At a U.S. Senate committee field hearing on Veterans Affairs in Eagle River Tuesday, U.S. Sen. Dan Sullivan called for an Alaska-specific solution to a federal health care program that he said has "been nothing less than an unmitigated failure" for Alaska's veterans.
The Veterans Choice Program, which was supposed to increase health care access for veterans across the country and is based on an Alaska model, is not working in the state, Sullivan said. He said the TriWest Healthcare Alliance, hired to run the program, and the Department of Veterans Affairs "are not communicating at all."
"The frustration levels have peaked in our state among veterans, among family members, and many of Alaska's veterans are going without care -- care that they've earned," Sullivan said at the hearing. "Some are even being saddled with bills in the tens of thousands of dollars, with collection agencies on their heels for nothing they have done wrong. So we're going to change this."
Sullivan, who sits on the U.S. Senate Committee of Veterans' Affairs, said he had written to the committee's heads for authorization to hold the field hearing so VA officials could hear about the problems and challenges Alaska veterans face. More than 50 people showed up to the hearing, held in an Eagle River church and titled "Exploring the Veterans Choice Program Problems in Alaska."
Before the hearing, Sullivan said he traveled to Fairbanks and Kenai to hold listening sessions with Dr. David Shulkin, VA undersecretary for health. Veterans at both sessions said that, for them, the Choice Program had added another bureaucratic layer to health care access. He said there was frustration and "the sense that, why did we fix a system was already working well -- it's not perfect but better than what we have presently."
The Choice Program was partly modeled on Alaska's system for VA care, designed to help veterans who were subject to long wait lists or distant travel for care. Sullivan said in an interview after the hearing that the Care Program "essentially blew up" the state's system, leaving veterans scrambling to figure out where they could get health care -- some ended up on the phone for hours with out-of-state TriWest employees only to have their calls disconnected. Others ended up with medical bills, Sullivan said.
The Choice Program launched in November 2014 and rolled out quickly. David McIntyre Jr., president and CEO at TriWest, said at the hearing Tuesday that his company hired 800 staff in 10 days. The company continues to add new staff every week and will ultimately have around 2,500 employees by November, he said.
McIntyre acknowledged at the hearing that the Choice Program was not working well in Alaska. Before Tuesday's hearing, he said TriWest had plans to route all Alaska calls to a call center outside of Tacoma, Wash. He said there were discussions about housing some staff at the Alaska VA office in Anchorage.
However, by the hearing's end, McIntyre said if a more Alaska-specific approach to the Choice Program was in the works, he would step back until he understood what the design would look like.
"It seems to me that the future of Alaska is really in the hands of the VA and Congress. You all need to decide and you need to let us know what we should do. What got implemented was also in the hands of Congress and, at the time, the VA," McIntyre said. "We were given 30 days, practically, to implement a new law. Not design a website and stand it up -- implement an entirely brand new program to respond to an access to care challenge that was articulated by Congress."
Verdie Bowen, director of Alaska's Office of Veterans Affairs, sat on one of the two panels at the hearing Tuesday. All four people on his panel, including two veterans speaking as individuals and a health care provider, called for an Alaska exemption to the Choice Program.
Before the Choice Program, Bowen said, the VA had successful partnerships with 26 Alaska Native health care programs as well as community health care providers. It also has an agreement with the U.S. Department of Defense. Veterans in rural Alaska and others who couldn't get an appointment with a VA doctor could receive care from these providers. The VA essentially turned five clinics into 127 clinics, Bowen said.
The Alaska VA has said it spends, on average, about $103 million a year on health care purchased in the community.
"The sad part about all of this is that we came to a magical day in time which was just June, not too long ago, and that was abruptly halted," Bowen said.
Bowen said that overnight, roughly 8,000 veterans in Alaska lost coverage through the partnership programs and were told to use the Choice Program, which he said still did not have the infrastructure to serve veterans.
"Veterans had appointments that were cancelled instantaneously," he said. Congress later passed a bill that would allow the Alaska VA to move funding set aside for the Choice Program to already established partnerships in the state
None of the panelists Tuesday night seemed to have positive things to say about the start of the Choice Program in Alaska.
Walter Watts Jr., a 63-year-old veteran from Fairbanks who sat on on the first panel, held up a packet of medical bills that totaled about $15,000. His said his health care benefits through the U.S. Department of Veterans Affairs should have covered the costs associated with a back surgery, but the bills remain unpaid.
Veteran Susan Williams, 58 of Chugiak, sat next to Watts and said her biggest issue with TriWest is that they wouldn't let her schedule her own appointments.
"They have to make it for you," she said. "They don't know our schedules, so how can they even do that?"
Williams is one of 73,276 veterans living in Alaska in 2015, according to a numbers in written testimony submitted by Shulkin to the Committee on Veterans' Affairs. Of that total, 32,104 Alaskans were authorized for VA benefits and 18,741 actually used them, he wrote.
Shulkin said at a press conference before the field hearing that Alaska would not receive an exemption to the Choice Program. He said the VA was not looking to change the relationships already established with Alaska Native health care programs. He said one possibility was for the VA to launch trial programs in Alaska that borrow from some of the concepts, like the partnerships, that have worked in the past.
"The good thing about people in Alaska is they tell you what they're feeling and they tell you that directly," Shulkin said in a press conference before the hearing. "So I got the message loud and clear that we need to step up and improve the type of care that we're providing in terms of getting patients and veterans a better experience with the Choice Program."