Legion works with VA to reopen clinics in Puerto Rico

Legion works with VA to reopen clinics in Puerto Rico

Veterans in Puerto Rico have been denied access to urgent-care clinics because of a technical issue over the naming of the facilities.

Each urgent-care clinic is part of a Department of Veterans Affairs CBOC (community-based outpatient clinic). According to the VA Central Office in Washington, urgent-care clinics cannot be housed in CBOCs.

Subsequently, the urgent-care clinics were shut down. Notices were posted that say “urgent care services cannot be provided” at the CBOCs, and that “urgencies and emergencies will be referred to the nearest emergency room.”

Last week, an American Legion team of health-care experts visited Puerto Rico and learned of the clinic shutdowns. Michael D. Helm, national commander of The American Legion, was aghast that VA would close much-needed medical facilities over a discrepancy in nomenclature.

“It is inconceivable to me that closing the urgent-care clinics was actually the intent of VA policy,” Helm said. “Those clinics are essential, and it makes no sense to turn away veterans who need medical care because a facility has been misnamed.”

Helm visited the Mayaguez CBOC last January and was concerned about staff shortages there. He sent a team led by American Legion Veterans Affairs & Rehabilitation Division Director Louis Celli and Executive Director Verna Jones to follow up on his concerns.

All CBOCs in the United States are affected by the nomenclature policy, which was put into effect last October by a directive signed by Robert Petzel, VA’s former under secretary for health.

While in Puerto Rico, Celli contacted VA to resolve the problem. Dr. Gary Tyndall, the department’s national program director for emergency medicine, explained that CBOCs could only be equipped with walk-in clinics, not urgent-care clinics.

“We asked Tyndall if the directive on urgent-care clinics could be clarified, and he said VA was in the process of doing that. In fact, their Emergency Medicine handbook is being revised right now,” Celli said.

According to Tyndall, the two clinics in Puerto Rico are eligible to reopen immediately and a new directive on urgent-care clinics should be completed this week. Celli said the closures have already cost VA millions of dollars in referral services to local emergency rooms in the private sector.

“Shutting down essential medical services because of a technicality is not in the best interest of veterans or taxpayers,” Helm said. “Nor is it good for employee morale. The VA staff were stymied by the directive to close the clinics – they didn’t understand how or why the situation could possibly be better for their patients.”

Besides visiting the two CBOCs, Celli and his team also met with the director and other executives at the VA medical center in San Juan, the only such facility on the island.