SPOKANE VA CUTS BACK HOURS AT URGENT CARE UNIT --

24-hour service cut to just 8½ hours -- Local veterans angry --

Cutback draws scrutiny from U.S. Senator.

The Spokane, Washington VA is cutting back the hours of their Urgent Care Unit...from a 24/7 operation to just 8½ hours a day!

This is a bad move that will severely impact veterans.

I recently interviewed the Director in Spokane who justified this move by saying he was using resources where they were needed...during the daytime.

However, this does not address the problems veterans will now face.

Veterans will now have to triage themselves during off hours...having to decide whether their health problem is serious enough to require immediate care.  This is where mistakes are made.  This is exactly why a 24/7 service is needed.

If a veteran decides immediate care is needed, then they will have to call an ambulance and go to a "civilian" medical facility.  The veteran will have to pay for this service and then seek reimbursement from the VA.  The veteran MAY be reimbursed if they meet a long list of qualifications...and, even then, reimbursement may not be at 100%.

And, the reimbursement process is so slow that if the veteran waits to pay the ambulance and hospital, hoping the VA check is in the mail, their bills could end up in the collection process.  So, the only way to avoid this is to pay out-of-pocket and hope the VA check comes in.

There is no good reason for this change because Spokane has the personnel to run the Urgent Care Unit 24/7.

Now, this change has caught the attention of Senator Maria Cantwell (D-WA) who wants some answers.

We have a news story and information from Senator Cantwell's web site.

Story here... http://seattlepi.nwsource.com/local/6420AP_WA_Cantwell_VA_Spokane.html

Story below:

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Cantwell questions VA over Spokane urgent care cuts

By NICHOLAS K. GERANIOS
ASSOCIATED PRESS WRITER

SPOKANE, Wash. -- A sharp reduction in urgent care hours at the Veterans Affairs hospital in Spokane has drawn the attention of U.S. Sen. Maria Cantwell, D-Wash.

Cantwell sent a letter to VA Regional Director Max Lewis asking why urgent care hours had been cut from 24 per day to 8 1/2 per day at the beginning of July.

"I've heard from concerned veterans in Eastern Washington who worry that under this plan, they will no longer have affordable access to the care they may need in an emergency," Cantwell said Wednesday.

A spokeswoman for the hospital said a lack of business prompted the change.

"The numbers dropped significantly after 6 p.m.," said Jane Schilke, spokeswoman for the hospital. "We were seeing four to six people from 6 p.m. to 8 a.m."

The urgent care center is for relatively minor medical cases, Schilke said. It is not set up as an emergency room for serious injuries, she said. There are no laboratory or X-ray facilities and no trauma surgeon on call, she said.

The VA sent letters to some 23,000 clients announcing that the center would be open from 8 a.m. to 4:30 p.m., rather than 24 hours a day, starting July 1, Schilke said. About 40 replies were received, she said.

The VA will pay for emergency room visits for veterans for service-related conditions, or those who have no other insurance, she said.

Medical care for veterans is a touchy subject in Eastern Washington. The VA in recent years has proposed closing or altering the VA hospital in Walla Walla. The exact fate of that facility is still not clear, although the VA says it will not close it down.

Cantwell, who faces a tough re-election fight this year, said veterans deserve medical care.

"We need to make sure these brave Americans who have given so much for our country always have access to quality health services, including urgent care," she said in a news release.

In her letter, Cantwell asked the VA to explain the changes in detail, outline potential effects of the plan on area veterans and describe how veterans would get urgent care after hours.

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Senator Cantwell's concerns here... http://cantwell.senate.gov/news/record.cfm?id=259710

Printed below:

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Cantwell Concerned by Move to Reduce Emergency Health Services for Eastern Washington Veterans

Senator demands answers following VA move to end 24-hour urgent care services at Spokane hospital

Wednesday, July 26,2006

WASHINGTON, DC – Wednesday, U.S. Senator Maria Cantwell (D-WA) expressed concern with a Department of Veterans Affairs (VA) plan to drastically reduce urgent care operating hours at the Spokane VA hospital. Under the proposal, Spokane urgent care facilities, which until recently were open 24 hours a day, would only be open from 8:00 AM to 4:30 PM. Cantwell is sending a letter to the VA asking for specific details on the reductions and an explanation of how the VA plans to continue quality urgent care services to veterans under the plan.

“I’ve heard from concerned veterans in eastern Washington who worry that under this plan, they will no longer have affordable access to the care they may need in an emergency,” said Cantwell. “We need to make sure these brave Americans who have given so much for our country always have access to quality health services, including urgent care. I will continue to push for clear answers from the VA to make sure that veterans have access to the care they were promised.”

In a letter sent Wednesday to the VA, Cantwell expressed her concern with the plan to reduce urgent care services and asked the VA to provide answers to a list of specific questions. In her letter, Cantwell asked the VA to explain the proposal in detail, outline potential effects of the plan on area veterans, describe how veterans would receive and be compensated for needed urgent care outside of the new proposed hours of operation, and detail how the agency planned to make veterans and veterans organizations fully aware of the plan.

[A copy of Cantwell’s letter to the VA follows below]

July 26, 2006

Dear Mr. Lewis,

Several veterans from the State of Washington have contacted me about the recent announcement to reduce the hours of operation for the urgent care facility at the Department of Veterans Affairs (VA) Medical Center in Spokane. Given their feedback, I am concerned about the potential impacts of this reduction in urgent care service availability on veterans in the Inland Empire and other significant impacts on health care delivery capacity in the region.

As I understand it, the VA recently announced that it would be reducing the operating hours for the urgent care facility at the Spokane VA Medical Center, which operated around-the-clock before the change. Following the change, urgent care facilities will only be available between 8:00 AM and 4:30 PM. While we need to use limited health care resources in the most efficient and effective way possible, numerous veterans in the region have contacted my office expressing concern about the reduction in urgent care hours and the process by which they were informed.

Providing adequate care for our nation’s veterans is obviously at the core of the VA’s mission. Further, the VA’s decisions regarding the availability and breadth of services the agency provides obviously affects veterans and other health care providers in the surrounding community. With that in mind, please provide your written responses to the following questions:

+ Can you please confirm the changes that have been made to the operating hours of the Spokane VA’s urgent care facility? + Can you please describe how the facility operated prior to the change? + If veterans need urgent care outside of the operating hours of the Spokane VA facility, will the VA reimburse veterans or the health care providers for urgent care services? If there are conditions on the reimbursement of veterans for urgent care services, please explain those conditions. + How did the VA consult with other urgent care providers in the Inland Empire about the impacts of the change in urgent care operating hours at the Spokane Medical Center? + Did the VA consult with representatives from Veterans Service Organizations about the potential impact that the reduction in operating hours for the urgent care facility in Spokane would have on veterans? + Is the VA confident there is adequate available capacity elsewhere to provide urgent care outside the new operating hours at a comparable cost to affected veterans? + How has the VA worked to inform Veterans Service Organizations and individual veterans about the change?

I know we both believe that providing care for our nation’s veterans is an important responsibility of the federal government. I look forward to your timely responses to these questions.

Sincerely,

Maria Cantwell United States Senator

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Larry Scott

(go back to VA Watchdog dot Org Home Page)

	Web www.vawatchdog.org

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