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VA Los Angeles- Community Care appointment scheduling and contract renewal delays


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Looking for suggestions on how to deal with VA Los Angeles Care in the Community office, and their constant delays in approving outside provider authorizations. Currently, issues are delays with SAR requests for Primary care and Urology.  Alas, Every one of my providers (Primary care, Opthalmology, Podiatry, Urology, Nephrology, has experienced delays intermittently over the last 2 years. Not only for initial referrals, but for secondary auth requests as well. Often times these delays force rescheduling of time sensitive appointments and lab work. The VA CITC staff seems unfazed even when made aware of imminent deadlines.  I have contacted both US senators numerous times to no avail. I  have contacted Congressman Carbajals office numerous times, and while helpful, the congressional inquiry process always seems to go slowly, (required 2 week minimum) not contacting me for followup on  resolution until usually after I have had to reschedule an appointment, (or two.... or three....) and its a moot point. Patient advocates- same story as my congressman.  I grow tired of a vicious cycle, where my doctors put in routine SAR requests, sometimes with time sensitive lab orders to be done, and the VA seems not to care about appointment or lab deadlines set by the doctor, treating each request like the  spanish inquisition, "under review" for anywhere from 2 weeks to 2+ months, with neither the doctor in question at the time or VA seeming to be aware of whats going on and the VA unwilling to address tight deadlines or give consistent answers. This problem has been ongoing since the Mission Act went into place in 2019. Something needs to be done, but what?

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RedoneMudcat Welcome to Hadit. I don't know what else to recommend; you seem to have pushed all the buttons I could think of. One very long shot: similar situation but the veteran I recall was very ill. He went to the newspapers and media. If there is a human interest story you might get a sympathetic ear from a reporter. The VA doesn't like those types of stories and if you call it to there attn. after publication (not the threat), there is a possible movement on their part. Might be worth the effort as you've tried most everything else. Best of luck.

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Welcome to hadit, and the VA hamster wheel!

Yours is a very valid question, and one that deserves an answer.  VA operates in "splendid isolation", which gives them much power over things like this.  

Have you tried going to your local VAMC "patient advocate" and/or VA hospital administrator?  

In MY VAMC, Vets have access to both of these.  Its a good idea to use these resources sparingly, only when all else fails.  

As an example, my doctor ordered physical therapy.   The usual method is for the PT office to call me to schedule appointments.  I waited a month, and called them.  They responded:

Quote

Physical therapy appontments have to be booked by Trina, and she is gone on vacation for 3 or 4 weeks.  Come back when she gets back.

So, I went to the hospital administrator, waited 10 minutes and spoke to the head honcho at my VAMC.  He said he agreed this is unacceptable to have "no one available" to schedule appointments for 3 weeks.  He contacted the head of physical therapy, who called me and apologized, and I had an appointment in 2 days.  

At my hospital, there are "a few key people" who know "how to get things done".  

I stumbled on such a person, after several years at my VA.  That lady got on the phone and had done what you needed almost immediately.  

Unfortunately, I tried to find her, and VA shuffles around offices and departments like they are a deck of cards.  I think she has retired.  So, now, when problems occur that cant/wont be solved by others, of a medical nature, I have to go to patient advocate or head honcho admins office.  

If and when you finally find this "problem solver" be sure and be extra nice to this person.  If I could locate that lady that helped me so many times, I would send her flowers.  Most important:  Remember that person who helped you's name.  And see them next time, too.  Dont bug them, but go there when all else fails.  

There may be more than one of these problem solvers.  I found another one in respiratory therapy.  Its a nurse.  He instantly got on the computer and solved my problem that I had/have getting a new cpap with the recall.  While I have not yet gotten the new cpap, I have been called to schedule an appointment to see the sleep doc.  In this case, I will remember this docs name.  Lets call him dr. Smith. 

     Now, if I get the hamster wheel again, I will say, "Dr. Smith said..Im supposed to have a replacement Cpap.  If you have questions, lets call him now."

    It was the same thing in the military.  To get things done, find out "who" is that person who has the authority and is willing to help you.  How do you find them?  If employee A, says no, I speak with employee B, and on through the alphabet until I find that one powerful yet Vet friendly employee who "gets er done".  

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 I think this is the person you need to contact
"
Robert McKenrick
(in part):

Mr. McKenrick was appointed the Deputy Medical center Director (SES) in March of 2021 and serves as the second to the Medical Center Director in the direct management of the Executive Leadership Team and day to day operations of the Greater Los Angeles Health Care System. Continue to serve as the Executive Director (SES) of the Community Engagement and Reintegration Service (CERS) and Office of Strategic Facility and Master Planning. He has previously served as the Executive Director (SES) of the Office of Care Centers and Clinics in the Community, managing the operations and planning of the two Ambulatory Care Centers (ACCs) and eight Community-Based Outpatient Clinics (CBOCs) for approximately 90,000 Veterans, across five counties and 19,000 square miles of the Greater Los Angeles and lower Central Coast regions of California. Additionally, upon joining VA in 2012, Mr. McKenrick also served as the Director (SES) of the Philadelphia, Wilmington and Los Angeles VA Regional Benefits Offices."

https://www.linkedin.com/in/robert-mckenrick-8b2a5753
If you join LinkedIn you might get contact info-

I would imagine his email is Robert.McKenrick@va.gov

You also might be able to contact him via your VAMC phone  directory:

https://www.losangeles.va.gov/contact/phone_directory.asp

If that fails to produce a result-----

call
The White House Veterans Hot Line 855-948-2311

Be prepared to briefly tell them what you told us.

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