Rep. Tulsi Gabbard Invites VA Secretary McDonald to Visit Hawai‘i to See First-Hand the Challenges Facing Hawai‘i Veterans

October 6, 2014
Press Release

Washington, DC – Congresswoman Tulsi Gabbard (HI-02) has invited Department of Veterans Affairs (VA) Secretary Bob McDonald to visit Hawai‘i to “see first-hand the unique health care challenges still facing Hawai‘i’s veterans.”
 
Gabbard and McDonald spoke at length on the phone shortly after his confirmation as the new VA Secretary, at which time she described to him some of the unique challenges that confront Hawai‘i’s veterans as they seek health care.  The congresswoman, herself a twice-deployed Army combat veteran and current captain in the Hawai‘i Army National guard, followed up today with a letter to McDonald outlining many of those challenges and inviting the VA Secretary to personally visit Hawai‘i.
 
“When Secretary McDonald and I spoke, I wanted to ensure he understood the unique challenges our Hawai‘i veterans face every single day just to access care,” Gabbard said. “Whether it is the geographic challenges to drive or fly to a VA health provider, or the longest-in-the-nation wait times for first-time primary care appointments, Hawai‘i veterans continue to face challenges accessing the care they’re entitled to from the VA. Having held a listening tour across our islands in June to hear from veterans directly, I was able to relay their many immediate concerns to the Secretary. I wrote him today to reiterate those questions and concerns, and to personally invite  him to visit our Islands to see first-hand the unique health care challenges still facing Hawai‘i’s veterans.”
 
In response to the VA health crisis, Congresswoman Tulsi Gabbard this summer introduced ACT Now for Veterans (H.R. 5131), bipartisan legislation to immediately allow eligible veterans to access non-VA healthcare with the assurance the VA will cover the bill. The final bipartisan VA reform bill signed into law by the President in August included the foundation of her bill.
 
The first bill she introduced after being elected, the Helping Heroes Fly Act, aimed to improve airport security for severely wounded veterans. It passed Congress unanimously and was signed into law by President Obama in August 2013.
 
In her letter (below) to McDonald, Gabbard wrote, “I look forward to hosting you in Hawai‘i so you can hear directly from our amazing veteran community, and to continue working together on our shared mission of serving and honoring our veterans.”
 
Full text of the congresswoman’s letter to Secretary McDonald is below and also available as a .pdf here.
 
October 6, 2014
 
The Honorable Robert McDonald
Secretary
Department of Veterans Affairs
810 Vermont Avenue, NW
Washington, DC 20420
 
Dear Secretary McDonald,    
 
I’m writing to follow up on our prior conversation and personally invite you to visit the Department of Veterans Affairs (VA) facilities in Hawai‘i and to meet personally with some of Hawai‘i’s veterans. I appreciated the opportunity to have a lengthy conversation with you about the future of the VA and its systemic issues which will require real reform in Hawai‘i and across the Pacific if we are to provide the quality of health care we both want for our veterans.
 
The first set of Veterans Health Administration (VHA) access data reported on June 9, 2014, revealed that Hawai‘i had the longest wait times for new patient primary care appointments in the nation, with veterans waiting on average over five months for their first appointment with a VA primary care physician. There remain other concerns about bottlenecks and longer waiting periods for follow-on care.  The vast majority of casework that my office handles in Hawai‘i is veterans seeking assistance, because they still face serious obstacles in accessing care and benefits within the VA system. As you are finalizing the rulemaking and implementation process for the Veterans Access, Choice and Accountability Act, I strongly urge you to visit both the Spark M. Matsunaga VA Medical Center (VAMC) and our Community-Based Outpatient Clinics (CBOCs) on each of our islands, and hear from veterans in Hawai‘i about the reforms they feel are necessary to meet the unique challenges they face.
 
