Veterans Affairs Secretary vows to fix system that causes some vets, providers anxiety

HONOLULU (HawaiiNewsNow) - U.S. Secretary of Veterans Affairs Denis McDonough is in Honolulu to give local stakeholders a status update on the agency’s efforts and find out how to improve services for the more than 100,000 vets in Hawaii.

“We’re looking at ways to extend the use of telemedicine and other virtual tools to reach vets here in Hawaii and throughout the Pacific,” he said in testimony during a public field hearing hosted by U.S. Senator to Hawaii Mazie Hirono, who serves on the Senate Committee on Veterans Affairs. “We’re working with our federal partners, including at the Department of Health and Human Services, whose Health Resources and Services Administration (HRSA) funds community health care centers in rural and remote areas. We’ve made hiring and retention one of our top priorities and make sure that we’re both attracting and keeping medical professionals to serve Hawaii vets. And we’re continuing to increase our capacity here in Hawaii.”

McDonough also listened to testimony from local veterans and representatives from the state, advocacy groups and TriWest, the network of private providers that help care for vets.

Many veterans express frustration with a system they say causes them more anxiety than healing, and the Secretary wants them to know their concerns are being heard.

“Too often veterans who come in, to seek care or to seek benefits are retraumatized by their experience with their providers, and with the VA benefits or personnel at VA. So we are aggressively training our personnel,” McDonough said.

It’s among the steps McDonough said he’s taking, after hearing from Hawaii veterans who criticized the VA’s red tape when trying to access healthcare inside and outside the system.

“Whenever I think VA, I always think they’re going to tell me no, they’re going to put as much roadblocks in front of me that I have to overcome,” said retired Air Force Senior Master Sgt. Roxanne Bruhn, who gave testimony as part of a second public hearing.

Bruhn retired after 32 years in the Air Force -- she says she was assaulted while on active duty and was diagnosed with PTSD when she got out -- that anxiety worsened when she tried to get mental health services at the VA where there were no female therapists.

“I didn’t feel comfortable talking to another male about what happened to me,” Bruhn said. “I feel that the women veterans are underserved.”

Senator Hirono says of 117,000 Hawaii veterans, about 12,000 are women, a number that’s growing. And with it the need for gender-specific services from routine mammograms and OB-GYN visits to abortion care after rapes and support after a sexual assault.

“We’ve set up a special fully trained group of claims reviewers who will handle all claims associated with military sexual trauma,” McDonough said. “So that we will not only award those benefits when we should award them. But that the experience, rather than being re traumatizing, is actually affirming of those brave veterans who come forward to tell their story.”

Another big priority for the VA -- hiring nurses and medical personnel.

“We need to hire 45,000 nurses in the next three years. Those are nurses of all specialties and all ranks: registered nurses, nurse practitioners, LPNs, assistant nurses,” McDonough said, adding that recent legislation like the Promise to Address Comprehensive Toxics (PACT) Act is allowing the VA to increase pay and give recruitment, retention and relocation bonuses up front. “We have to hire faster and on board more quickly.”

Candidates are “conditionally hired based on what is called onboarding which is a series of background checks, paper filling out exercises even in some cases writing an essay about why you want to be a nurse. I wish that were a joke but it’s not,” McDonough said. “That sometimes can take three to four months after you’re hired and during which time you are not paid. We can’t continue to be competitive if we continue to conduct our business that way.”

Senator Hirono said comprehensive immigration reform can help alleviate the healthcare worker crisis.

“A huge percentage of nurses in our country are immigrants. We need to fix our immigration system. We need to enable more professionals and others especially in some of these needs categories to come to our country,” Hirono said. “Most of the nurses, frankly, come from the Philippines. They are trained where there are massive wait times for them to come to our country. So there are things that you know, we need to do to address the huge nursing needs.”

Other priorities -- reducing homelessness and suicide rates among veterans, and improving the reimbursement process for private health providers who care for vets. Advocates say disputes with the VA over benefit payments are causing financial hardship for some small providers.

“It really makes them question whether they’re going to take more VA patients,” said Diane Haar, founder of advocacy group Hawaii Disability Legal Services. “I had doctors really reach out to me. And let me know that they really are seriously considering not taking veterans anymore. They’ve got one foot out the door already, because they don’t know how to handle this.”

McDonough said claim processing times are improving.

“Right now we’re processing veteran claims faster than ever before. In fact, VA processed 1.7 Million veteran claims this past fiscal year, shattering the previous record, which was the year before by 12%,” he said.

The already taxed VA system is also preparing for a flood of claims from veterans who were exposed to toxins during service over the last 30 years. The PACT Act that President Joe Biden signed into law made them eligible for additional benefits.

Veterans and survivors are urged to apply for toxic exposure-related care and benefits through the VA as soon as possible. Claims will be processed beginning January 1, 2023, and will be retroactive from August 2022. For more information, visit va.gov/pact or call 1-800-MY-VA-411. So far, about 70,000 claims have been filed.

Isaac Nahaku’elua of Hilo is among the 30,000 veterans who live on the neighbor islands. He served in Afghanistan and signed up for PACT Act benefits.

Despite criticism, he says VA services have improved, especially with care now available via telehealth and a VA app.

“I can’t help but to wonder if a lot of the frustrations come from maybe an elderly population... who have to deal with this new technology but it’s super frustrating. I can’t help but to wonder that and if the frustrations lessen as the age goes down with people that are around technology,” he said.

Nahaku’elua said he’s happy with the service and staff at the Hilo VA clinic.

“I’ve been with the VA services here in Hilo since 2008-ish. And I’ve seen the difference in improvement over the years,” Nahaku’elua said. “I’d like to praise Dr. Jesse Maag and his crew at the Hilo Veterans Affairs community behavior outpatient clinic, along with the awesome social workers Kevin Iwasaki, Tricia Kalihiva, Jasmine Kaahanui, and Angie Evans.”

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