A system worth saving, 2010 edition

The American Legion delivered its annual System Worth Saving Task Force Report to Congress this week, compiled from field reports by a Legion task force that evaluated VA medical centers (VAMCs) across the country.

The task force conducted two-day visits at 32 VA facilities this year, focusing on health care for women veterans, mental health care and timely budget appropriations. American Legion national staff members interviewed senior leadership and staff, inpatients in hospitals, outpatients at clinics and family members of those receiving VA health care.

“We don’t conduct these site visits just to find out what problems may exist at a particular VA facility,” said Barry Searle, director of the Legion’s Veterans Affairs and Rehabilitation Division. “We also have extensive discussion with staff and patients in figuring out ways to make improvements for the entire VA health-care system,”

Peter Gaytan, executive director of the Legion’s Washington office, said the System Worth Saving program began in 2003 and was designed, “to make certain that VA’s health-care services and programs are implemented at the local level as intended. We are well aware of all the hard work that Congress and VA put in to ensure that our veterans get access to high-quality health care. But it is also important for us to evaluate how well that effort is being carried out at individual VA medical facilities.”

Following are highlights from the 113-page document’s executive report, written by Michael D. Helm, chairman of The American Legion Veterans Affairs & Rehabilitation Commission:

One challenge the (VA) facilities faced was not receiving the fiscal year 2010 budget in a timely manner. According to the finance officer at the Miami VAMC, during March 2010, the facility had not yet received their FY 2010 appropriations. Additionally, none of the medical centers have received confirmation about their FY 2011 budgets.

Other challenges faced by all facilities visited include lack of facility clinical space for veterans and administrative space for staff, insufficient parking spaces, lack of competitive salaries for recruiting and retention of highly skilled and in-demand medical professionals. The issue of retention has been found to be a problem particularly in the maintenance of trained personnel, which has led to violations of cleaning protocols at several facilities.

However, veterans queried by the (American Legion) national field service representatives and task force members during all the SWS site visits were content with their level of care and treatment at VA.

All the facilities have been affected by increases in enrollment and workload due to the Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF) conflicts and the economy. Veterans are having financial difficulties and are seeking treatment within the VA health-care system. The VA expects to treat over 439,000 OEF/OIF veterans during FY 2011.

“The American Legion is concerned that VHA’s (Veterans Health Administration) priority of giving hiring preference to veterans is not being adhered to by all VAMCs. Within the 32 VAMCs visited, approximately 25 percent of the employees are veterans. In contrast, the National Cemetery Administration reported over a 70 percent rate of veterans on staff, including a mandate that every VA cemetery hire five OEF/OIF veterans per year. Local interpretation and directives vary amongst VAMCs, as some facilities reported high numbers of veterans hired while some ratios were lower.

VA continues to address the issue of rural health care by opening new CBOCs (community-based outpatient clinics) in more rural areas. Clearly, veterans in rural and highly rural areas continue to be underserved…. It can be said, however, that veterans receiving their health care at these facilities expressed their content with the community feel of the CBOCs. Also, the clinics have helped to reduce the cost of beneficiary travel claims within the VA health-care system because veterans can now receive treatment locally.

A common theme throughout the visit cycle was the requirement for additional funding for geriatric care units. It was explained that this increase in funding is necessary because comprehensive care for mental-health geriatric patients has become a major health care-related issue within the VA health-care system.

Long-term care amongst the VAMCs has been increasing steadily over the past three year, yet there appears to be a freeze on beds available versus beds authorized. The American Legion believes this bed availability is directly tied to employment issues and hiring practices, not veteran needs or requirements.

“Progress is being made to change VA health care for a male-centric to a gender-neutral option. However, in some cases due to VA’s lack of gender-specific treatment options, women veterans are experiencing defragmented care. They are forced to seek both VA and private health care to address their unique issues. This cannot be deemed a successful transition from active duty to veteran status.

VA continues to address the need for more continuity of care for women veterans. Each VAMC was mandated to hire a women veterans coordinator, and all of the facilities we visited had adhered to this mandate. Only two of the thirty-two facilities had a stand-alone women’s clinic; however, they all provided a clinical space where women veterans could receive gender-specific care.

The American Legion is very active in volunteering regularly scheduled and occasional hours, as well as donations. The main challenges of this program are streamlining the hiring process and recruitment of younger volunteers…. Despite the difficulties in recruiting new volunteers and improving total hours for the VAVS program amongst all participating organizations, The American Legion had 202 new volunteers and a 7,118 hours increase in FY 2009. In total, The American Legion had 6,307 members that volunteered 916,598 hours in FY 2009, a total cost savings of $18.4 million to VA.

