Fix VA patients’ access to Choice

The reputation of the Department of Veterans Affairs’ medical-care system, heavily tarnished by failures to deliver quality care in a timely way, seems to be slowly on the mend.

The Veterans Choice program, which gives veterans private avenues for medical treatment in concert with their VA providers, has been a necessary addition, given the scandalous delays faced by patients at VA centers.

While incremental improvement has resulted, serious problems remain to be addressed. Some of the patients and providers taking advantage of Veterans Choice have run into a logjam as the VA bureaucracy struggles to coordinate the exchange of medical records and other information with private providers. The result could be more frustrating or perhaps health- threatening delays for the patient.

The slow pace of reform cannot be accepted for a simple reason: Time is the enemy for the veterans, whose benefits are degraded with every passing year that the problems persist.

They have been especially vexing at the VA Pacific Islands Health Care System, based on Oahu. While the crisis afflicted centers nationally a few years ago, Hawaii’s new VA patients suffered the most, with longer wait times for a primary-care physician than anywhere else in the country.

Wait times have been reduced, but the region’s challenges remain. They are exacerbated by a shortage of providers, the logistics of its trans-Pacific service area and the patients’ diversity.

In addition, all VA beneficiaries are eligible for Choice in Hawaii, whereas in other states beneficiaries are only eligible if confronted by delays of more than 30 days or if they live more than 40 miles away from a center. The expanded eligibility is the right approach for veterans in isolated Hawaii, but it added to the patient load disproportionately.

And in the midst of all these headaches, the Hawaii-headquartered system has lacked a permanent director for more than a year. In February 2016, its last director, Wayne Pfeffer, resigned. He had come under fire for administrative problems, with Hawaii’s U.S. Rep. Tulsi Gabbard leading the charge.

“I won’t speculate on why he left, but I had long called for his resignation,” she said. Ironically, Gabbard now finds herself at the helm of the push to replace him and other directors in a more timely manner, through legislation called the VA Health Center Management Stability and Improvement Act.

Hawaii is not alone with the turnover issue among top administrators. It is one of more than 20 VA medical centers lacking a permanent director.

Gabbard, along with Republican Congressman Mike Bost from Illinois, co-sponsored the bill, which passed unanimously in the House on Friday.

Its bottom-line aim is for the VA secretary to craft a plan to fill the vacancies with a “highly qualified” medical director within 120 days. This could involve programs of training and promotion from within the VA.

Passing this bill would be one measured step toward resolving the lack of consistent leadership, which surely has factored in the reportedly low morale at the Honolulu-based VA system.

A 2016 survey of staffers showed dissatisfaction levels below national averages for the agency, with the nation’s worst scores in three-quarters of the more than 80 categories.

Staff morale is undeniably key to improving service to the patients. But the core problem remains delays in getting veterans medical treatment.

Hawaii’s congressional delegation should work with the agency to improve coordination with private providers, and with the Trump administration, which has prioritized VA reform and favors increasing its funding.

The Pacific region’s veterans, like those in the nation’s service from every state, have already waited too long for an efficient VA to deliver the care they deserve.