With this in mind, I would like to highlight a few areas of concern regarding reform across the VA, and encourage you to concentrate your attention in the following areas:
 
1.      Our priority must be to ensure veterans have immediate and ongoing timely access to care, particularly for those who live in rural areas and are geographically limited from receiving care at the nearest VA medical facility.  I introduced legislation that would have created an easy option for veterans to receive care within their communities using their VA identification card.  A similar provision, called the Veterans Choice Card, was included in the legislation that was enacted.  I urge you to accelerate your cooperation with private industry to create and disseminate these Veterans Choice Cards to eligible veterans. This action will allow veterans who wait too long or live too far to get timely care from a provider in their community.
 
2.      The VA must do whatever it takes to eliminate the significant backlog on benefit claims and appeals.  The recent announcement that the VA will employ a new standard form for filing claims, including a new standardized Notice of Disagreement form that initiates the appeal process, is a good first step. Streamlining the data collection process will be key to significantly reducing the amount of time a claim is pending.  I urge you to continue to take the direct action necessary to end the disability claims backlog, and reduce the time a veteran or their survivor must wait to receive the benefits they have earned and deserve.
 
3.      Creating more direct and timely avenues for veterans to access their benefits and submit their information electronically is critical for the veteran, and for more streamlined VA processing.  There continue to be significant issues with the eBenefits system displaying incorrect information, as well as unnecessary delays in processing the documents that the veterans have uploaded. Oftentimes, there is no verification letter sent, or notice that the document or form is being processed.  Across the board, a simple follow-up phone call would go a long way.
 
4.      A key step to changing the culture within the VA must be true accountability and stronger whistleblower protections.  Our nation’s trust in the VA was shaken when severe delays in care and false record-keeping were revealed across the entire VA health care system. However, veterans and VA employees have reported serious issues such as these within the Department for a long time, with no action, accountability, or change - the problem just got worse. Reestablishing a culture of accountability, professionalism, and commitment to serving our veterans, is critically necessary at all levels within the VA. Moreover, I encourage you to continue to work with the U.S. Office of Special Counsel to rigorously investigate all instances of whistleblower retaliation in your organization, and hold bad actors accountable.
 
As I mentioned to you when we spoke, veterans in Hawai‘i and across the Pacific face a unique set of challenges; what works in the 48 contiguous states often applies differently to Hawai‘i and Alaska, due to our unique geographic situation.  I would like to highlight just a few of these special challenges that veterans in Hawai‘i face, including:
 
1.      The island geography of Hawai‘i often presents access challenges for our veterans, particularly when they require neighbor island transportation and access to get medical care and treatment. Many Hawai‘i veterans face delays in receiving travel reimbursements, have difficulty booking interisland airline reservations or securing the ground transportation they require to get to a facility. I encourage you to hear directly from our veterans about these challenges, which are also present in communities across the Pacific.
 
2.      In Hawai‘i, medical provider shortages often complicate a veteran’s ability to access the care they’re entitled to. CBOCs across the islands remain short-staffed, and replacement medical staff take months, or over a year, to hire.  For example, veterans on the island of Molokai no longer have access to medical care and treatment from a VA provider on the island. These veterans are sent to the local hospital for immediate medical services, but often experience either delays in reimbursement for their care, or their claim is outright denied by the Honolulu Regional Office, leaving our veterans stuck with a bill they cannot afford to pay. I urge you to consider the critical role that Community Health Centers can play in delivering comprehensive care to veterans, particularly in rural areas that have few other providers, and setting up a more direct reimbursement process for these community health providers in their care for our veterans.
 
3.      There has been a noticeable delay in processing travel reimbursement vouchers. As stated previously, many veterans must fly from neighbor islands to receive specialty care at the Honolulu VAMC.  Many of these veterans are on fixed incomes.  A round trip airplane ticket costs over $200, in addition to hotel and ground transportation costs.  In some cases, veterans have been forced to wait months to be reimbursed for their travel. This could be easily mitigated if they were able to receive care from a local non-VA provider instead of flying into Honolulu for a specialty care appointment, or if there were a more direct, efficient, streamlined reimbursement process that recognized the unique challenges these veterans face in accessing care.
 
Mahalo for your consideration of these important issues. I look forward to hosting you in Hawai‘i so you can hear directly from our amazing veteran community, and to continue working together on our shared mission of serving and honoring our veterans.
 
Sincerely,
 
Tulsi Gabbard
Member of Congress

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