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Federal report outlines problems at 6 VA community outreach clinics across Kansas

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WICHITA, Kansas — The federal Office of Inspector General for the Veterans Affairs Department released a report Wednesday citing a list of needed improvements and performance review for the six community-based outpatient clinics across Kansas overseen by the Robert J. Dole VA Medical Center in Wichita.

Its recommendations are based in part on a site visit to the Parsons clinic along with other data from VA outpatient facilities in Hays, Salina, Hutchinson, Parsons, Dodge City and Liberal. The routine review had been scheduled before national outcry over reports of patient deaths, widespread treatment delays and falsified records at VA facilities nationwide.

Most of the issues cited in the report target the single Parsons clinic that inspectors visited in May, when the OIG found problems such as no panic alarm system, incomplete diagnostics, inadequate staff training and poor medication management. Inspectors found, for example, that the staff at the Parsons clinic did not do complete diagnostic assessments on 38 percent of patients who had positive alcohol-use screenings.

The Dole VA Medical Center, which administers the clinics, said in an email that it would be able to meet all the recommendations in the OIG report, noting it touched on issues that can be resolved in a "timely fashion."

Its executive secretary, Diane Henderson, noted in an email that the report specifically speaks of the Parsons clinic in which everything listed — from fire drills to women veterans in exam rooms having access to gender-specific bathrooms — are "routine matters" that will be resolved.

"Overall, the goal is to have all recommendations completed by January 2015," she said.

The Inspector General made a detailed list of recommendations for improvement, and target dates for meeting each of them. The report noted that the issues are "significant enough to be monitored by the OIG until corrective actions are implemented." Those recommendations included things like installing a panic alarm system, conducting disaster exercises, and additional staff training.

In addition to the specific recommendations for Parsons clinic, the report also compares how well all the six Kansas outpatient clinics were able to meet wait times of under seven days and whether they follow up with patients once they are discharged. The report covered data for the fiscal year ending in September 2013.

The outpatient clinic with the worst record for scheduling patients was the one in Liberal, where it met that target just 56 percent of the time in September. The VA clinic in Hays met the wait time target about 65 percent of the time, and Salina met it 85 percent; Hutchinson was at 91 percent; and Parsons and Dodge City were the best with 98 percent.

But the OIG report did not address some of the more vexing problems facing the VA outpatient clinics in Kansas, such as the difficulty in recruiting and retaining health care providers in rural communities.

U.S. Sen. Jerry Moran has long criticized the VA for not having a permanent primary care provider at its Liberal clinic. The last permanent doctor at the Liberal clinic left in November 2007, Henderson said. The clinic has since relied on doctors filling in temporarily and other staff to provide services.

"Recruitment has been ongoing but it is hard to get a qualified provider in that community," she said.

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