Local vets laud, decry Palo Alto VA system

VA leadership, congresswoman answer questions, hear stories at town hall meeting

At a meeting hosted at the Palo Alto VA Hospital Monday, an auditorium full of veterans, their children and spouses spoke candidly to Reps. Anna Eshoo and Jackie Speier and Palo Alto VA Director Lisa Freeman about their experiences with the VA, some lauding the Palo Alto medical center and others decrying long wait times and a lack of communication.

One of the first speakers, whose wife is a veteran, called the Palo Alto VA "a shining example of what the VA system should be." Another man said that in 15 years he's never experienced any wait times. Sandra O'Neill, a former Navy nurse, said she has had three hip replacements within the local VA health care system since 2006 and has received "beyond-call-of-duty kind of care."

"I've gotten just excellent, quality care and timely care," she said. "I'm especially happy that they have a special women's veterans center, and I believe that this medical center pioneered that concept and made it available to women veterans."

Such positive experiences contrasted sharply with those of a man who said he waited 13 months to get an appointment so instead sought outside treatment; a Marine Corps veteran who said he waited six years for a hip replacement and called the process "inhumane"; a Vietnam War veteran who has been coming to the Palo Alto VA for 20 years and criticized the Patient Advocacy Program as "a listening post and not an action post."

Director Freeman acknowledged the institution's difficulty with wait times, processes and "a culture of compliance." She said the Palo Alto VA Health Care System in May had two groups of more than 20 veterans on electronic wait lists, which are designated for those who have waited for more than 90 days for care. The two groups were neurosurgery and dental, with more than 200 veterans waiting for dental appointments. Freeman said the entire neurosurgery backlog has been worked down to zero, but she would only say that the VA had reached out to almost all of the patients in need of dental appointments and knew that fewer than 70 had not been seen yet but were on track to receive care.

Freeman also admitted that Palo Alto VA's scheduling software, now 30 years old, is antiquated and must be updated. She also acknowledged the need for an updated, state-of-the-art phone system but said a limited budget and government-imposed red tape make it difficult for individual VA's to make necessary purchases, however large or small.

Another common concern raised was communication. One man, speaking for his father, a 90-year-old World War II veteran, said his father was not aware of the full spectrum of services he could access at the VA. He said he lost his hearing the Battle of the Bulge in the mid-1940s and spent "thousands of dollars" on hearing aids and treatment at local clinics because he didn't think the VA would cover his care.

"(Veterans) don't like talking about what happened in the service," he said. "They're very proud. They think they can take care of themselves. ... I have never seen an effort by the VA to let the veterans, whether it's the older veterans or the new veterans, know of all the things that are available for them."

Freeman said she completely agrees that the VA needs to improve its outreach efforts, though she did not offer specific remedies.

"We could do a much better job of advertising what the VA offers and who it offers it to," she said. "I have had the same experience with my uncles who are both World War II veterans (and) who just thought the VA is for anybody but them."

Speier and Eshoo, sitting at a table at the front of the room next to Freeman, continually probed the VA director on the hospital's efforts to reach homeless veterans, its funding challenges and the division between internal and external care, among other issues raised. Eshoo said all the processes need to be more "seamless" and reflect how patients live their daily lives and need health care.

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Posted by Wayne Martin
a resident of Fairmeadow
on Jul 8, 2014 at 3:51 pm

Quite a lot was said at this meeting, but it was clear that the VA was not being all that open with its internals performance, or budget data, at this meeting—or on its web-site.

> but said a limited budget and government-imposed

At one point, Director Lisa Freeman said that “this is a 900 million dollar facility”—suggesting that it’s yearly operational funding was 900 million dollars. So, that seems like a lot of money. There were frequent hints about “money”, or funding issues, but no specifics. One comment suggested that the VA needed to be able to pay its California people more than those in the Heartland, but not details were provided.

The following link is to a web-site that tracks Federal government salaries:

Web Link

The top earner for 2013 for California is employed by the Palo Alto, VA.

There are a few job descriptions on the Palo Alto VA Hospital Web-site, offering salaries.

We know that in most government situations, salaries/benefits consume about 85% of the budgets. Is the same true at the VA?

