Senator Ken Salazar
702 Hart Senate Building
Washington, D.C. 20510

RE:  CBOC for NW Colorado

Dear Honorable Senator Ken Salazar

In NW Colorado we are greatly concerned about the health care of our aging veterans.  The presence of a VA facility to care for our veterans is severely lacking and we are in serious need of a CBOC to provide health care for our veterans.  Our counties in NW Colorado, Grand, Jackson, Routt, Rio Blanco, and Moffat are spending a great deal of money annually on transporting veterans to the nearest VA hospital in Grand Junction, CO.  We have all worked together to provide the needed transportation to the VA by writing grants and getting donations from local businesses in NW Colorado.  Although it is not necessarily our responsibility to transport these veterans, it is a needed service, since many cannot drive and others do not have family or friends that can transport them to the VA hospital in Grand Junction, which is an all day trip.  Our aging veterans are required to travel 300-500 miles round trip just to get their health care.  This can be between 3-5 hours one way over winding mountain roads, which can be significantly increased during the winter months because of bad weather.  In addition to bad weather and slick roads our veterans also experience open range cattle, deer and elk migrations that cross the roads endangering their safe travel to the VA hospital.

The long distance to the VA Hospital in Grand Junction to obtain needed health care is taking its toll on many of our aging veterans and it is almost counter productive.  Because of the length of travel to the VA hospital many veterans require several days to recover from the trip.  Those veterans who have diabetes or heart trouble may require a couple of trips a week for blood tests to adjust their medications, which really takes it toll on them.  It would be much easier on the veteran to have the blood tests locally and the VA pay for the test, but the VA will not do this as it costs them money.   It is easier for the VA to inconvenience the veteran to come to the VA for these tests.  Although there is funding for local care in some cases it is extremely difficult to get approval and I don't know of a single case that we have asked for local care that it has been approved.  We have had to send our veteran service officer to the VA and get him qualified to take blood tests and blood pressures to reduce the number of trips to the VA for the veterans.  Why can't the VA coordinate this service with the local hospital or VNA (visiting nurses)?  If we had a CBOC in the local area it would simplify much of the treatment for our aging veterans and reduce their travel time for treatment significantly.

We in NW Colorado want to ensure our veterans receive the health care they deserve and that it is received in a timely manner.  Many veterans are waiting as long as a year just to get an appointment to see a doctor in the VA hospital system, which is unsatisfactory.  Our veterans have served their country honorably and it is time we provide the health care they were promised when they answered the call of our country.

The VA has created many artificial roadblocks that hinder veterans from getting their health care.  They have changed the rules for obtaining health care so many times that it is very difficult for even an attorney to decipher if you qualify and what you must do to obtain treatment at a VA facility.  The ?means test/survey? is a typical example of this.  Veterans who have a combined income of $32,500 are currently not eligible to enroll in the VA care system.  Prior to September 2003 all honorably discharged veterans were eligible to enroll in and receive health care regardless of income.  The country never told us that if we got out of the service and became financially stable that we would not receive our health care benefits.  Between the government and the VA changes over the past decade the veteran has always drawn the short straw and has been told to just suck it up and go on.  It is unconscionable that we should expect a veteran to spend his life long savings for his health care leaving his widow destitute in her waning years wondering what she will have to do to receive the health care she may require.  The ?means test/survey? is another means of denying health care to our veterans, because their assets exceed an artificially determined value set by the government and the VA.  They have also established a time frame on how frequently you must update the ?means test/survey? or once again your health care is denied until it is filled out and submitted to the VA.  Outdated ?means test/survey should never be the determining factor whether a veteran gets his health care from the VA or has to pay for it himself at a private facility.  If you do not see a doctor at a VA facility within a period of two years, once again your health care is denied until you make an appointment and see a VA doctor and if you have an emergency and have to go to a private facility the VA will not pay the bill.  It becomes the responsibility of the veteran to pay the private facility.

At this time I would like to cite 3 recent cases where the Grand Junction VA has failed to provide service or refused payment on veterans.  Four years ago Mr. Ray Wagner was working in Pine Dale and had a heart attack.  He was evacuated to the emergency room in Rock Springs, WY.  The emergency room personnel at the Rock Springs hospital called the VA and ask that he be transferred to the Grand Junction, VA hospital, since he was a patient of theirs.  The Grand Junction VA refused to make the transfer and told them to transport him to Salt Lake City, but not to the VA as they were too busy, but rather to take him to the LDS hospital.  The Rock Springs staff asked them if they would pick up the bills if treated in a private facility, since they had failed to do so on numerous other occasions, and the Grand Junction staff confirmed Mr. Wagner was a patient of theirs and things would be taken care of.  When the LDS hospital and the Rock Springs Hospital billed the VA, they refused payment and said the patient would have to pay his own bills, as the attendant on duty at the time had no authorization to make the decision for Mr. Wagner to be transported to the LDS hospital.  The VA has put Mr. Wagner into a state of poverty trying to pay off  over $50,000 worth of medical bills incurred from his heart attack.  Mr. Wagner contacted an attorney, who contacted the VA to get restitution on his bills and the VA told him they would have to sue them to get it and they could keep it tied up in court for at least 10 years, by which time Mr. Wagner would probably die and they would not have to pay.  This is no way to treat a veteran who has 2 bronze stars for valor and 3 purple hearts from WWII.  The VA has Mr. Wagner classified in Group 5 and with a purple heart he should be at least a Group 3 patient.  They have also failed to give him any service connected disability for his hearing or any of his other wounds, such as shrapnel wounds from artillery, bayonet wounds and other wounds received from close order combat with German soldiers.  Since Mr. Wagner's attorney contacted the VA for payment of his claim the VA has cancelled his appointment in December of 2004 and rescheduled it to January 2005, which was cancelled and rescheduled for March 2005, which was cancelled and rescheduled for April 2005, which was cancelled and rescheduled for August 2005.  The VA should be ashamed of the way they have treated this American veteran who has served his country with honor and distinction during WWII.

