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Wait times at Colorado VA facilities among worst in the nation, new data show

Two years after scandal broke, Denver is worse off than Phoenix was

Feb. 13, 2008--Denver Post consumer affairs reporter David Migoya.   The Denver Post, Glenn Asakawa
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Wait times for medical appointments at veterans facilities in eastern Colorado and the Denver area are among the worst in the nation, U.S. Department of Veterans Affairs data show. Front Range veterans have seen little improvement in the three years since a national scandal erupted over the problem.

The average wait for a primary care appointment at just the Denver VA Medical Center has grown to more than 18 days as of July 1 — three times higher than those at the main VA facility in Phoenix, where the problem was first exposed in 2014, and nearly four times the national average.

The waiting period in Denver had been half of what it was in Phoenix, according to VA data released earlier this month.

Throughout the 13 hospitals and clinics that make up the Eastern Colorado Health Care System, the average wait for a primary care appointment as of July 1 was more than 12 days. Only Amarillo, Texas, and Palo Alto, Calif. — both smaller than ECHCS — were worse.

In all, though, nearly 13.5 percent of all the appointments at the ECHCS had longer than a 30-day wait, federal data show — worst in the nation — even though the VA in 2011 said its goal was for each veteran to be seen by a doctor within 14 days.

Navy veteran Al Montoya of Denver said he has become accustomed to waiting up to three months to see a primary care doctor at the Denver facility.

DENVER, CO - June 30: Outside ...
David Zalubowski, The Associated Press
The Denver Veterans Affairs Medical Center on Tuesday, June 30, 2015 in Denver, Colorado.

“It’s not always like that for everything, but primary care takes longest,” he said. “It does no good to complain, and I know they’re doing the best that they can. They’re very good people here.”

The national wait-time average is 4.9 days, and about 5.8 percent of all appointments across the country had longer than a 30-day wait, according to VA data.

In May, the VA reported that more than 92 percent of all completed appointments in eastern Colorado were handled within 30 days, but that was the lowest in the nation. The average was nearly 97 percent, data show.

“Not much has really changed here since what happened in Phoenix,” said Randy Proctor, an Army veteran who said he has been visiting the VA center in Denver for 30 years. “Some appointments aren’t so bad, but if it’s dental, that’s the worst. It takes a long time.”

Colorado congressmen assailed the agency for its continued — and worsening — issues over veteran care, especially after the VA battled other controversies such as the massive delays and cost overruns in constructing a new $1.7 billion facility in Aurora, which is expected to open in the spring.

“I find this deeply troubling and I will be discussing it with (VA) Secretary David Shulkin,” said U.S. Rep. Mike Coffman, R-Aurora, who is a member of the House Committee on Veterans’ Affairs and the Armed Services Committee. “Additionally, I will be spending time … at the VA to find out why our veterans in the Rocky Mountain region are not receiving the timely care that they need and have earned through their military service.”

Congressman Ed Perlmutter, D-Arvada, said he was surprised wait times were still an issue here.

“Clearly, we need to be continuously focused on how to reduce veteran wait times, and I plan to take another look at the issue,” he said. “Denver’s wait times shouldn’t be above the national average.”

Sen. Cory Gardner, R-Colo., said via Twitter that “this is unacceptable. Colorado veterans deserve better.”

In January 2015, not long after the wait-time scandal came to light in Arizona, the average wait time at the Denver facility for a primary care appointment was just 7.5 days, records show. Phoenix was 14 days.

The current backlog for ECHCS is worst in La Junta, which showed average waiting periods of more than 24 days, up from about three days in 2015.

ECHCS officials on Thursday said critical shortages in medical personnel — doctors, physician assistants and licensed practical nurses — make it difficult to keep up with the growing demand Colorado has seen from an increasing veteran population. And sometimes it’s simply because veterans would rather wait for a familiar face.

“Veterans want to come to us,” ECHSC Chief of Staff Dr. Ellen Mangione said. “They can go elsewhere, but they choose us.”

The system currently has a 16 percent vacancy rate — there are 336 physicians — even though it offers some primary care doctors as much as $200,000 a year in salary and additional training.

“It’s a challenge to keep up with the demand,” assistant director Josh Pridgen said. “The marketplace has become very competitive.”

The Denver facility has improved in one key area: the average wait for a mental health appointment has dropped from nearly 20 days in 2015 to fewer than nine days today, data show. But that is still more than double the national average.

The number of scheduled appointments in the ECHCS has grown by 41 percent in 2½ years to 91,278, data show, while those in Phoenix have risen by 48 percent to 102,363.

“I know the Golden clinic has been a bright spot in providing another option for veterans, and I believe the new medical facility will be too, but we need to shorten these wait times for our veterans moving forward,” Perlmutter said.

The average wait at the Golden clinic was more than seven days in 2015. Today, it is about five days, data show.

Denver insiders challenged the accuracy of VA’s national numbers, saying patients are better off today than three years ago. However, they concede that hiring medical professionals remains a problem at facilities in Colorado Springs and Pueblo, where the number of patients on waiting lists is larger than Denver.

“That’s to do with not enough available people wanting to work for the VA,” said Bernie Rogoff, a volunteer veterans advocate who serves on a patient-care team at the Denver center and is a board member of United Veterans Committee of Colorado. “They are distorted (wait-time) numbers. Primary care waiting times are likely five, at most seven days, and there ain’t nothing wrong with that.”

Since the scandal broke in 2014, average wait times at the Carl T. Hayden Veterans Affairs Medical Center in Phoenix have improved dramatically, to six days for a primary care appointment. Regionally, about 7 percent of all appointments in Phoenix were outside the 30-day window.

Medical staff makes their way through the Surgical Intensive Care Unit on Tuesday, June 30, 2015 at the Denver Veterans Affairs Medical Center.
Brent Lewis, The Denver Post
Medical staff makes their way through the Surgical Intensive Care Unit on Tuesday, June 30, 2015 at the Denver Veterans Affairs Medical Center.

“VA facilities learn from each other by sharing information and best practices,” Schabert said. “But ultimately, every VA health care system is unique in a number of ways, including the demographics of its veteran population, the geography it covers, the number and size of clinics and the number and certifications of its health care professionals.”

The wait-time scandal broke in 2014 with allegations that VA hospitals intentionally falsified records to make it appear patients were being seen promptly when, in fact, they were placed on long waiting lists. Some veterans in Phoenix died waiting to see a doctor.

Findings from ensuing investigations caused the creation of the Choice program, which offers veterans federally paid medical care outside the VA when waiting times exceed 30 days or the drive to a VA medical facility is more than 40 miles.

Congress on Monday approved a $2 billion funding shift to cover Choice expenses despite objections it took money away from other VA programs.

Through May and since its inception in 2014, the VA has issued more than 108,000 Choice program authorizations to more than 49,000 veterans in Colorado, a VA spokesman said.

Mangione said she knows it’s a challenge to improve, but she won’t give up.

“Am I worried about improving?” she asked before taking a long pause to respond. “Other than every morning realizing there’s a veteran behind every one of those numbers, I’m absolutely focused on doing a better job.”

Traffic passes by the campus of ...
David Zalubowski, The Associated Press
Traffic passes by the campus of the Veterans Administration hospital under construction Thursday, June 8, 2017, in Aurora, Colo.