LOS ANGELES — About 15 miles from the Sacramento Capitol Building, thousands stream into the veterans hospital seeking everything from sleep advice to hearing aids.
About 6.8 percent of the roughly 133,300 medical appointments completed at the Sacramento Veterans Affairs Medical Center from Sept. 1 to Feb. 28 missed the VA's timeliness goal, which calls for patients to be seen within 30 days.
The Sacramento hospital had the highest percentage of appointments delayed by at least a month among VA centers in California and ranked sixth-worst nationally out of 150 full-service VA hospitals.
VA officials acknowledged the challenges, spurred by an influx of patients.
"We would like to do better," said David Stockwell, director of VA Northern California Health Care System, which includes the Sacramento hospital. "Our goal is to provide timely service."
Nationally, nearly 894,000 appointments — or about 2.8 percent— completed at VA centers from Aug. 1 to Feb. 28 involved a delay of at least 31 days, according to government data reviewed by The Associated Press. This doesn't include cancellations, no-shows or cases where the veteran gave up and went elsewhere.
The AP examined wait times at 940 individual VA facilities to gauge changes since a scandal over delays led to the resignation of VA Secretary Eric Shinseki in May and prompted lawmakers to pass the Veterans Access, Choice and Accountability Act in August. It is difficult to quantify exactly how things have changed because the VA introduced a new method for measuring wait times at the end of the summer.
The trend across the nation, however, is clear: In either analysis, the number of vets waiting more than 30 or 60 days for non-emergency care has largely stayed flat. The number of medical appointments that take longer than 90 days to complete jumped to nearly 13,000 in January and more than 10,000 in February, compared to an average of around 5,900 the previous five months.
The longest waits were in the South and parts of the West while relatively few VA facilities in the Northeast, Midwest and Pacific Coast states reported having significant numbers of patients with extraordinary waits. In California, nearly 40 percent of the state's 61 VA hospitals and clinics had a higher-than-average percentage of delayed appointments.
VA officials have cautioned that it will take time for reforms to make a difference. The agency has received an additional $16.3 billion to hire doctors, open more clinics and build the new Choice program that allows vets facing long delays or long drives to get care from a private-sector doctor.
The Northern California VA system, which cares for about 108,000 veterans at 10 sites, is the busiest in the state. Last fall, it saw a 4 percent jump in new patients, many of whom sought care in Sacramento. Officials said most of those seeking care are baby boomers who served in Vietnam.
Veterans face long waits to get hearing aids, see orthopedic specialists for chronic knee pain or enroll in a sleep study. To meet the demand for sleep studies, the VA is adding two beds and allowing veterans to do take-home sleep tests.
It's also hiring 271 people — doctors, nurses, physical therapists, mental health counselors, technicians — to boost its existing staff of 3,000. About a quarter already started and the rest will come on board this year.
In recent years, there has been a building boom, with the addition of new medical buildings and parking in Sacramento and the Martinez outpatient clinic to accommodate veterans.
There have been improvements. About 6.3 percent of appointments at the Sacramento VA in February missed the timeliness goal, down from 7.24 percent in November and December.
While the VA offers veterans the option to see a private doctor if the wait is too long, some choose to stick it out, officials said.
"They're voting with their feet. They're choosing to wait in line at the VA rather than walk to the community provider to get care," Stockwell said.
Some 400 miles to the south, the Long Beach VA Medical Center isn't as backed up.
Of the nearly 261,000 appointments completed from September to January at the Long Beach hospital, about 1.3 percent failed to meet the VA's timeliness goal. The hospital cares for about 55,000 veterans.
At least once a month, the hospital schedules appointments at night and on weekends to keep up with demand and cater to students and working veterans.
"We've looked at where the bottlenecks are and whether we can fix them in the off hours," said Long Beach VA spokesman Rich Beam.
Besides offering after-hour appointments, the hospital occasionally hires temporary doctors and staff.
AP writer David B. Caruso contributed to this report.