The struggle of connecting veterans to care

“There’s this kind of inside notion that I can’t go to the VA unless I am a victim of some kind. If you just look at the numbers, if there’s 252,000 veterans in Oregon: How many are actually enrolled in VA care? Why and why not,” said Mathew Balkwill, a retired Oregon Army National guardsmen and vocational rehabilitation specialist at Roseburg VA Medical Center.

According to the Department of Veterans Affairs, there are 266,691 veterans in Oregon. The majority, 100,990 veterans, served in Vietnam. When the Promise to Address Comprehensive Toxics Act was introduced by President Joe Biden in 2022, it extended VA benefits and health care to those exposed to burn pits or toxic substances like Agent Orange.

Even with a massive expansion of accessibility to VA health care, only 1% of veterans in Oregon applied for PACT Act related health care between 2022 and Feb. 24, 2024.

DESERVED CARE

Balkwill said for many veterans, their glass is half empty even before setting foot in the VA. The mentality among some veterans have, when contemplating whether they deserve those benefits and health care, heavily relies on the kind of service they contributed to the military.

Some veterans will say they never saw combat and therefore do not deserve the benefits that come with service. Others will say they don’t want to take valuable resources away from those who served on the front lines, saw combat and suffered because of their service.

For those working at the Roseburg VA Medical Center, it does not matter if you facilitated supply lines, worked in communications or served as a mechanic.

“There’s that persona that the VA is meant for damaged individuals. That’s where that victim piece comes into place, you’ve got to be damaged in order to go to the VA,” Balkwill said. “That is simply not the case.”

Douglas County Veteran Service Officer Mary Newman-Keyes had great things to say about those who work at the hospital.

“I always tell people that the workers at the (Roseburg VA Medical Center) are great, they are pro-veteran. They have restrictions from higher levels, but they are, for the most part, wonderful,” she said. “Most of our veterans say that.”

THE LONG WAIT

Many veterans in Roseburg must wait weeks and sometimes months before they are able to make an appointment with the single primary care physician at the Roseburg VA Medical Center. The paperwork alone takes significant time to process.

“Things take a long time. It takes a long time to get a primary care provider at the VA, it takes a long time to get a benefits claim to go through because the VA has to have evidence. I think that is one of the main complaints is that this is taking a long time. We get a lot of status requests,” Newman-Keyes said. “On the benefits side, once you submit an application the next thing is about three months away. That’s not resolution, that’s just the next thing in the process.”

Balkwill said one of the major problems with the Roseburg VA Medical Center is a capacity issue.

“Really it has to do with shortages of providers, coupled with a lack of adequate housing for them, those are chronic issues. Eventually that will get resolved but that’s a systems problem. From a relational standpoint, meaning my interactions with the VA, has always been positive,” Balkwill said. “They get hamstrung by capacity to provide services is being hamstrung. Not just here, but here is a good example.”

Steve Stayberg, a VA employee and retired major with the U.S. Air Force, said capacity became a bigger issue with an influx in veterans after 9/11, when laws began to change on who qualified for VA care.

“When the definitions started to change all of a sudden, for example, 600,000 people or 800,000 people or a million more people are now eligible for health care,” Stayberg said.

That kind of influx results in not enough health care providers, nurses, technicians, advocates and more. Stayberg said it takes time for legislation to catch up. This trickles down throughout the system where a veteran may only have had to wait a month to see a primary care physician, now it can take much longer.

“I’ve been here a decade and I have watched a lot of veterans walk away from the VA because services have been so watered down by the influx and the opening up of access towards a more social welfare type of approach,” Stayberg said.

OUTSOURCING CARE

Dave Sayler has been integrated in the VA health care system since the early 2000s after his military service. He has worked as a national service officer in Portland through the Military Order of the Purple Heart and worked in several outreach programs through the Department of Veterans Affairs.

“Just about everything is outsourced here at this point,” Sayler said. “If (the Roseburg VA Medical Center) can’t help they will outsource you and pay for it. If they send you to someplace in Roseburg, if they send you to some place in Eugene or Medford or Grants Pass you are getting quality care that the government is still paying for.”

Sayler said it may take longer but the services are there for veterans.

“Military minded people understand the hurry up and wait, and embrace the suck,” Sayler said. His advice is to find a good advocate.

Roseburg VA Health Care Systems Director Patrick Hull said it’s important for people to get enrolled early, before they need the care.

“I remember when I was young, and I didn’t think I needed health care. This is why it’s important for younger veterans and older veterans from all ages to get enrolled because when you need VA, it’s better to be enrolled and at least have made the connection,” Hull said. “So, when the time comes that you need care the VA is there waiting for you with open arms to help support them and their families.”

In his first year as the director, Hull has largely made it his goal to listen to the community, veterans and staff.

One of his priorities is having a 0% vacancy rate at a time when there are 16 postings at the Roseburg VA Medical Center and when one of the biggest complaints he hears is getting appointments made to see a primary care physician.

Hull said he is working to hire six primary care providers and nurse practitioners. This includes an initiative he started to make sure those new hires and current employees are retained.

“But we have hiccups like any organization does, there are fallouts that maybe we have missed, and I apologize for that,” Hull said. “When we do have those situations occur, we try and get in there and make it right for the veteran but that does take some time. We just try to make it as minimal as possible.”

Balkwill said staying connected and understanding each of the resources that are available is critical. Additionally, Balkwill said getting involved in local Veterans of Foreign War chapters, American Legion and others help in regard to making that information more accessible.

“Connecting to outlets of information is critical. Joining an organization, the service organizations like the American Legion, the VFW. They are basically starting to disappear because nobody is joining anymore,” Balkwill said. “Those folks have been the best advocates for veterans for the last 50 years.”