Gianforte talks Veterans Affairs in Havre

With the Mission Act going into effect earlier this year, U.S. Rep. Greg Gianforte has been traveling across the state touring Veteran Affairs Clinics, speaking with veterans and VA staff about how the VA clinics can improve and what success they have been seeing.

Gianforte, who is running for Montana Governor, met Tuesday with Veterans Affairs Northeast Regional manager Peter Lucas and veteran Bill Tucker at the Havre Great Northern Inn and Suites to discuss the local VA clinic.

"The goal is to make sure our veterans are getting the care that they fought for and earned," Gianforte said after the meeting.

The clinic is not very big, so is constrained on space, which is preventing additional services for critical programs, he said. He added that he was glad Lucas and Tucker met with him to discuss their experience and efforts with the VA.

Gianforte was expecting more veterans to attend but due to a miscommunication from his office about the time, most missed the meeting.

Lucas, who has managed the VA clinics in Havre, Great Falls, Lewistown and Glasgow for the past five years, said the Havre clinic is steady as far as staff, but has been struggling with finding health care providers. He added that the problem is a statewide issue, and the VA is trying to utilize a program called Telehealth to help veterans meet with providers.

Telehealth is a way veterans can receive, and providers can administer, medical care through a video chat.

The VA also has recently implemented a new video-on-demand program which can be used by any veteran who has a smart device to connect with a health care provider from home, he said. It is good for veterans who are in more rural areas because during inclement weather conditions they can still see a provider if needed. All a veteran needs is a smart device and internet connection.

He added that Telehealth is the way of the future when it comes to providing care to civilians and veterans in rural areas. The lack of medical providers is a nationwide issue with fewer physicians going into general practice. VA having the ability to communicate with their patients through the internet is an important tool to assure veterans are getting the care they need. But it's not for everyone and the VA knows it, he said.

A number of elder veterans, WWII, Korean War and Vietnam War veterans, may have hearing problems or vision problems and may need to work with a provider in person, he said. A number of veterans also feel more comfortable working with a physical provider. Telehealth also still requires veterans to see and physical health care professional to care for any illnesses or injuries.

Tucker, Havre Veterans of Foreign Wars Post 497 commander and American Legion Chapter 11 vice president, has worked in health care for 39 years, starting as a civilian emergency medical technician before enlisting in the U.S. Army, where we served three years as an EMT and 10 as a paramedic. After he was discharged, he became a phlebotomist at Northern Montana Hospital. 

He said that, from his own experience and after hearing from other veterans, the Havre VA Clinic needs a permanent provider. He added that the Havre clinic has not had a permanent provider for the past four years and every time providers are changed. Veterans have to start over with their new provider, their file not picking up from where the last provider left off.

He said some of the conditions veterans are in are life-changing and need to be treated. He added that he has seen better service and treatment by and through the VA since the Mission Act passed than previously with the Choice Program.

Gianforte said the Choice Program was good in concept, but didn't work. He added that the Mission Act is an attempt to provide more to complement the VA with more community-based care outside of the VA.

Tucker added that it is also dependent on the employees. He said he had a nurse who helped him with a number of issues and made the process easier for him to get care. He also noticed it was significantly easier for patients to receive authorization for exams and appointment since the Mission Act passed.

Lucas said one change the VA implemented in Montana was establishing a nurse specifically tasked with reviewing and approving appointments to each clinic.

He added that if the Havre clinic could find a permanent provider it would, but it is difficult to find one. He said the Havre clinic will also have the provider from Lewistown holding appointments two-and-a-half to three days out of the week.

Tucker said that the clinic is also very small and needs to be expanded.

"We would all really like to see that happen," he said.

Lucas said the VA is looking into expanding the facility although it will take time. He added that it is in the process.

Tucker said another issue veterans face and the VA needs to address is mental health care.

Lucas said the VA has a program similar to Telehealth called iFrontier, which allows veterans to speak with a provider through video call if they are in crisis or in need of help. He added that the program has been used in the Glasgow clinic and has seen great success.

He added that he will start pushing for the program to be used in the Havre clinic.

Havre clinic does have a nurse who is able to work with veterans if they are in need, but cannot serve to the level needed, he said, adding that a number of veterans still need to see an additional mental health care professional. Lucas said iFrontier should be able to simplify their care for veterans with veterans only needing to see one mental health care professional. 

For after hours, he added, the VA has limited options. He said veterans have the options to either turn to the crisis line and or local medical care. 

Gianforte said the iFrontier is a great option for veterans and hopefully will have success in the Havre clinic.

"It's so critical," he said. "These guys have suffered on our behalf, we want to take care of them. ... We want to make sure vets on the Hi-Line are getting the care they deserve."

Gianforte said after the meeting that mental health care for veterans is critical, Montana had the highest rate of veteran suicides in the country. 

"We have men and women who have worn the uniform of the United States coming home and they're not healthy and we need to make sure we have access to the care that they need and mental health is part of that," he said.

He said he has been touring around the state about the VA issues and will be in Malta, Glasgow, Sidney, Glendive, Scoby and Great Falls in the following weeks.

"I think that it's very important for people to hear one-on-one," he said.