It was enlightening, and helpful, to have Veterans Affairs Secretary Denis McDonough in town recently, to air the range of health-care issues faced by veterans in Hawaii. But it also was dispiriting to hear of frustrations faced on many fronts.
Difficulties in access to care, which can be severe in an island state. Serious staffing shortages across the VA system. Billing snafus for care, which have led some practitioners to quit treating veterans.
“Health care of all kinds is in short supply throughout the Pacific islands and Hawaii,” McDonough acknowledged, during a congressional field hearing last week chaired by U.S. Sen. Mazie Hirono at the Oahu Veterans Center.
It was one thing to hear of care gaps; it must now lead to improvements. The Oahu-based VA Pacific Islands Healthcare System serves about 100,000 veterans in Oahu and 30,000 on the neighbor islands, as well as those in the Pacific island territories of American Samoa, Guam and the Commonwealth of the Northern Mariana Islands.
Among the key issues:
>> The alarming increase in suicides among U.S. veterans, roughly 6,000 in 2020. “Suicide prevention continues to be our No. 1 clinical priority,” McDonough stated.
Pacific Islanders served in the Iraq and Afghanistan wars in particularly high numbers — and during the hearing, Hirono cited statistics showing that Asian American and Pacific Islander veterans have the highest suicide rates of any demographic. It’s hoped that a $1.5 million VA study on the issue in Hawaii will bring meaningful help to combat this.
>> Billing disconnects between the VA’s claims contractor here and its ecosystem of community clinic partners. Hassles over reimbursement discrepancies have caused private-sector providers to rethink veteran patients, narrowing options for care. Better, proactive guidance on proper billing procedures would lead to a more-efficient and less-contentious process.
>> Staff shortages that hinder the VA system. About 45,000 nurses need to be hired nationwide over the next three years — and Hawaii isn’t immune. “One thing we have to do better on, and this is squarely on me, we have to hire faster, onboard more quickly and get them providing care,” said McDonough, adding that the new Retention and Income Security Enhancement Act gives the VA more options for raises and bonuses.
Many eyes, and high hopes, are on a new clinic in Leeward Oahu named after the late U.S. Sen. Daniel Akaka, due to open late next year.
But a new building alone won’t equate to quality health care. Given the current problems with staffing, the VA Pacific Islands Healthcare System should be strategizing now to get medical talent in the pipeline to expand and optimize care — there on the Leeward side, and at its flagship Tripler Army Medical Center.
