Jaime Herrera Beutler today called on the local VA to explain the real reasons for why its mobile medical units are not serving rural veterans, and they are sitting unused for up to 25 days out of each month.
Jaime began requesting that the Puget Sound Region's mobile medical unit start serving rural veterans in Southwest Washington in 2012. These units are supposed to provide basic care, such as prescriptions and flu shots, to veterans in remote and rural areas.
Since then, the response from the VA's local unit has been a comedy of errors. At least, it would be a comedy if basic health care for rural veterans wasn't suffering as a result.
As recently as last week, the Veteran Integrated Service Network (VISN) 20 -- the VA's regional management unit -- had been issuing excuses to Jaime Herrera Beutler's office that conflicted with previous explanations. Some explanations were internal communications that appear to be sent unintentionally, and others were quickly recalled by the VA.
VA: No idea how many units exist or how much they cost
In May, as a result of Herrera Beutler-authored legislation, the VA's Office of the Inspector General issued a report stating that the VA didn't know how many mobile medical units it possessed, how many veterans they had helped, or their operating costs. Even worse, the VA couldn't demonstrate whether the $29 million they have spent on mobile medical units had increased rural veterans' access to health care. Some units, such as the Puget Sound-area unit located in American Lake, sit unused for up to 25 days a month.
"Calling the management of these mobile medical units a mess would be an understatement," said Jaime. "At best, the VA's coordination of these units has been grossly incompetent. At worst, the conflicting excuses I've been given for the lack of action suggest intentional manipulation of information. In light of the other issues the VA needs to address, I would hope it would finally respond to this problem with transparency and accountability. Instead, I've seen the "sweep the problems under the rug' approach continue.
"For two years I've been urging the VA to better utilize this resource, and this week, VA Acting Secretary Gibson pledged to deploy Mobile Medical Units to increase access to VA health care," Jaime continued. "While I'm hopeful that they will follow through on this promise, I'm going to keep them accountable for identifying the real reasons these units are sitting idle and ways they can fully utilize them to get care to those veterans who need and deserve it."
Timeline of Jaime Herrera Beutler's efforts to get Mobile Medical Units deployed to Southwest Washington:
November 2011 -- At Jaime's Chehalis Veterans Resource Fair, a VA health care provider informed her about the Puget Sound mobile medical unit. The provider's request to take the mobile medical unit to a coastal community to administer flu immunizations had been denied.
Early 2012 -- Jaime made inquiries to the Washington State Department of Veterans Affairs, the VA Congressional Liaison, and then connected with Veteran Integrated Service Network (VISN) 20, WA, OR, ID, AK.
July 2012 -- Jaime sent a letter to VISN 20 Acting Director Michael Fisher asking for the mobile medical unit to come to rural areas in her district.
August 2012 -- Acting Director Fisher sent a formal letter response citing staffing challenges and mechanical problems as the cause of the Puget Sound's mobile medical unit scarcely being utilized for 2.5 years.
January 2014 -- Jaime's legislative provision requesting an independent report on mobile medical unit utilization, efficiency, and cost effectiveness is signed into law.
May 2014 -- Report comes back with alarming findings. The VA didn't know how many mobile medical units it had, how many veterans were being served, or how much they cost to run. Jaime supported the improvement recommendations included in the report.
June 2014 -- Jaime again requests to have the Puget Sound mobile medical unit serve rural communities in Southwest Washington. VISN 20 staff cites electronic health records not being able to interface as the reason it cannot serve the region.
June 2014 -- Jaime wrote a letter to VA Acting Secretary Sloan Gibson regarding wait times and urged him to consider expanded use of mobile medical units. She also asked for the mobile medical unit to visit her district, and that she had been told the problem was that the electronic health systems not being able to interface.
July 8, 2014 -- VISN 20 staff accidentally sent internal working notes. An excerpt from the note, apparently instructing VA staff on how to construct the response:
"The Congresswoman only wants to know why we can't send the MMU to Portland to help out, the reason it is too expensive and Puget Sound needs it up there and back that up with data."
July 8, 2014 -- VISN 20 recalls the previous message, and states via email "It is not too expensive."
July 9, 2014 --VISN 20 staff sends the July 9 communication, and states:
1. It is not an IT issue that prevents the MMU from treating veterans in our district, and any suggestion that it was was a miscommunication.
2. That the Mobile Medical Unit has been consistently been deployed at full capacity.
July 9, 2014 -- VISN 20 staff recalls the prior communication.
July 16, 2014 -- VA News Release states "VHA facilities are adding more clinic hours, aggressively recruiting to fill physician vacancies, deploying mobile medical units, using temporary staffing resources, and expanding the use of private sector care."