Daily Nonpareil - 6/11/2017

OMAHA - VA officials said Friday they hope that a new federal initiative plus more local hiring will stop a trend that has seen more western Iowa and Nebraska veterans waiting longer to see doctors.

Two years ago, Department of Veterans Affairs data examined by The World-Herald showed that only one in 278 clients of the VA Medical Center in Omaha had to wait longer than 30 days to see a doctor. More than 99.6 percent saw a doctor on time. That placed the hospital among the top three of 152 VA hospitals in the country.

Nearly every other clinic in the VA Nebraska-Western Iowa Health Care System - which serves veterans from North Platte, Nebraska, in the west to Shenandoah in the east - boasted similarly impressive numbers.

Since then those numbers have slipped. A new look at recent data shows that the rate has dropped to 98.3 percent in Omaha. Eleven other hospitals now rank ahead of it, though Omaha still ranked well above the VA's national average in April of 96.8 percent.

The problem is even more serious at the VA clinic in Norfolk, Nebraska, where in April more than 6 percent of patients waited more than 30 days. That's far more than the national average.

The problem in Norfolk began when the clinic lost two of three primary care physicians who work there, said Dr. David Williams, the health care system's chief of staff.

"One of our big challenges is staffing," Williams said. "If a doctor gets sick or retires, it takes a long time to replace them."

He said new physicians recently have been hired.

"I would say by August we'll see significant improvement," he said.

VA officials said the slippage in Omaha and across the region is, ironically, the result of a program meant to help shorten veterans' wait times.

Congress created the program, called Veterans Choice, in 2014, after revelations that some VA hospitals - but none in Nebraska or Iowa - had created phony waiting lists to cover up scandalously long waiting times.

The law allowed veterans who had waited more than 30 days or live more than 40 miles from a VA clinic to visit a doctor in the private sector instead.

A private contractor, called Health Net, was hired to run the program. But the company has struggled to keep up, said Jenny Rosenbalm, business office director for the VA Nebraska-Western Iowa Health Care System. That has led to longer wait times for a few veterans needing to see certain specialists.

"Historically we had a very good non-VA care program. We would buy anything our veterans needed in the private market," Rosenbalm said. "Choice has added some hurdles."

She said she expects improvements with the recent passage by Congress of a successor program, called Veterans Choice 2.0. Rosenbalm said the new version will involve the local VA more directly in setting up appointments for affected veterans.

Since the current fiscal year began Oct. 1, 2016, the local VA has processed nearly 17,000 Veterans Choice claims, according to VA officials. That compares with 21,304 during the entire previous year.

"We're going to be one of the first sites to try it," Rosenbalm said. "Our staff will be more heavily involved in the care of the veterans."

Also on Friday, Health Care System Director Don Burman briefed reporters on planned improvements as part of a "State of the VA" initiative begun last month by VA Secretary David Shulkin that calls for improvements in 13 areas of service.

Burman said the VA wants to offer wider choices for veterans, improve quality of care, modernize electronic records, boost employee accountability and enlist the community's help in stopping veteran suicides.

Among planned VA improvements:

» Begin construction next spring on an $86 million ambulatory care facility at the Omaha VA hospital through a groundbreaking public-private partnership. When completed, the new facility will allow most outpatient services to move out of the aging and outdated hospital building, which opened in 1950.

» At the same time, begin building a 350-stall parking garage to ease the hospital's chronic parking woes. The garage is expected to cost between $8 million and $9 million, said Will Ackerman, a VA spokesman.

» Begin construction of a new Fisher House on the Omaha campus. The house provides rooms for families to stay while veterans from out of town receive extended care.

» Fill vacancies faster with the help of events like a recent job fair, at which VA recruiters collected résumés from more than 400 job candidates.

The system has a particularly urgent need for nurses, said Eileen Kingston, associate director for patient services, with 15 current openings for acute-care surgical nurses.

» Boost the Omaha VA hospital's current four-star (out of five) quality rating to the top mark by the end of the year. "Our metrics all point to us as a five-star facility," Burman said.