Sacramento VA Hospital Has Highest Percentage Of Month Delays For Appointments

LOS ANGELES (AP) - About 15 miles from the Sacramento Capitol Building, thousands stream into the veterans hospital seeking everything from sleep advice to hearing aids.

About 6.8 percent of the roughly 133,300 medical appointments completed at the Sacramento Veterans Affairs Medical Center from Sept. 1 to Feb. 28 missed the VA's timeliness goal, which calls for patients to be seen within 30 days.

The Sacramento hospital had the highest percentage of appointments delayed by at least a month among VA centers in California and ranked sixth-worst nationally out of 150 full-service VA hospitals.

VA officials acknowledged the challenges, spurred by an influx of patients.

"We would like to do better," said David Stockwell, director of VA Northern California Health Care System, which includes the Sacramento hospital. "Our goal is to provide timely service."

Nationally, nearly 894,000 appointments - or about 2.8 percent- completed at VA centers from Aug. 1 to Feb. 28 involved a delay of at least 31 days, according to government data reviewed by The Associated Press. This doesn't include cancellations, no-shows or cases where the veteran gave up and went elsewhere.

The AP examined wait times at 940 individual VA facilities to gauge changes since a scandal over delays led to the resignation of VA Secretary Eric Shinseki in May and prompted lawmakers to pass the Veterans Access, Choice and Accountability Act in August. It is difficult to quantify exactly how things have changed because the VA introduced a new method for measuring wait times at the end of the summer.

The trend across the nation, however, is clear: In either analysis, the number of vets waiting more than 30 or 60 days for non-emergency care has largely stayed flat. The number of medical appointments that take longer than 90 days to complete jumped to nearly 13,000 in January and more than 10,000 in February, compared to an average of around 5,900 the previous five months.

The longest waits were in the South and parts of the West while relatively few VA facilities in the Northeast, Midwest and Pacific Coast states reported having significant numbers of patients with extraordinary waits. In California, nearly 40 percent of the state's 61 VA hospitals and clinics had a higher-than-average percentage of delayed appointments.

VA officials have cautioned that it will take time for reforms to make a difference. The agency has received an additional $16.3 billion to hire doctors, open more clinics and build the new Choice program that allows vets facing long delays or long drives to get care from a private-sector doctor.

The Northern California VA system, which cares for about 108,000 veterans at 10 sites, is the busiest in the state. Last fall, it saw a 4 percent jump in new patients, many of whom sought care in Sacramento. Officials said most of those seeking care are baby boomers who served in Vietnam.

Here's a look at how California VA centers fared from September to February, when facility-level data became available. Each facility is accompanied by total appointments completed during that period, care that was delayed at least 31 days and percentage delayed at least 31 days.

