The 13,536 veterans residing in Hays County have had more access to health care since April, when Seton Medical Center Hays joined a program aimed at addressing months-long wait times at health care facilities managed by the U.S. Department of Veterans Affairs.

Jude Prather, Hays County veteran services officer, said Seton Hays’ participation in the program could be “a game-changer” for those who have served in the armed forces and live in Central Texas.

Months-long wait times at VA clinics sparked national dialogue about how best to care for veterans and led Congress to pass House Resolution 3230, also known as the Choice Act, in 2014. The act expanded the number of health care providers veterans could use to receive care and reorganized the taxpayer-funded system that spent $59.42 billion on their care in 2014, according to the VA.

According to the most recent data available from the VA, new patients at Central Texas’ two VA hospitals—located in Temple and San Antonio—waited an average of 54.71 days and 31.3 days, respectively, for a general care appointment between May 15 and Sept. 1, 2014.

“The Choice Act is that first step that provides additional access for veterans for health care—that first step in the privatization of health care,” Prather said. “Years ago something like this would have been unheard of.”

Hays County has been a popular destination for veterans for years, Prather said, because of its proximity to two major military hubs in San Antonio and Temple. The county’s location also makes health care access at veterans hospitals difficult.

The distance from San Marcos, Buda and Kyle to the Audie L. Murphy Memorial Hospital in San Antonio ranges between 49 and 67 miles. The distance to Olin E. Teague Veterans Medical Center in Temple ranges between 79 and 97 miles. 

Veterans living in Hays County seeking inpatient services—such as surgeries or other services requiring patients to stay at the health care facility overnight—would have had to drive to Temple or San Antonio to receive care before Seton Hays joined the program.

Veterans are eligible for the program if they live at least 40 miles from a VA health care facility, have to wait at least 30 days for an appointment or have a major transportation challenge to get to the nearest VA health care facility.

Choice at Seton

Since the hospital became a Choice facility 27 veterans have used the Choice program to access heath care at Seton as of May 27, according to the hospital.

Jesus Garza, CEO of Seton Healthcare Family said the most popular services veterans are seeking from Seton Hays are related to obstetrics and gynecology, behavioral health and neurology.

Garza said advances in medical care on the battlefield mean more veterans are returning home after conflicts, but it also means many are returning with major medical complications including amputated limbs and post-traumatic stress disorder.

“When Congress [created] the [Choice Act], they realized that the VA didn’t have all the tools they needed to serve the growing needs of this very vulnerable population,” Garza said.

Seton Hays has created a network of “navigators” to help veterans through the often-complicated process of dealing with health insurance, Garza said.

Prather said he has often wondered why more facilities were not available to veterans for health care.

“I would drive a veteran up to Temple for an MRI, and I would be thinking, ‘I’m driving by all these hospitals. I’m driving by all these MRIs. Why couldn’t we just get [an MRI] there or there? Why are we driving this two-hour trek to Temple?’” Prather said.

Veteran needs

Bradley Jenkins, a veteran who served four tours of duty in Iraq and is now attending Texas State University, requested an appointment for shoulder surgery from the VA in 2015. He was told he may have to defer the surgery for months because of a long wait list for appointments. Jenkins’ shoulder had been in a sling for 12 weeks, so he decided to pay out of pocket for the surgery at Seton Hays.

The $40,000 surgery worked out well, Jenkins said, and he worked with the VA to repay him for the procedure.

He would have never had to pay out of pocket for the procedure had he been able to access a health care provider participating in the Choice program.

Jenkins has since enrolled in the Choice program, and he said he seen improvements in the veterans’ health care system.

“It’s a life-changer because accessibility to care is not just for the elderly,” Jenkins said. “There are young guys who are vets, and we need to go to the hospital, too.”

According to a 2015 study, the VA anticipates a decrease in the total number of veterans but an increase in the number of veterans demanding health care services from VA facilities.

Jenkins is one of the nearly 5.8 million veterans who have served in the armed forces since the Gulf War in the early ’90s, according to the VA. The average age of a veteran in that group is 41 years old. Jenkins, who is in his mid-30s, said he expects he will begin using health care from the VA—through VA hospitals and clinics or through Choice providers—much more in the future.

“When I start hitting 50, I’ll probably be using it a whole lot more,” Jenkins said.

The future of the Choice program is not entirely clear though. When Congress passed the Choice Act in 2014, the program was set to expire after the VA had spent all of the $10 billion allocated to the program or by Aug. 7, 2017, whichever comes first.

Congress may choose not to renew the program, but Garza said he would be surprised if Congress let the Aug. 7, 2017, deadline pass without extending it.

“We know there is a great passion in Congress to make sure these individuals are treated correctly, and my guess—even though it’s always subject to politics and a vote—is that [the Choice Act] would probably be extended,” he  said.

Jenkins, having received care before and after the Choice Act was passed, said he believes the legislation represents the future of veterans health care, when more private providers will be available to care for those who have served in the armed forces.

“I really feel like our veterans should be taken care of,” Jenkins said. “We can’t ask a 20-year-old kid to go to Iraq and do all this cool guy stuff, and then [ignore him] when he’s 34 and has arthritis in his knees. That’s not normal.”