(SWS) is an ongoing effort; throughout the task force visits, we found that even with some of the issues outlined, VA’s health-care system is staffed by dedicated individuals, who are working hard to care for the nation’s veterans and to provide "the Best Care Anywhere."

The entire SWS 2010 Task Force Report should be available by the end of October on The American Legion Web site.


  1. 2 items: (1) The funding of VAMC. I an many others have been under the belief that is was now a matter of law that the funding must be done an in a timely manner. Is this more lies? (2) The influx of newly returned vets. is obviously taxing a system that was already way behind. Personally, I was bluntly told at the Wichita VAMC that "You guys (referring to my age group I suppose), need to realize that you will be in the back of the lines now. I am not saying I agree with this but it is fact." An people actually ask me, "Why did you avoid the VAMC for the past 43 years"? I have never, never asked for anything. Now with my health sliding down, I did ask for help, an boy am I now remembering why I avoided for 43 years. Somehow, I do not believe I am the only one like this.
  2. Been in Flroida to help parents, one who we've lost plus other family members.Success, but cannot help myself with new physical problems mentioned above. Told to wait on incontinence and they may do something surgically. Pain absolutely excruciating, Pain clinic says Aleve the answer, plus wheelchair to help when I fall down. That is it. Told need surgery by neuro-surgeon, but did not say when. Breaking down physically as getting worse, as well as mentally as there are no opinion about condition, let alone 2nd or 3rd. Am at mercy of this hospital with no help in sight. Suggestions. No-one is touching my spine,especailly someone I do not know, and paralysis has been mentioned more than one occassion. I am a big boy and afraid of nothing , til now. Suggestions.Just need answers on condition, surgical possibilities, possibe success, simply some answers to very serios problem. Thats all!- help please.RK
  3. I amhere in Flroida to support il members of family. Had zero prolems with Detroit Dingell VA hospital, treated ike King. Diddrefent story Haley-tampa. Had Mri's take after tremendous pain set in waist down, it showed T-10 through S-1 serious issues. Sfter numerous visists to pain clinic, given apirin. Falling down, told to get Aleve, they reduced meds receiving from Detroit Va by one per day, wanted to put me in rehab from get go. What about four pain clinics in VA system said meds absolutely essential. , excruciating pain, and they give me or waiting on a wheelchair and told to get more aspirin.Know nothing but what I have read from reports received from ROI section. But this is serious, and I am suppose to wait for incontinence til something done. pain does not matter. Here to help family with their problems, but cannot even hel myself with VA system designed to help me. All efforts fruitless and on verge of physical as well as mental breakdown. Thoughts?? Thanks Ron
  4. The American Legion told me I was going to get a call within the next two days on another matter. It's been over 6 months now and I haven't heard from the American Legion. I am wondering how much you care about you veterans or is it just the money you get from us that matters. The Government has charged me with extortion while trying to get my benefits. I was arrested and 2 months after the trial started I received my 100% disability but the government is still pursuing with the trial. They are stooping very low to stop us from pursuing to get our disability. Now, is the American Legion going to make that call to me or is there no help on this.
  5. why is the government charging you with extortion? something had to raise a red flag with the claims you filed, or the evidence you presented. not accusing you just curious.
  6. I was told at the VA hospital in Nashville to get my gall bladder out as soon as possible. I tried to set up an appointment to have it taken out and was told I had to have a stress test done first. The stress test came about 6 months later. This was in March of 2010. It's now the end of September and a date has still not been set to have this gall bladder taken out. I have been in pain from this for almost 2 years now. They are forcing me to go to outside channels to get this operation done.
  7. I would like to get connected with the V.A. that you are talking about.The Care given at the Indianapolis V.A. Med-center does not fit in your description.Needed sugary is promised and canceled and you are left in pain and told to take Tylenol. When I went to orientation at the med center they said once it is determined that you need surgery our policy is that it is done in 31 days or farmed out to other hospitals. I have been waiting 5 months on surgery and two days before it was to happen it was canceled and now they are saying it will be January before it can be done. and that was with the first knee surgery. How much longer will I have to wait for the Second.And in the meantime I am unable to work.You call this good health care ? Oh well ignore this if you want but I am writing my congressman about it along with anybody else I Can find that will Listen. I was told that VA health care was the way to go.But now I find out that all I have is empty promises and NO health care.
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