Nationally, about 20% of the VA employees make more than $100K (out of 342K employees), and about 18,000 of these people make more than $180K. Assuming that most of these high earners are doctors—it would seem past time to begin to review their productivity records to see what were are getting for our money. Director Freeman hinted that the VA was not doing a very good job in this area—but didn’t pursue the topic very far.

As to the Administrative side of the operation—it’s likely that we will never come to know who exactly was making the decisions that has caused these problems to exist.

The issue about old software seems to pop up at other facilities, and would seem to be strictly and administrative issue—since it stands to reason that the VA would want all of its important internal systems to be the same. The scheduling software issues (called VistA), are described briefly at the link below:

Web Link

One bit of data worthy of note was found on the VA (National) web-site for 2013:

Number of enrollees: 8.9M
Number of Outpatient Visits: 86.4M
Number of Inpatient admissions: 694K

All-in-all, this is a big system, and it’s not clear that those in charge have done the job for which we have paid them to do. Perhaps we have been lucky here at the Palo Alto VA, but the same can not be said for other facilities around the country.

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Posted by Nora Charles
a resident of Stanford
on Jul 8, 2014 at 5:18 pm

Nora Charles is a registered user.

My heart goes out to the WWII veteran who lost his hearing in the Battle of the Bulge. This gentleman's hearing aids and all other healthcare needs should be a top priority of our country. What his son said is so true, as I know firsthand; they are proud, independent men who have absolutely no sense of entitlement. Hats off to him, and all of America's vets. They deserve the best, and anything less is shameful.

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Posted by Clueless
a resident of Another Palo Alto neighborhood
on Jul 8, 2014 at 5:18 pm

One of the biggest problems in medical and mental health care for vets today is that it is IMPOSSIBLE for a non-combatant. To even imagine what a soldier suffers.

Part of this is because the vets themselves can't tell us--some because they cannot find the words, some because they cannot even formulate the words without breaking down and weeping inconsolably.

They quite literally suffer hell on earth, in fear of death every minute, watching close companions die unspeakable deaths--sometimes while being splattered with the very blood of these companions. Eating rations left over from wars fought decades before. Wearing boots so long without removing them that the socks inside begin to rot ( along with the flesh underneath). Finding the remains of trees and shrubs decorated with human limbs and organs after an explosion. Having to pick through human remains to find some sort of identification. Trying to save the lives of a new mother and baby shot repeatedly by the Taliban. Having sleep disrupted, when they get to sleep, by a car loaded with explosives crashing into the front gate of the base, on an almost nightly basis. Being comatose after surviving an IED. Then awakening in the hospital to find out you will NOT get a medical discharge, but returned to duty in two weeks.......

I doubt that if we really understood what our vets have gone through, that we would stand by and allow them to be treated in such a shabby way, as the VA, it's programs, and it's medical facilities do. They should be asking themselves, "How can we even begin to repay them for their suffering, their losses, and the trauma and sorrow they will feel for the rest of their lives?"

The truly tragic part of all this is that, more often than not, these men and women sacrificed so much in vain.

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Posted by SteveU
a resident of Barron Park
on Jul 8, 2014 at 7:35 pm

SteveU is a registered user.

How can the VA solicit patients with Non-combat related conditions when they can't even handle those with Combat related issues.

An IED takes seconds to maim, not 16 WEEKS to get a care appointment.

I for one, will NOT take 1 minute away from those in need even though I am 'entitled' to use the system.
Mr President: You and you crew sent those people into harms way, at least you can use the same SPEED in care delivery.

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Posted by Darryl
a resident of Downtown North
on Jul 8, 2014 at 8:41 pm

Software was cited as a reason for the wait problems, however whistleblower protection was never mentioned by the Director or Congresswomen. Unless staff are protected from retaliation,the problems will not be reported at the VA Palo Alto.

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Posted by SNAFU 100% DV
a resident of Los Altos
on Jul 9, 2014 at 8:03 am

[Post removed.]

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Posted by SNAFU 100% DV
a resident of Crescent Park
on Jul 9, 2014 at 8:39 am

[Post removed.]

Sorry, but further commenting on this topic has been closed.

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