Kilili: Veterans’ voices heard on healthcare needs

Veterans on Saipan, Tinian, and Rota had an opportunity to meet and speak directly with researchers putting together the feasibility study for a Community-Based Outpatient Clinic, or CBOC, in the Marianas.

Delegate Gregorio Kilili C. Sablan (Ind-MP) included the study in Section 213 of the VA MISSION Act, signed into law on June 6. He followed up, when the U.S. Department of Veterans Affairs contracted out the work, to make sure it included a site visit to the Marianas, so veterans could describe first-hand the difficulty of getting routine healthcare without their own CBOC.

The MISSION Act requires the study to be completed by the end of the year. Sablan plans to begin working on funding for a clinic as soon as the new Congress convenes in January. Because of the relatively small population in the Marianas, Sablan may also have to adjust standards about how many veterans a CBOC has to serve.

The congressional office helped Romanyk Consulting president and CEO Nick Romanyk and senior planning and facility practice leader Jeff White set up the face-to-face meetings with veterans at the Joeten-Kiyu Public Library on Saipan and at the Tinian Public Library. Rota veterans and veterans who were unable to attend in person were also able to join via videoconference.

The two researchers also met with Sablan for a briefing last week. They aim to complete the report by Thanksgiving.

“I just want our veterans to get the care they need,” Sablan explained. “They should have a place of their own that they can go to for care. We have one of the highest per capita recruitment rates in the nation, but we do not have the services that our veterans need when they come home.”

Since gaining representation in Congress 10 years ago, Marianas veterans have seen steady improvement in healthcare services. When a VA plan to contract with a Marianas doctor to see vets at an outreach clinic on Saipan was stalled, Sablan pushed to get the contract completed.

Sablan was also able to get statutory language enacted that allowed vets in any remote location in America to see non-VA community providers through the Veterans Choice Program, after he explained to other members of Congress the challenges veterans face when they can only access VA services by flying or taking a boat. When he learned the Choice program was not being well utilized in the Marianas, Sablan got the CEO of TriWest, the company in charge of managing the program, to come to the Marianas for a series of workshops with veterans and providers. As a result, the number of healthcare providers participating in Choice went from 21 to 80 and more veterans got better service.

After conducting a series of listening sessions and other outreach efforts with Marianas veterans last year who impressed upon Sablan the need for better mental health services, he appealed to the VA to do more to support island veterans struggling with transition to civilian life, post-traumatic stress, and other mental health issues. The Guam Vet Center responded to the delegate’s call by launching clinical and outreach services for veterans in the Northern Marianas early this year. The Guam Vet Center is also assisting in a needs assessment that will be instrumental in establishing a stand-alone Vet Center in the Northern Marianas.

And, this month the VA added a licensed clinical social worker to its Marianas staff, the result of Sablan’s meetings with VA Secretary David Shulkin and Undersecretary for Health Operations Steve Young last summer. The new social worker is William Moore, a retired Air Force major, who served as an embedded combat and operational stress control officer with the 10th Mountain Division of the U.S. Army in Afghanistan. He had a leadership role in the Air Force’s suicide prevention program, as well as programs addressing substance abuse, domestic violence, child abuse, and mental health/life skills. And he has already committed to working with partner agencies in the Marianas, sharing his experience in suicide prevention.

Vet count remains a problem
An issue for the CBOC feasibility study and for any VA staffing request is the number of veterans living in the Marianas who need the service. According to the Romanyk consultants, the typical threshold for a full-time, primary care VA physician is 1,200 veteran patients.

“We understand that close to 2,000 veterans are registered with the Commonwealth Veterans Affairs office, but the number of veterans who are actually signed up to receive VA healthcare is much lower,” Sablan said. Only about 450 veterans are presently enrolled for VA health care.

To increase enrollment, Sablan’s office recently initiated a registration drive.

“Our Wounded Warrior Congressional Fellow, Randy Johnson, has been setting up a tent at the Joeten Superstore on Saturdays, twice a month, working to encourage more people who have military service to register for VA services,” Sablan said.

This month’s registration drives are scheduled for Oct. 13 and 20, from 10am to 2pm at the Joeten Superstore in San Jose.

“I look forward to the completion of the CBOC feasibility study, and hope it will provide useful guidance for our efforts to enhance VA health care in the Marianas,” Sablan said.

“But we need the numbers, too, to make the case for expanding and improving care,” he added. “So, I urge all individuals who have served in our nation’s armed forces to register now for VA services.”

For more information about the congressional office’s veterans registration drive, contact Johnson at 323-2647 or email randy.johnson@mail.house.gov. (PR)