Veterans get timelier care in the Capital Region than in other major upstate New York metros, but wait times are still longer than local officials would like.
More than 1,500 patients across the region — 1,558 to be exact — had to wait more than 30 days for nonemergency care from the Samuel S. Stratton VA Medical Center in Albany from September 2014 to February 2015, according to an Associated Press analysis of government data.
The U.S. Department of Veterans Affairs has been auditing and reporting monthly data on the timeliness of medical appointments at its facilities following last spring’s scandal over widespread manipulation of wait-time data. Officials within the Veterans Health Administration had been gaming wait list data for years to make their numbers look better than they were, contributing to dozens — possible hundreds — of veteran deaths from lack of timely care.
By the numbers
The data below was compiled by The Associated Press using government data from September 2014 to February 2015. The VA clinics in Clifton Park, Fonda and Schenectady are community-based outpatient clinics within The Gazette’s coverage area.
Samuel S. Stratton VA Medical Center (Albany)
Total appointments completed: 112,314
Care delayed at least 31 days: 1,558
Percent delayed at least 31 days: 1.39
Care delayed 31-60 days: 1,139
Care delayed 61-90 days: 309
Care delayed more than 90 days: 110
Clifton Park VA Clinic
Total appointments completed: 2,040
Care delayed at least 31 days: 17
Percent delayed at least 31 days: 0.83
Care delayed 31-60 days: 15
Care delayed 61-90 days: 1
Care delayed more than 90 days: 1
Fonda VA Clinic
Total appointments completed: 1,610
Care delayed at least 31 days: 5
Percent delayed at least 31 days: 0.31
Care delayed 31-60 days: 5
Care delayed 61-90 days: 0
Care delayed more than 90 days: 0
Schenectady VA Clinic
Total appointments completed: 2,311
Care delayed at least 31 days: 2
Percent delayed at least 31 days: 0.09
Care delayed 31-60 days: 2
Care delayed 61-90 days: 0
Care delayed more than 90 days: 0
In a report out today, the AP analyzed six months of statistics gathered just after the VA introduced a new methodology for calculating delays and after Congress approved an extra $16.3 billion for the VA to attack the problem by hiring more doctors, opening more clinics and expanding a program to make it easier for vets to get care outside the VA system.
The data shows the Capital Region outperforms both the nation and a half-dozen upstate metro areas when it comes to the percentage of VA appointments completed outside a 30-day window. From September to February, 1.39 percent of 112,314 total appointments failed to meet the VA’s timeliness goal, which calls for patients to be seen within 30 days for all nonemergency care.
That’s better than places like Watertown (5.24 percent), Syracuse (4.46 percent), Binghamton (3.53 percent), Poughkeepsie (3.42 percent), Buffalo (2.05 percent) and Rochester (1.53 percent). Nationwide, 2.78 percent of appointments were completed beyond the 30-day window.
“Upstate New York does very well,” said Peter Potter, a spokesman for the Stratton VA in Albany. “New York as a whole does very well. But the biggest challenges we have are problems you’ll find in the private sector just as much, if not more.”
These problems include a nationwide shortage of physicians and high demand for specialty doctors. At the Stratton VA, appointments to diagnose sleep apnea or treat gastrointestinal issues might take a long time to book for want of specialists who deal in sleep disorders or can perform scope procedures, Potter said.
“We just hired a dermatologist, and something like that is a big win for us,” he said. “If you try to get a dermatology appointment at a private facility as a private citizen, you’ll find yourself waiting three to nine months because the pool of doctors and nurses who work in these specialties is just very small.”
Potter also said no-shows and cancellations inflate wait times it reports to Washington. Patients who are scheduled for a colonoscopy every 10 years might forget their once-a-decade appointment or decide it’s not so urgent to keep when family is visiting from out of town, he said. Many appointments are canceled during cold, snowy or otherwise miserable weather and rescheduled for another time, also inflating wait list numbers, he said.
The VA changed its delay-reporting methodology in August to adjust for these no-shows and cancellations. The new system measures waits based on something called the “preferred date,” either the date the veteran wants to be seen or the date deemed medically necessary by a provider. This methodology change makes it difficult to compare statistics reported after August to those reported just before the scandal in Phoenix broke last spring, but VA officials say it will paint a more accurate picture of delays.
One of the developments that has helped the Stratton VA cut down on wait times is telehealth, the delivery of health care using telecommunication technologies like high-definition video. Aside from its main facility on Holland Avenue, the Stratton VA oversees veteran care across a large swath of eastern New York through 11 community-based outpatient clinics in areas as far north as Plattsburgh, as far south as Kingston and as far west as Chenango County. About 40 percent of Stratton’s annual visits are at these clinics.
“Telehealth is huge for us, because if we have somebody up in Plattsburgh or Malone, it takes them three to four hours to get to Albany,” Potter said. “If you think about it, you can drive that long to come see our dermatologist only to have them tell you to come back another time so he can freeze something off. With telehealth, we have high-def cameras that can eliminate that first trip right out the gate.”
After last year’s scandal, the Stratton VA was one of hundreds of medical facilities across the country to hold town hall-style meetings that urged patients and the public to come out and air any grievances or concerns they might have about veteran care in their local communities. Most comments from the local public praised the center.
Perhaps nothing is more telling of what patients think of care at Stratton, Potter said, than the number of participants in the new VA Choice Program, which pays for eligible veterans to receive care outside a VA setting rather than waiting for a VA appointment or traveling to a VA facility. Designed to ease wait times, the program launched in November and has so far only seen light use locally.
“We identified 658 veterans who qualified, and only four of them requested to go outside the VA for an appointment,” Potter said. “One came back and decided to stay with us after he saw what the wait list was like on the outside.”
Stratton VA officials have declined to comment on an ongoing investigation by the U.S. Office of Special Counsel into allegations made last year by one of their nurses alleging mistreatment of patients, stolen drugs, undelivered prescriptions, dirty bathrooms and whistleblower retaliation.
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