Prentiss Carl Haupt and Mitch Slraggerberg
on Behalf of the
Vietnam Veterans of Maui County
Committee on Veterans' Affairs
Dear Chairman and Members of the Committee:
Thank you, Senator Akaka, for convening this session. We are proud of our VA facilities and staff on Maui, and grateful for your swift action when our clinic had no doctors, and arrangements were made for the veterans' health care on Lanai. We appreciate this opportunity to testify today about health care for veterans on Maui.
VA Community-Based Outpatient Clinic
When Senator Inouye dedicated the Maui CBOC, he said this clinic will be our model clinic for the nation. Is our clinic still fulfilling Senator Inouye's and Senator Akaka's vision? I don't think so. Two issues, about quality of care have come to our attention. The first is equipment and the second is staffing.
We are now losing our optomologist because he is not provided with even the most basic equipment to do his job. Where is the. retina machine Dr. Hastings said was in the warehouse back in March?
A VA cardiologist comes for examinations on Maui. He doesn't have proper equipment at the clinic. Why are we wasting his time and our money?
Why does our clinical staff continue to have to work evenings and Saturdays, with no extra pay, just to get caught up on their paperwork? The Washington Post brought attention to the problems with records transfer between the Department of Defense
Vietnam Veterans of Maui County 8/23/2007
Statement to Committee on Veterans' Affairs p. 2
and the Veterans Administration but VA staff in Hawaii have been c ping with it ever since the cooperative agreement with Tripler was signed, even before 9/11. It is contributing heavily to staff burnout and turnover.
There are approximately 600 people on the CJ3OC waiting list who are not yet able to get VA care. These people are paying as much as $600-$800 per month for their maintenance prescriptions; their VA co-payment would be about $35. Many of these veterans are our oldest and most distinguished World War II and Korean veterans.
According to a 2004 study sponsored by the VA Health Services Research and Development Service, "...about one in seven VA pharmacy outpatients fit a definition of having only a small number of outpatient visits annually with a relatively :Large pharmacy cost. This number was 10 percent of VA patients. The budget impact of this 10 percent was only about 1 percent of medical care appropriations."'
Many people seem to forget that because of these great men who fought in World War II, Korea and many other conflicts, we have the greatest democracy right now. What can be done right now to alleviate this terrible financial burden on our oldest, most distinguished heroes?
When will we get the necessary staff and equipment to properly fulfill the Maui clinic's promise?
We have heard enough off-the-record comments about the quality of care in Hawaii to believe that outside Congressional-level investigators should interview past and present VA clinicians to get an accurate picture of our veterans' care.
We need the psychologist we've been promised. So far no luck on filling this gravely needed position. What can be done about incentives to get the proper staff? We hear the same concerns about money from all the applicants. Even with the 25% COLA, our housing, food and gasoline are among the highest priced in the nation, discouraging many applicants who see themselves going financially backward if they come to Maui.
Zhu, Gardner and Hendricks, 'Just How Many Enrollees Come to VA Just for Pharmacy?" HCFE Data Brief #2004-10, p. 2, VA Boston Health Care System Research and Development, Health Care Financing and Economics, funded by HSR&D SDR 97-001-01
Vietnam Veterans of Maui County 8/23/2007
Statement to Committee on Veterans' Affairs P. 3
Hawaii State Office of Veterans' Services
The Office of Veterans' Services, although it belongs to the State of Hawaii and not the Federal government, has long been instrumental in helping our veterans receive the benefits and care to which they are entitled, The Maui office no longer has a councilor and is being covered one day a week by someone from Oahu.
As of June 30, 2007 the State councilors' offices had the following number of office visits with the following level of staff:
3 councilors, 1 clerical
1 councilor, 1 clerical
1 councilor, 1 (unfilled) clerical
1 councilor (unfilled), 1 clerical
Oahu has more telephone and outreach presentation contacts, which of course is due to the large active duty population on the island. The other islands have fewer active duty residents-in the case of Maui, almost none. Their councilors work intensively with their clients on a one-on-one basis, almost always on specific issues involving veteran's benefits or health care.
With the departure of the Maui councilor, Mr. William Staton, and the beginning of the new fiscal year, the office needs a permanent full-time hire right away. We know 2 fine candidates now working full time at other jobs. One of them would probably fill the position but who would quit a permanent job for a temporary position?
The Maui Office of Veterans' Services is a vital part of the infrastructure supporting Maui veterans and is in danger of being overwhelmed. The demand for their services, like the Veterans Administration's, will only increase as our soldiers come home after fighting in conflicts for far too long,
We believe that Maui and the Big island each need 2 councilors and 2 clerical staff-instead of a multi-year supply of grave liners for the state cemeteries. How do we get this changed and these very important community positions filled as soon as possible?
The VA needs to supplement volunteer staff to drive the van. Lack of staff has led to clinic transportation difficulties for handicapped and infirm veterans,
Vietnam Veterans of Maui County Statement to Committee on Veterans' Affairs
8/23/2007 p. 4
Mr. Chairman, we believe the problems we've recently encountered on Maui are largely logistical and administrative, but magnified by cost and distance. As such, they are a barometer of VA health care efficiency in far flung, rural areas. Our clinicians are very dedicated, but the weather is stormy.
Thank you for this opportunity to testify about veterans' health care in Maui on behalf of the Vietnam Veterans of Maui County. We also thank the Committee for its continuing support of the nation's veterans.
Vietnam Veterans of Maui County Statement Committee:
Mitch Skaggerberg Michael Covich Theresa Garcia
Tilliam Staton Francine Atwell Prentiss Carl Haupt
Table of Contents