AUGUSTA, Maine — President Barack Obama is scheduled to sign a long-debated bill Thursday to make crucial improvements to the Veterans Administration’s medical program.
The bill, which came together last week before Congress adjourned for its summer recess, represents a relatively rare example of bipartisan agreement in Washington.
For the most part, the serious problems within the Veterans Administration, which led to a national outcry and legislation that breezed through Congress last week — such as extended waitlists and isolated instances of falsifying records — have been absent in Maine. But with U.S. Rep. Mike Michaud, Maine’s Democratic gubernatorial candidate and ranking minority member on the House Veterans Affairs Committee, involved in negotiations, it has become a central issue in this year’s campaign.
What will the $17 billion bill accomplish? The more worthy questions are what will it do immediately, and what does it aim to do in the future?
The bulk of the money — about $10 billion — will fund a pilot program focused on eliminating medical waitlists by allowing veterans who live more than 40 miles from a VA medical facility or who have waited more than 30 days for an appointment to seek care at a non-VA clinic or hospital. The bill also includes $5 billion to hire more primary and specialty care physicians, including incentives to lure more medical personnel to the VA.
The bill also extends Project ARCH (Access Received Closer to Home), a pilot program already underway in Maine, Virginia, Kansas, Arizona and Montana. In Maine, Project ARCH is located at Cary Medical Center in Caribou and essentially means veterans who live in northern Maine can receive specialty care and other medical services without needing to travel hundreds of miles to the Maine VA Medical Center in Augusta.
Cary Medical Center’s involvement in Project ARCH began in 2008 and would have expired at the end of September. The bill to be signed by Obama on Thursday will extend the program for two years. As of this June, more than 1,400 veterans received specialty care at Cary Medical Center because of ARCH. Cary spokesman Bill Flagg said the hospital performed some 3,000 consultations through the program.
Maine already has a network of VA community-based outpatient clinics for veterans in Bangor, Calais, Caribou, Lewiston, Lincoln, Portland, Rumford and Saco, as well as satellite clinics in Bingham, Fort Kent, Houlton and Portland. Those facilities are designed to provide primary care while ARCH at Cary Medical Center is intended for more involved specialized care, including surgery and overnight hospitalization.
“It’s been great for the veterans in our area and also a good thing for the hospital,” Flagg said. “It identified a new patient population for us to serve.”
Peter Meisburger of Caribou is the legislative chairman for the Department of Maine, Veterans of Foreign Wars. He also is a veteran who broke his hip over the winter. Because of Project ARCH, he received care five minutes’ drive away at Cary, as opposed to years past when he was forced to make the 10-hour round trip to Augusta.
“The program is really working well up here,” Meisburger said. “It’s unbelievable how many vets have been seen under the ARCH program. It’s dynamite.”
According to a transcript of a hearing Republican Sen. Susan Collins held in March with the Senate Appropriations Subcommittee on Veterans Affairs, whether to expand ARCH is a decision that mostly is in the VA’s hands. Collins, who is known for her support of the pilot project, asked then-Under Secretary for Health Robert Petzel why the VA had yet to recommend continuation of the program.
Petzel called the Caribou ARCH program “one of the most successful aspects of Project ARCH” but said the VA was in the process of evaluating how or whether it could meld with other programs run by the VA.
“We’re still in the final stages of evaluating the project,” Petzel said. “We’ve learned a lot of lessons from that pilot.”
Michaud spokesman Dan Rafter said Michaud wanted to extend the pilot program to preserve the services for veterans in northern Maine but also in hopes more data would sway the VA.
“As more data on ARCH comes in from Cary Medical Center and other locations, it will make the case for why the program is so essential,” Rafter wrote in response to questions from the BDN.
The VA bill, which can best be described as an emergency short-term fix, also has an eye toward the future. It installs greater accountability measures and reduces funding for pay bonuses for VA employees, which were seen as a motive for the falsifying of waitlist records — most notably in Arizona. The bill also calls for an independent assessment of VA medical care and establishes a Congressional Commission on Care to evaluate access to care across the VA system.
In June, Maine Gov. Paul LePage and five other Republican governors wrote to Obama asking for permission to launch state-level probes in the VA medical system. LePage spokesman Peter Steele said Tuesday there has been no response so far but said LePage has asked state agencies to recommend ways to “ensure that the state fills any gaps in the federal system.”
For some in Maine, the bill doesn’t go nearly far enough. Chick Ciciotte of Topsham, the legislative chairman for the American Legion Department of Maine and a staunch advocate for veterans services, said the care he has received at Togus over the years has been “excellent” but said he knows of several instances of veterans waiting for months for certain procedures, ranging from knee surgery to skin treatments.
“I don’t know if [the VA bill] is going to work,” Ciciotte said. “To me, it’s just someone throwing a whole lot of money at a problem and forming committees to work on it. We’ll just have to sit back and see.”