For military veterans living in northern New Hampshire, accessing medical care from the Veterans Health Administration can be a challenge. Veterans, many of them elderly, often travel long distances to get to VA clinics scattered throughout Coos and Grafton Counties. And it’s an even longer drive to White River Junction, Vermont, which is the only full-service VA hospital nearby.
VA officials from White River Junction hosted two town hall meetings in the North Country Monday to discuss a new proposal that attempts to provide care for veterans closer to home.
"So we’re going to go around the room and introduce you to my team. So like I said, my name is Al Montoya. A little bit about myself, I’m an Air Force Veteran, so you can’t hold that against me…"
Al Montoya is the director of the VA Medical Center in White River Junction. He’s addressing about 40 veterans seated in folding chairs at the Berlin Town Hall.
He’s here to unveil something he says veterans asked for at a town hall meeting last July.
"I will tell you that the resounding theme back in July from 120 or so vets in that room, is that you wanted access to care five days a week," Montoya says.
Right now, the mobile vet clinic in Berlin is open just one day a week. That clinic and the one at Indian Stream Health Center in Colebrook, which is only open two-half days each week, will be closing in February. The two clinics serve about 180 veterans. Both started service last year and were intended to be temporary. In its place is a new system that Montoya came to Berlin to discuss.
"I would ask that everyone listen with an open mind and give us some feedback that we can then incorporate and truly make this your healthcare delivery model," Montoya says.
This model makes greater use of the VA's Veterans Choice program. That’s a program that allows veterans to get care at participating hospitals and medical centers, with the VA covering the cost. Case managers would be based in the North Country to fix any problems with Veterans Choice. Hugh Huizenga, chief of Primary Care at White River, explains how this new model may work.
"The idea would be that if you’re a veteran up here in Berlin, you could get your care through Coos County Family Services. They’d be able to coordinate that care through the VA. You’d have access to all the same VA benefits that you have now," Huizenga says.
Huizenga says veterans would still be welcome to come to White River Junction for services, but the idea is to provide more care locally. Coos County Family Services is just one option the VA has lined up. Officials passed out a sheet at the meeting with 18 others.
Still, the veterans in attendance weren’t completely sold. Bill Bonney, an Air Force veteran from Berlin, says he's not happy about the mobile clinic’s closing.
"I'd rather keep it right here. That's why I'm wondering about how this thing is going to work. (Montoya) thinks it will. Probably will, I don't know," Bonney says.
Bonney says he'll likely have to look into getting on Vets Choice to avoid having to drive to Littleton, about 40 miles from where he lives. Vets Choice may allow him to stay in Berlin for some of his care.
Robin Lavertu, also from Berlin, says veterans in the North Country have been promised local, full-time clinics before. A promise, he says, the VA hasn't kept.
"You can only break a promise so many times before you start to feel the disbelief. So my concern is for the veterans in the area to get the care they need without having to take a trip in the snowstorm," Lavertu says.
Later in the afternoon, at the Colebrook Town Clerk’s office, veterans were critical of the increased role the Veterans Choice program would play. As he did in Berlin, VA medical center director Al Montoya gave out his government-issued cell phone number, inviting veterans to call him if they have problems. Barb Lynch interrupted his pitch to say that yes, veterans were asking for five-day-a-week care, but they weren't necessarily asking for the Choice Program.
"You didn’t hear five days of access to VA Choice. I was there at that meeting. You did not hear that," Lynch says. "That’s what you wanted to hear." Lynch turned to the veterans surrounding her. "Am I right?” she asks them. Several veterans murmur their assent.
The Veterans Choice Program provokes such strong emotions in some veterans, in part, because of delays in getting appointments and other bureaucratic hurdles.
Peter De Pontbriand said that it takes six to eight weeks to see a doctor through Choice.
“Best you’re going to do is two weeks getting an answer from Choice, and that’s pushing it, that’s multiple calls. It may be a month. That was my first-case scenario," says De Pontbriand.
The VA says it has made some headway in fixing these problems. But they’re not completely corrected. Doctors also report delays in getting paid by the VA and its partner Health Net. That may make more providers reluctant to start accepting Choice patients.
Robert Napsey is a former Marine from Pittsburg. He says he had a good experience at the VA clinic at Indian Stream Health Center. But he’s says he’s optimistic about this new arrangement.
“If it works as good as they say it is, it’s going to be fine. But like everything else, you got to get the right person to help you on the phone. Otherwise it’s mass confusion," says Napsey.
And Napsey says if confusion sets in, he won’t hesitate to call Montoya’s cell phone.