Letter to Dr. Jonathan Woodson, Assistant Secretary of Defense at the Department of Defense Health Agency - Urges Department of Defense to Make Critical Healthcare Fix for Coast Guard Families in Southwest Washington

Letter

I am concerned about access to health care for Coast Guard families stationed in remote locations in Washington state and Oregon. Last month, I had the opportunity to visit with the remarkable Coast Guard men, women, and families who are currently stationed at Station Cape Disappointment and the National Motor Lifeboat School in Ilwaco, Washington and Sector Columbia River in Warrenton, Oregon. This remote area in the Pacific Northwest is sparsely populated, and the Coasties serving here are often tested by the rough sea conditions and the sheer volume of fishermen and other mariners operating at the mouth of the Columbia River.

Recently, Station Cape Disappointment, the National Motor Lifeboat School and Sector Columbia River were re-designated as Tricare Prime units, a change from their previous designation as Tricare Prime Remote units. This change occurred because the Department of Defense (DOD) now recognizes Sector Columbia River Medical/Dental Clinic as a Military Treatment Facility (MTF). I believe that the Sector Columbia River Clinic is incorrectly listed as a Military Treatment Facility, which is putting an inappropriate and disproportionate burden on the Coast Guard men and women stationed there

The purpose of a Military Treatment Facility is to deliver medical and dental care to all eligible individuals, including active duty, reservists, retirees, and dependents. This is simply not the case at the Sector Columbia River Medical/Dental Clinic--nor will it ever be. The Clinic's 15 member staff offers basic preventative medical and dental services to nearly 800 active duty Coast Guard members in the immediate area. The Clinic does not offer any services for families because there simply is not enough space, staff, or the resources to cover those individuals.

Tricare Prime Remote coverage is critical for families stationed at Cape Disappointment, the National Motor Lifeboat School and Sector Columbia River. Tricare Prime Remote allows for families to utilize private care facilities outside of the Tricare network, an option not extended to personnel covered by Tricare Prime. Tricare Prime Remote also provides incentives to help increase the number of health care providers accepting Tricare patients, which is critical in remote areas like Southwest Washington state where there are few providers to begin with.

I heard from numerous families that nearly all of the primary care providers located near these two units are full and not accepting any additional patients. Families stationed in the area are often referred to other Military Treatment Facilities, located at Madigan Army Medical Center and Bremerton Naval Clinic, which are 137 miles and 154 miles away from away from Sector Columbia River. Due to the rural roads between these facilities and the Coast Guard stations on the coast, the drive time is 2 hours and 36 minutes and 3 hours and 22 minutes without traffic, each way, respectively. Many families simply do not have the time for a six hour round-trip drive to seek medical attention. Families are left to opt for private sector care in Portland, which is 99.7 miles away. However, families commuting to Portland for health care are not offered any sort of travel reimbursement. Based on the DOD's Joint Federal Travel Regulations (JFTR), families are only reimbursed when their medical facility is at least 100 miles away, which at 99.7 miles, Portland is just shy of. Therefore, families are paying the travel costs of commuting nearly 200 miles, round trip, for health care, in addition to any required co-pay. This places an undue financial and personal burden on Coast Guard personnel and their families who are already making sacrifices to serve their country.

I find it hard to believe that Coast Guard members serving in Portland, Oregon, a metropolitan area served by many hospitals, are covered by Tricare Prime Remote, while members serving at Cape Disappointment in Ilwaco, Washington, are not. Its small capacity, limited services, and inability to treat all eligible personnel and dependents prevents the Columbia River Clinic from meeting the definition of a Military Treatment Facility. I urge you to reverse the Clinic's designation so that the families stationed at the Sector, Station Cape Disappointment, the National Motor Lifeboat School, and other impacted units, will qualify for Tricare Prime Remote allowing their families to access health care where they live. In addition, I urge you to update the JFTR to allow for rounding up from 99.7 miles traveled to 100 miles so that families that are forced to commute to Portland for care will be reimbursed for their travel costs.

The lack of Tricare providers in Southwest Washington is negatively impacting the quality of life of Coast Guard families living and serving there. I look forward to discussing solutions with you so we can better serve the men and women of the Coast Guard--and their families--who serve us so well.

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