Recently, while acting as a volunteer veterans service officer for Moffat County, we referred a patient who was bleeding rectally to the VA emergency room for treatment.  He had his brother take a day off from work to take him to the VA hospital for treatment.  When they arrived at the emergency room the emergency room staff refused to treat this patient, because he did not arrive by ambulance.

Recently we had a patient arrive in our veteran service office who was suffering from chest pains and a tingling in his arms.  We called the VA in Grand Junction to let them know, since he was a patient of theirs.  They said we should take him to The Memorial Hospital in Craig and have him treated.  We sent the patient to the ER where he was hospitalized.   We contacted the VA for authorization per their policy and they told us they would not pay any of his bills because it was not service connected,  he had not seen a doctor in the VA in the past two years and his means test was outdated.  We had this patient come into the office when he got out of the hospital in Craig and filled out a form 10-10 (means test).   We took him to the VA the other day to see a doctor and we were welcomed by a very rude lady, who had to process the form 10-10, who said ? don't walk in here and expect to see a doctor with out an appointment?.  A doctor was walking by at the time and asked what our problem was and we told him the patient had had a heart attack 7 days prior and he took the patient back to his office and examined him, checked his medicine issued at the hospital and had the necessary lab work done and scheduled him an appointment in three weeks.  I think many of the people who work at the VA think it only exists for them to have a job and they have lost sight of their mission, which is to serve our veterans.  No veteran should ever be turned away or belittled when arriving at a VA facility for treatment, because of out dated paper work.

Many veterans realize how busy they are at the VA hospital and if they are feeling okay they don't feel like they should bother the VA by going in for checkups every 6 months.  It is also very inconvenient for veterans to get to the VA when they live 250 miles away.  It is an all day trip and they may not have family or friends who can take them to these appointments.  Many veterans are still working and may have difficulty getting off work all day to make an appointment.  If we had a CBOC in the local area, this would be a real asset to the veteran and he would only have to take off an hour or so for their appointments.  It would also be easier for veterans to find transportation to their doctor appointments.

Several years ago when the VA closed the VA Medical Center at Fort Lyon, CO they put in a CBOC in Lamar, La Junta, Pueblo, Alamosa, Durango and Montrose, which is only 60 miles from the VA hospital in Grand Junction.  There was no consideration given to NW Colorado or NE Colorado to provide health care for those veterans.  It is time we rectify this situation and put a CBOC in NW Colorado.

I shutter to think that this country is not willing to uphold its responsibility to care for the veterans who made many sacrifices to ensure the security and freedom this country and many others enjoy.  Our government thinks nothing of putting soldiers in harms way to protect the rights of people around the world.  We spend hundreds of millions of dollars annually to aid and prop up foreign governments and countries around the world.  Charity should start at home.  At times I think we should give every soldier a Medicare card when he gets out of the service and let him pay the 20% and get his health care where he lives and we could shut down many of our VA facilities saving millions of dollars.  Medicare may not be the best care possible, but it seems to work.

Our government, over the years, has promised our soldiers they would be taken care of if they served their country.  The veterans have fulfilled their duty and responsibilities to our country, it is now time for our country to fulfill its responsibilities to our veterans.  In this country today we take better care of our prisoners who are incarcerated than we do our honorably discharged veterans.  There is a famous quote by Calvin Coolidge that reads ?The Nation Which Forgets Its Defenders Will Itself Be Forgotten?.  We are seeing evidence of this today, as our recruiters are not meeting their quotas.  The youth of this country are very bright and they see that the government has lied to its veterans of the past and they have not taken care of them.  They are not willing to serve this country, knowing full well they will never be taken care either.  If we ask a soldier to stand in harms way we assume a responsibility to him to take care of him in his time of need.  

We in NW Colorado want to ensure our veterans receive the health care they deserve.  It should be received in a timely manner, it should be second to none, and it should be relatively convenient to the veteran, not 3-5 hours away.  Nowhere else in the state of Colorado are veterans required to travel so far or to endure so much to receive their health care.  We value our veterans and their contributions to this country and we would greatly appreciate your assistance in obtaining a CBOC in NW Colorado to service our aging veterans.

     Sincerely,
     Charles G. Watkins
     Lieutenant Colonel
     United States Army (Ret)