1. Northern California VA-Sacramento Valley	133328	9011	6.76%
2. San Luis Obispo VA Clinic	5419	348	6.42%
3. Sepulveda VA Clinic	86373	4618	5.35%
4. Martinez VA Clinic	73352	3854	5.25%
5. Santa Maria VA Clinic	15854	829	5.23%
6. Mare Island VA Clinic	10487	481	4.59%
7. Ukiah VA Clinic	8742	396	4.53%
8. Central California VA-Fresno	99534	4356	4.38%
9. Stockton VA Clinic	14258	608	4.26%
10. McClellan VA Clinic	45706	1907	4.17%
11. Gardena VA Clinic	3704	151	4.08%
12. Greater L.A.  VA-West L.A.	167096	6772	4.05%
13. Palo Alto VA-Livermore	34671	1370	3.95%
14. Eureka VA Clinic	15960	587	3.68%
15. Murrieta VA Clinic	11006	371	3.37%
16. Clearlake VA Clinic	6428	214	3.33%
17. Los Angeles VA Clinic	51883	1676	3.23%
18. Monterey VA Clinic	24678	796	3.23%
19. Oceanside VA Clinic	42464	1342	3.16%
20. Loma Linda VA	263144	8302	3.15%
21. Palo Alto VA	108085	3356	3.10%
22. Oxnard VA Clinic	9482	283	2.98%
23. Modesto VA Clinic	15654	453	2.89%
24. San Diego VA	214232	6132	2.86%
25. Chico VA Clinic	19956	522	2.62%
26. Victorville VA Clinic	9226	241	2.61%
27, San Jose VA Clinic	28295	705	2.49%
28. Sonora VA Clinic	5411	121	2.24%
29. Fremont VA Clinic	4885	97	1.99%
30. Merced VA Clinic	4982	95	1.91%
31. San Francisco VA	173272	3270	1.89%
32. Santa Rosa VA Clinic	22303	398	1.78%
33. Redding VA Clinic	44566	779	1.75%
34. Chula Vista VA Clinic	13825	237	1.71%
35. Santa Ana VA Clinic	11219	188	1.68%
36. Mission Valley VA Clinic	64498	1068	1.66%
37. Rancho Cucamonga VA Clinic	8559	139	1.62%
38. Oakhurst VA Clinic	2672	43	1.61%
39. Escondido VA Clinic	10096	151	1.50%
40. Sierra Foothills VA Clinic	6244	93	1.49%
41. San Francisco VA Clinic	4905	68	1.39%
42. Antelope Valley VA Clinic	4763	66	1.39%
43. Santa Barbara VA Clinic	6272	84	1.34%
44. Long Beach VA	261390	3288	1.26%
45. Tulare VA Clinic	7084	84	1.19%
46. Anaheim VA Clinic	5713	66	1.16%
47. Laguna Hills VA Clinic	4935	57	1.16%
48. Oakland VA Clinic	35290	378	1.07%
49. Bakersfield VA Clinic	20695	196	0.95%
50. Diamond View VA Clinic	1882	16	0.85%
51. San Bruno VA Clinic	5446	43	0.79%
52. Fairfield VA Clinic	10679	82	0.77%
53. Santa Fe Springs VA Clinic	3862	25	0.65%
54. Corona VA Clinic	6161	29	0.47%
55. Imperial Valley VA Clinic	2650	11	0.42%
56. Yuba City VA Clinic	6603	24	0.36%
57. Palo Alto VA-Menlo Park	16095	50	0.31%
58. Palm Desert VA Clinic	11631	28	0.24%
59. East Los Angeles VA Clinic	5176	8	0.15%
60. Capitola VA Clinic	811	1	0.12%
61. Cabrillo VA Clinic	2910	0	0.00%

Veterans face long waits to get hearing aids, see orthopedic specialists for chronic knee pain or enroll in a sleep study. To meet the demand for sleep studies, the VA is adding two beds and allowing veterans to do take-home sleep tests.

It's also hiring 271 people - doctors, nurses, physical therapists, mental health counselors, technicians - to boost its existing staff of 3,000. About a quarter already started and the rest will come on board this year.

In recent years, there has been a building boom, with the addition of new medical buildings and parking in Sacramento and the Martinez outpatient clinic to accommodate veterans.

There have been improvements. About 6.3 percent of appointments at the Sacramento VA in February missed the timeliness goal, down from 7.24 percent in November and December.

While the VA offers veterans the option to see a private doctor if the wait is too long, some choose to stick it out, officials said.

"They're voting with their feet. They're choosing to wait in line at the VA rather than walk to the community provider to get care," Stockwell said.

Some 400 miles to the south, the Long Beach VA Medical Center isn't as backed up.

Of the nearly 261,000 appointments completed from September to January at the Long Beach hospital, about 1.3 percent failed to meet the VA's timeliness goal. The hospital cares for about 55,000 veterans.

At least once a month, the hospital schedules appointments at night and on weekends to keep up with demand and cater to students and working veterans.

"We've looked at where the bottlenecks are and whether we can fix them in the off hours," said Long Beach VA spokesman Rich Beam.

Besides offering after-hour appointments, the hospital occasionally hires temporary doctors and staff.

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AP writer David B. Caruso contributed to this report.

Copyright 2015 The Associated Press.