Alaska Native Veterans Dissatisfied with Health Services

Alaska Star

October 30, 2008 – Alaska Native veteran Walter Sampson wants to know why the U.S. government, and Veterans Affairs specifically, have not kept their promise to care for him and his veteran friends.

“For the last 38 years I have been trying to cut the red tape,” Sampson said. “And until this point, I’ve been unable to.”

Sampson, a Vietnam veteran, spoke to a panel of leaders from the National Guard, VA, Indian Health Services, Alaska Federation of Natives and the Yukon-Kuskokwim Health Corp. at the Alaska Federation of Natives Convention Oct.23. The panel discussed what each group is doing to increase quality and access to health care in rural Alaska, and what the future may look like.

Barriers to health care are often caused by geographical and financial challenges, as well as access to medical specialists or community health aides, said panelist Chris Mandregan, Alaska director of the federal Indian Health Service.

Sampson lives in Kobuk – a $400 flight away from Kotzebue – and is vice president of lands and natural resources for NANA Regional Corp. He says that during his three years of Army service his heart was damaged. He has seen top cardiologists and paid his own way with his health insurance, he said. He can’t get the help he needs in Kobuk or Kotezebue and must come to Anchorage. He makes too much money (more than the allotted $12,000 per year) to qualify for travel aid from the VA.

“I am punished for working,” he said.

Sampson also wants help for the emotional scars he carries from the war.

“If I were to talk to a head-shrinker, I would prefer to talk to someone that I know,” Sampson said “Somebody that has knowledge of my background, of my culture.”

The audience of fellow veterans applauded.

Sampson said he tried to get counseling for his best buddy, also a veteran, through the VA – but the friend committed suicide before Sampson could get him help.

Just getting to the VA system is something many veterans find challenging. Veterans must come to Anchorage, get a physical exam and submit their medical and service records in person. Veterans also have to fill out a lot of paperwork, said Jerry Beale, administrator for the state’s Department of Military and Veterans Affairs.

A person traveling from some place in Southeast like Hoonah would have to take a ferry or flight to Juneau and then fly to Anchorage. That veteran can expect to be away from his or her family for three days. Some rural areas take longer to get in and out of.

To get travel arrangements, records, funds and an appointment for a physical exam can take months, Beale said.

“It is a problem we have recognized in rural Alaska and we’ve been trying to resolve that issue for several years,” Beale said.

Once in the system, a veteran can then make an appointment to get help at a regional medical facility that will work with the VA in Anchorage, Juneau, Fairbanks, Kenai and, soon, Wasilla.

Younger veterans returning from deployments have an easier time getting into the system. The VA helps the new veterans with the intake process upon arrival home. The National Guard starts assessing veterans for emotional problems such as posttraumatic stress disorder immediately. They talk with veterans 30, 60 and 90 days after resettling in their communities. Sometimes these check-ins are over the phone.

The Indian Health Service envisions something different for healthcare in Alaska. Instead of brining people to Anchorage or hub cities, or using telemedicine – a combination of Internet and phone technology – Indian Health Services would like to institute video conferencing at village healthcare clinics. Then the provider or VA could see the veteran and look for outward signs of distress, depression, weight loss and other symptoms that can’t be seen over the phone.

“The Indian Health Service has a long history of providing care with a pretty broad footprint with all the community health aides and regional clinics,” said Chris Mandragan, Alaska director for the federal Indian Health Service. “And yet we have huge unmet need.”

The Indian Health Service said it is striving to offer medical treatment similar to what is used for village residents near the Bethel area.

One of the biggest barriers to getting treatment is cost. For soldiers who deployed from Hooper Bay, it costs them about $400 roundtrip to fly to Bethel, and additional $600 if they have to come to Anchorage.

“Our veterans don’t have the money to do that,” said Gene Peltola, president and Chief Executive Officer of the Yukon-Kuskokwim Health Corp.

Peltola’s corporation has taken its own lead by using a microwave bandwidth system at outlying community clinics, main clinics and hospitals. If a health aide can’t make a mental health diagnosis, they use a camera and video system, like a live television broadcast, to reach a clinic or hospital in Bethel. If the person in Bethel needs help, they will contact psychiatrists or psychologists contracted in the Lower 48 via satellite. Then the patient may only travel as far as Bethel to get help.

“(Veterans) have put their life on the line for us,” Peltola said. “We’re committed at YKC, working with the department of military affairs and the VA to bring them competent professional services as close to home as possible.”

The Yukon-Kuskokwim Health Corp. system is unique.

Although Congress has recognized the problems with veterans’ access to healthcare in Alaska, the money to fix the problem has yet to come.

“We need to have veterans money going into these tribal organizations and Native organizations to provide the care across the state,” said Lt. Col. Craig Campbell, adjutant general of the Alaska National Guard. “We need a Congressional fix now, we can’t wait any longer to get these services back to veterans in Alaska.”

At the end of his criticism of the VA and benefits, Sampson did complement Campbell and the others for the progress that is being made.

“I think what you are doing is good, at least you are breaking the trail, making an effort in trying to address the very crux of the issues.” Sampson said. “You’re just breaking the ice. Got a long way to go.”

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