Dear Secretary Shinseki,
Many of our nation's brave veterans call New Hampshire's rugged and rural North Country home. As you testified at an April 23, 2013, Senate Budget Committee hearing, veterans who live in rural areas can and should expect to receive the same quality health care as those who live in urban settings. The VA must fully honor its commitment in New Hampshire's North Country, and I ask you to help rectify health care access shortcomings which veterans continue to face in rural parts of the state.
As I have brought to your attention in the past, our North Country veterans must frequently travel more than 130 miles in order to receive medical care. Depending on conditions, this trip can take two to three hours. The nearest Community-Based Outpatient Clinics (CBOCs) are in Littleton and Conway, NH, requiring a one to two and a half hour drive each way. During inclement weather and winter conditions, the driving times are much longer and travel more hazardous. If veterans from the North Country choose to go to the Manchester VAMC, they still face a 150-mile trip.
In a May 24, 2013, letter to me and other members of the New Hampshire delegation, you acknowledged that "The geographic challenges and absence of general health care services in the Colebrook region pose a potential gap in care access for Veterans in the region. The White River Junction VAMC is committed to providing enhanced access for Veterans residing in the north market..."
To rectify this gap in care for our veterans, in a July 5, 2012, letter you stated that "the White River Junction leadership team is considering establishing a telehealth site in the Colebrook area." In a November 5, 2013, letter, you stated that VA officials were "working on an access plan for their entire catchment area to ensure access standards are met." You also mentioned several trips that VA officials have made to Coos County "to seek opportunities to better serve local Veterans."
While I welcome these statements and commitments, to date, North Country veterans have not seen significant and tangible progress in the quality of health care. To improve the care provided, I ask you to answer the following questions:
1) From a VA perspective, please describe in detail the "potential gap in care access" that veterans in the North Country confront that you described in your May 24, 2013, letter.
2) What metrics does the VA use to judge access standards? Please provide all standards and metrics that are considered and how the North Country compares to national averages and other similar regions.
3) Please provide a copy of the "access plan" that you referenced in your November 5, 2013, letter.
4) In the last two years, based on your May 24, 2013, letter, how has the VA "enhanced access for Veterans residing in the north market..."?
5) What is the status of the VA's effort to establish a telehealth site in the Colebrook area?
6) What is the status of the VA's efforts to establish a health contract agreement with a Federally Qualified Health Center in the North Country such as Androscoggin Valley Hospital?
7) Has the White River Junction VAMC considered working with Androscoggin Valley Hospital to provide inpatient services for North Country veterans? Please provide an update on this effort.
Thank you for your service to our nation on behalf of our veterans. I look forward to working with you to ensure the veterans in New Hampshire's North Country have the health care they have earned.