Spokane VA to expand urgent care while scrapping plans to re-open emergency room

Efforts to reopen the emergency room at Mann-Grandstaff VA Medical Center have flatlined, and the fate of rural outpatient clinics appears to be sealed.

U.S. Rep. Cathy McMorris Rodgers said she’s been fighting for the emergency room since she was first elected to Congress in 2005. The VA emergency room closed in 2014 and administrators have failed to hire enough doctors to reopen it.

After years of calling for its return, McMorris Rodgers said Friday that she now supports a plan to expand the hours of the existing urgent care to 24 hours, seven days a week.

“I think it’s very important for veterans in Eastern Washington to know that they have a place available for them 24/7. This is a longtime challenge,” she said. “The way we show our gratitude is to make sure they get the care that they need when the time comes.”

However, neither she nor the VA staff could say when they expect urgent care, which currently is open daily from 8 a.m. to 6 p.m., to expand its hours. “The biggest challenge has been the recruitment of doctors,” she said.

In addition, McMorris Rodgers said the Veterans Choice Program, which allows veterans to choose private doctors who are then paid by the government, is putting an end to clinics in rural communities. Outpatient clinics remain in Coeur d’Alene and Libby, Montana, but clinics have closed in Colville and Republic. A contract that expired in July has not been renewed in Tonasket.

“The clinics in the rural areas were a longtime priority for me,” McMorris Rodgers said. “But Choice came along and those rural contracts went away.”

She previously championed the rural clinics to avoid forcing veterans to drive over mountain passes or three hours one way for appointments in Spokane.

“If we could get Choice to work, then the veterans in those areas would get the care they need.” McMorris Rodgers said. “But, there are some really big hurdles.”

VA officials began offering the Choice program after a 2014 wait-time scandal was discovered at the Phoenix VA hospital and spread throughout the country. Veterans had been waiting weeks or months for appointments while phony records covered up the lengthy delays.

The program, which was extended in August by President Donald Trump, originally allowed veterans to receive care from outside doctors if they had to wait 30 days for an appointment or drive more than 40 miles to a VA facility. But McMorris Rodgers and U.S. Rep. Phil Roe, R-Tenn., who came to Spokane on Friday for the announcement, both said those distance and time requirements have been eliminated.

Roe, a 72-year-old physician who chairs the House Veterans Affairs Committee, said Spokane’s problem of finding doctors is not unique to the country, which has 168 medical centers like Mann-Grandstaff.

“The way health care is going, more and more care is provided in the outpatient setting,” he said. “I’d like to see us take the care to the veterans, push the care for where the veterans live. The VA needs to be more nimble … so people don’t have to drive long distances.”

Roe, who spent 31 years as a doctor in Johnson City, Tennessee, said he supports the idea of a 24-hour urgent care rather than forcing the facility to reopen its emergency room.

“Having a place where you can take 95 percent of the problems is a real plus,” he said. “It’s not just here. It’s a nationwide shortage of providers.”

New director arrives

McMorris Rodgers praised the work of Interim Director Tracye Davis, who was brought over from Portland to cover for former Director Ron Johnson, who now works in Virginia.

“I appreciate the way she has come in and addressed a long list of challenges we have faced for many long years,” McMorris Rodgers said. “In September, I was told it would take about a year to get a new director.”

But on Friday, she introduced Dr. Robert Fischer, who will take over as the Mann-Grandstaff director on Dec. 5. Fischer, a retired Air Force veteran, comes from several years of service at Army Landstuhl Regional Medical Center in Germany.

“I’m very excited to be here,” Fischer said.

In addition to tackling several issues, including fixing a 5-year-old hole in the hospital’s roof, Davis implemented a new wellness program that ended protests from several veterans who were upset when they lost access to exercise equipment at the facility.

Asked if Fischer will follow through with Davis’ plans, McMorris Rodgers replied: “That’s my understanding, yes. She was part of identifying the new director. She spoke very highly of him.”

Partnership with medical schools

Roe said Spokane has a unique opportunity to partner with the medical schools in Spokane from Washington State University and a cooperation between the University of Washington and Gonzaga University to help alleviate the VA hospital’s staffing problems.

In Johnson City, the VA allowed a medical school on its campus in 1980, which has been a boon for that community, Roe said.

The partnership between the VA and the Spokane-based medical schools “would really put this VA hospital on steroids,” Roe said. “I think you have a tremendous opportunity … to teach (medical) students and provide care for veterans.”

As part of the partnership, VA officials hope to open 36 positions that could be filled by the students, McMorris Rodgers said.

“Getting residents here can provide some stability,” she said. “We have had a challenge retaining physicians here. If we can get the partnership going … that is a way to meet the need here.”