I-Team In-Depth

Filling The Primary Care Gap: Nurse Practitioners

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Alison McGrory-Watson, a private cook who lives in Deep River, had serious medical problems, including Hepatitis C and post-traumatic stress disorder (PTSD), when she was assigned Nichole Mitchell as her primary care provider at Community Health Center Inc. (CHC) in Middletown. McCrory-Watson was uninsured, and Mitchell went to great lengths to get financial assistance for two new drugs aimed at addressing her medical problems. As a result, McGrory-Watson is now Hep C-free, and she hopes a drug she’s taking for PTSD will quell the lingering effects of being gang-raped as a teenager and witnessing a brutal stabbing as an adult.

There’s something about Mitchell that might surprise you. She’s not a doctor; she’s a nurse. A nurse practitioner (NP), to be precise. But McGrory-Watson insists that the care Mitchell provides is every bit as good as she would get from a physician.

Veterans' Health

New Report Cites Long Wait Times For VA Primary Care

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Some newly enrolled veterans seeking a primary care appointment at the Department of Veterans Affairs (VA) wait more than 90 days before they see a provider, and the agency’s way of calculating wait times understates them, according to a new report by a government watchdog office. “This most recent work on veterans’ access to primary care expands further the litany of VA health care deficiencies and weaknesses that we have identified over the years,” Debra Draper, director of the Government Accountability Office’s (GAO) health-care team, said in testimony to the House Committee on Veterans’ Affairs. “As of April 1, 2016, there were about 90 GAO recommendations regarding veterans’ health care awaiting action by VHA … (including) more than a dozen recommendations to address weaknesses in the provision and oversight of veterans’ access to timely primary and specialty care, including mental health care. “Until VHA can make meaningful progress in addressing these and other recommendations,” she added, “the quality and safety of health care for our nation’s veterans is at risk.”

 

The new GAO report looked at wait times for newly enrolled veterans seeking primary care appointments at six VA medical centers around the country. Among a random sample of 180 of those veterans, 60 who requested care had not been seen at all by primary care providers, in some cases because the VA never contacted them or because they were left off an eligibility list in error.

Veterans' Health

Veteran Found Dead At VA Died Of Heroin Intoxication

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A U.S. Army veteran found dead in a public bathroom at the Veterans Affairs Hospital in West Haven died of accidental heroin intoxication, according to Dr. James R. Gill, the state medical examiner. Zachary Paul-Allen Greenough, 28, of Uncasville, was participating in a residential program where he was free to leave the hospital campus during the day, according to Pamela Redmond, spokesperson for the West Haven VA hospital. She said, as a result, Greenough could have obtained the drugs “anywhere.”

She said the VA would not comment on the cause of Greenough’s death, which occurred on Dec. 22, 2015. She said an investigation by the hospital’s Patient Safety Program has been completed, but the results are not yet available.

Veterans' Health

Efficient, Effective Home Care For Veterans

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U.S. Army veteran Bob Swirsky’s face lights up when home health care nurse Jeanette Hutchinson enters his room to check his blood pressure and attend to his body to prevent bedsores. “It’s going to be 120 over 60,” Swirsky says, as Hutchinson inflates the cuff on the meter on his left arm. “Close,” she said, “124 over 60.”

In Connecticut, there are 209,882 veterans, according to the most-recent U.S. census data, and 29.4 percent are over the age of 75. This group forms the core of veterans with chronic medical issues who are targeted by a VA program to treat them in their own homes. Most of the patients in the VA’s Home Based Primary Care (HBPC) program are like Swirsky, who is bed-bound and not able to easily get to the West Haven VA Hospital.

Veterans' Health

Vets At Risk Of Suicide Not Getting Adequate Post-Discharge Care: Report

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Nearly a third of veterans deemed at high risk for suicide don’t receive the recommended follow-up care after they’ve been discharged from Veterans Health Administration inpatient mental health facilities, according to a new report from the VA inspector general. The report — which comes as the U.S. Department of Veterans Affairs grapples with a rise in suicides that claim an estimated 22 veterans’ lives a day — recommends that the VA take action to improve post-discharge follow-up for patients with acute mental health problems.

The VA requires its mental health clinicians to evaluate patients considered at high risk for suicide at least weekly for the 30 days after their discharge from Veterans Health Administration (VHA) mental health care. But of 215 patients whose medical records were examined by the inspector general’s office, 65, or 30 percent, did not receive all of their follow-up evaluations, the report shows. Records of 33 percent of the 215 patients did not contain documentation that a suicide-prevention coordinator or other case manager had made attempts at contact. “Although MH (mental health) providers scheduled follow-up appointments prior to patient discharge, timely post-discharge MH evaluations were not consistently provided,” the report says.