Federal officials get an earful from Martha’s Vineyard veterans

Congressman Bill Keating promised to address complaints about health care access and VA programs that do not meet Islanders’ needs.

The room was crowded at the American Legion in Tisbury as veterans and family members came to talk about healthcare. — Photo by Sam Moore

Veterans of military service living on Martha’s Vineyard came out in force to American Legion Post 257 in Vineyard Haven on a stormy Tuesday night. They packed the pine-paneled hall to air their grievances about Veterans Choice, a program begun in 2014 that was intended to provide better health care access to veterans who live in remote areas, and has, ironically, made access more difficult for many.

All Island service veterans who qualify for Veteran’s Administration (VA) benefits are eligible for Veterans Choice, because travel to the closest VA facility — the clinic in Hyannis or Providence VA hospital — is an “undue burden,” e.g. requires the veteran to take an airplane or a boat to that facility.

Dr. Monty VanBeber, associate chief of community-based outpatient clinics for the Providence Veterans Administration Medical Center, has been making monthly trips to treat Island vets for the past three years. The indifference and ineptitude at Veterans Choice call centers had become so bad, Dr. VanBeber was concerned it was exacerbating the symptoms in his patients with post-traumatic stress disorder (PTSD).

Dr. VanBeber and JoAnn Murphy, Veterans Affairs coordinator for Dukes County, organized the meeting.

“My hope is, once the people from Health Net see how difficult it can be for Island vets to get to off-Island appointments, they’ll be more responsive to their needs,” Dr. VanBeber told The Times in a recent interview.

Ironically, the boat that was supposed to bring Congressman Bill Keating and the Health Net coterie to the meeting was canceled due to a storm.

“You know what, I’m glad it happened,” Dr. VanBeber told The Times after getting off the phone with the landlocked contingent. “Now they’ll really get a taste of what these guys have to deal with.”

Dr. VanBeber, a battle-tested corpsman with two Navy Achievement Medals, improvised and adapted. The meeting went ahead as planned, with Dr. VanBeber holding his phone up to a microphone.

It worked surprisingly well.

System overhauled

Over the next hour, Rep. Keating; Matthew Ruest, vice president of Government Services Field Operations at Health Net; David Hunter, manager of Field Operations at Health Net; and Toni Jefferson, Non-VA Care Program manager, listened to the frustrations of men and women who served, and to varying degrees still carry mental and physical scars from their service.

“We’ve appropriated $15 billion to improve [Veterans Choice] because of the disgraceful way our veterans have been treated,” Congressman Keating said in his opening remarks. He was referring to appropriations in President Obama’s proposed FY 2017 budget, released last week, which includes $5 billion for hiring new doctors and staff for Veterans Choice and $10 billion to improve the VA physical infrastructure.

“This is to make sure the problems we’ve had are corrected, and quickly,” Rep. Keating said. “There will be a concerted effort to rectify problems with call centers and appointment scheduling, and to add physicians and staff to the VA.”

Rep. Keating said the appointment process has already been overhauled. A major change will begin next week, when call centers will have operators specially trained to handle calls from veterans who live in Martha’s Vineyard and Nantucket ZIP codes. “They will know the idiosyncrasies of island life, and will be sensitive to that,” Rep. Keating said. “It will no longer be veterans conforming to the needs of Health Net. It’s Health Net that is conforming to the needs of our veterans.”

Mr. Hunter said that the call center operators dedicated to the Island are being trained, and will begin taking calls on Monday, Feb. 22: “We’re just starting, so it won’t be perfect on day one, but know that we are working for you.” Mr. Hunter said the people who schedule appointments will all be veterans themselves.

Totally dysfunctional

“I tried to get into [Veterans Choice] and it was totally dysfunctional,” Bill Stafursky, veterans liaison at Martha’s Vineyard Community Services (MVCS), said. Mr. Stafursky listed a number of difficulties: “If this call center is going to work, they have to know who the qualified providers are on the Island.” He said the current system was also inept at paying health care providers, which serves as a disincentive for health care providers not registered with the VA system.

Mr. Hunter said the dedicated call center operators will have a list of registered providers on the Island: “Take a look at that list, tell us who’s not on there that you think should be on there. We’ll contact that doctor directly and register him.”

One veteran spoke about life-threatening health problems he was battling, and in a quavering voice, said that his wife was “fractured” with serious health issues and that she is suicidal. He talked about an exchange he’d had with Veterans Choice earlier that day, during which, after 45 minutes, he was told by a curt operator that he would get a call back sometime in 30 days to schedule an appointment. He said the Veterans Choice representative had told him his wife was not qualified under the plan, then the next day he got a call from Veterans Choice that his wife is covered, and the closest facility for her was in Vermont.

As she would several times over the meeting, Ms. Jefferson gave her phone number, and implored the veterans to call her directly if they were having problems with access to care.

Rep. Keating also said that veterans can call his office directly if they have problems getting proper care.

Heard it before

Woody Williams, a former Marine, directly challenged Rep. Keating: “We tried to get in touch with you and the county commissioners with a formal letter on Oct. 23, and we heard absolutely nothing from you. I know you know what the problems are, you’ve known what the plans are, and nothing’s getting better, it’s actually getting worse.”

“In October we received that letter and we began working with people in this room,” Rep. Keating said. “Today, we’re talking to you to let you know we’re changing the system, to specifically address veterans on both islands. It should be a huge benefit going forward.”
Mr. Williams made it clear that he remained skeptical. Rep. Keating was not about to take his complaints at face value.

“Woody, I happened to see correspondence in my office that was a thank-you letter from you, so don’t give a blanket statement,” Rep. Keating said.

A number of veterans said the care they’d received at Martha’s Vineyard Hospital was excellent. But handling the subsequent torrent of bills was a nightmare.

Limited access to mental health care for veterans with PTSD was cited several times as a hole in the health care safety net. Tom Bennett, associate executive director at Martha’s Vineyard Community Services and mental health counselor, said he thought there was good psychiatric coverage and that his big concern is the frustrations with Veterans Choice, which are frequently expressed to him in group therapy sessions. “Any time you have difficulty and frustration getting their health needs met, you’re going to see an exacerbation of PTSD symptoms and any other emotional and psychological issues.”

One veteran asked why emergency care is not covered with VA insurance.
He was told by Ms. Jefferson that no one can be turned away from an emergency room in Massachusetts, and that it would be covered.

“I’ve heard that before,” he said.

“You never heard it from me,” she said.

“If you’re having problems, please call us right away. We don’t want to find out in three weeks that it’s a disaster,” Rep. Keating said.

Dr. VanBeber also offered to help. “If you got to the ER and they ask about coverage, give them my number and I’ll take it from there,” he said.

Pick up the phone

After the call was over, Dr. VanBeber implored the veterans, until he was literally red in the face, to notify him or Ms. Jefferson or Rep. Keating if they’re having problems.

”You have to let us know,” he said. “This drives me nuts. You can call my office, 24/7. These people are working their best to change the system on this Island. You’re going to have to give this some time. I guarantee it’s not going to work perfectly right away. Give it a chance. If it’s not working, call me, call Toni; we’ll get the right people involved.”

The numbers provided are: Dr. Monty VanBeber (508-771-3190, ext. 1741);

Congressman Bill Keating (202-225-3111); Toni Jefferson (401-457-3039).