SETH ROBBINS, Associated Press - SAN ANTONIO (AP) - H.W. "Bill" Sparks never had trouble scheduling his annual physical at a Veterans Affairs clinic in El Paso until his doctor left early this year. Now he's been left in limbo, waiting several months to be paired with a new physician. Sparks, a retired Army warrant officer, said the clinic has tried to reduce wait times since an audit last summer revealed it had one of the nation's worst backlogs. Yet it still struggles to attract staff and build enough capacity to treat a large veteran population.
"They don't have enough staff to do it," he said. "So why promise something you can't deliver?"
Despite a nationwide push to lessen the wait times for veterans seeking health care, VA medical facilities across Texas have shown little to no sustained progress. The dilemma mirrors a trend across the country in which facilities are struggling to improve how often they meet the U.S. Department of Veterans Affairs' goal to have patients seen within 30 days.
Nearly 66,000 medical appointments completed from September through February at VA facilities in Texas didn't meet that threshold, equating to 3.4 percent of patient visits, according to government data reviewed by The Associated Press. That's slightly higher than the 2.8 percent national rate for delayed appointments during that period. Of Texas' delayed visits, more than 12,700 took longer than 60 days.
The public outcry over the long wait times and attempts to cover them up led Congress to pass legislation last August providing an additional $16.3 billion to hire doctors, open more clinics and expand a program that allows vets to get private-sector care.
But lengthy delays persist across the massive health system in Texas, from small clinics along the Mexico border to medium-sized facilities near sprawling military bases and large medical centers in major cities.
"Texas is ground zero for new veterans. It is where we get things right or wrong," said Paul Rieckhoff, founder of the advocacy group Iraq and Afghanistan Veterans of America, which recently developed a website called "The Wait We Carry," where vets describe their injuries and, at times, frustrations in getting care.
The AP examined waiting times at 54 VA hospitals and outpatient clinics in Texas to gauge improvements since the scandal last year led to the resignation of VA Secretary Eric Shinseki.
It's difficult to quantify exactly how wait times have changed because the VA introduced a new method of measuring them at the end of the summer. But the trend is clear: The number of lengthy delays in Texas has not shown consistent improvement.
The VA clinic in El Paso saw nearly 6 percent of its appointments delayed, ranking it among the highest in Texas. The numbers fluctuated from 5.6 percent in September to 5.9 percent in February.
Peter Dancy, director of the El Paso VA Health Care System, which treats some 40,000 veterans, described an increasing demand in certain areas of care such as mental health, which has more than a dozen vacant positions.
Recruiting staff to fill these and other vacancies in the remote West Texas city remains a challenge. El Paso's VA system received federal funding to hire 60 health care workers, but so far 20 have been hired.
"It's a matter simply of supply versus demand," said Dr. Homer LeMar, the health system's chief of staff. "And the demand is a little ahead of the supply right now."
Austin's VA clinic has also had difficulty meeting patient demand but for a different reason: a rapidly growing veteran population. A new clinic opened in July 2013 and by the end that September had about 25,300 patients. By the same time last year, the facility was serving 27,400 patients and far exceeding projections, which didn't predict 30,000 patients until 2025.
About 6.8 percent of the clinic's appointments took longer than 30 days during the six-month span - the highest rate in Texas. But its monthly rate in February was 4.8 percent, part of a downward trend since December.
"Austin is a great place to live, and they are close to Fort Hood," said Dr. Olawale Fashina, the health system's chief of staff. "So a lot of retirees are staying in the area and many of them are going to the Austin (clinic), and we do believe the patients like the care we provide."
Two of the state's largest medical centers largely stagnated in reducing delays. The Houston facility's numbers rose from 2.8 percent in September to 3.8 percent in February. The San Antonio center saw 3.6 percent of its appointments delayed more than 30 days.
The VA Texas Coastal Bend facilities, which by some measures had some of the longest average wait times nationwide last year, saw improvement at its small Harlingen clinic in the Rio Grande Valley.
The outpatient clinic saw delayed appointments fall to about 5 percent in February from about 8 percent in September. Administrators say extra staffing - the clinic added a physician, two nurses and a clerk - helped reduce wait times.
But the clinic still ranks high among Texas VA facilities in the percentage of delayed appointments.
"We know we have come a long ways in access to care," said Hugo Martinez, the health system's spokesman. "But we know there is room for improvement."
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