ST. GEORGE – A group of local veterans are taking matters into their own hands to push for what they see are much-needed changes at the Veterans Affairs St. George Community Based Outpatient Clinic, 230 N. 1680 East, Building N, in St. George.

The St. George Community Based Outpatient Clinic is the only VA clinic in the St. George area available to local veterans who need medical care under their Veterans Affairs benefits. 

At a veterans town hall meeting held at the Southern Utah Veterans Home in Ivins Jan. 22 with the purpose of opening communication channels between the outpatient clinic and veterans, many veterans voiced their discontent with the clinic.

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Read more: Veterans town hall leaves many feeling voiceless, choiceless; STGnews Videocast

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A group of four area veterans met Tuesday morning, and formed a committee “Veterans for Veterans,” formulating a plan of action for meeting with management at the outpatient clinic to discuss issues.

Veterans concerns

Complaints about the outpatient clinic focus on several issues, including the way the clinic prescribes, or doesn’t prescribe, medications. The clinic does not have a licensed psychiatrist to prescribe medication for conditions such as post-traumatic stress disorder, which many veterans deal with.

While the clinic has four medical doctors, one nurse seems to be in charge of prescribing medications, the committee members said.

Kimberly Hendrix, a Black Hawk helicopter pilot who served in Afghanistan, is a member of the committee. She was taken off benzodiazepines so suddenly that she ended up in the emergency room from withdrawals, she said, even though benzodiazepines should be reduced gradually over time to reduce complications.

Changes to her previously stable medication regimen were also made without explanation or even an intake interview, Hendrix said.

Sudden and unexplained changes in psychiatric medications can completely destabilize a veteran, the committee members said, and can lead to more serious issues such as violence or suicide.

“It really is scary,” Hendrix said.

“This has been going on with me and those people (at the outpatient clinic) for almost 10 years,” veteran Marlon Halford said. “I’ve gotten absolutely nowhere being a nice guy,” he said.

“She’s going to kill somebody, is what she’s going to do,” Halford said of the nurse in charge at the outpatient clinic. “Either they’re going to blow their brains out, or they’re going to end up in the hospital, and die in the hospital. This is really some stupid stuff.”

Halford said he personally knows 25-30 veterans who have had similar experiences with the outpatient clinic’s prescribing practices.

“It’s critical that this thing gets fixed, before it gets worse,” St. George Vet Center Readjustment Counselor Bruce Solomon said. The VA-funded Vet Center is a separate organization that offers counseling to veterans, but not medical care or medications.

“It’s a good thing that there is action being taken, that there’s this opening to dialogue. I hope that it’s not frustrated, because it’s important that it get resolved before it gets worse for the veterans,” Solomon said. “They’re pretty upset.“

Meeting canceled

The newly formed Veterans for Veterans committee had planned to meet with the outpatient clinic manager George Dunnigan at 9 a.m. Tuesday, but the meeting was canceled by Dunnigan, who cited security concerns.

“The meeting, unfortunately, was canceled after contacting George at 0830,” Hendrix said in a written summary of the meeting. “He would not allow the meeting to proceed as long as committee member, Kimberly Hendrix, was present.”

“He (Dunnigan) stated that members of the clinic were concerned about their safety in her presence,” Hendrix further wrote in the summary.

“When approached with solutions, such as having security present, meeting outside of the clinic at a neutral location and even meeting at the police station, George still refused to meet with the veterans of the Committee,” Hendrix wrote in the summary.

The meeting was ultimately canceled after repeated attempts from committee member Erwin Aguayo to compromise in a way that would allow the meeting to take place, Hendrix wrote in the summary.

However, Jill Atwood, chief communications officer for the VA Salt Lake City Health Care System, said Wednesday that because the committee was planning to bring a member of the media, Dunnigan would not have been authorized to have such a meeting.

Dunnigan cannot speak to the press without prior approval, Atwood said, although she would be happy to authorize him to speak to St. George News in the future.

Committee concerns

After a lengthy discussion, the committee came up with several issues they would like addressed with management at the outpatient clinic, outlined by Hendrix in her summary of the meeting as follows:

–  Communication between the St. George VA CBOC and the Veterans for Veterans Committee needs to be established. Include us, don’t exclude us. This is crucial for a cooperative effort to develop solutions to any clinic issues.

– A veteran advocate (or committee) should be established to serve as a mediator between the clinic and its management staff.

– Regulations: What are the VA regulations regarding patient care, specifically as they pertain to behavioral health and the ability to override previously prescribed medication. Additionally, what is the clinic’s written procedure for medication changes? i.e. Does it require a medical intake, how are medication changes monitored by the clinic, how are adverse effects to medication changes addressed, are medications not recommended by the VA still available for veterans who already take them?

– A licensed psychiatrist should be a part of the CBOC staff.

– Training regarding patient care and policy should be conducted at the clinic, taking into account prior complaints or issues. Following the training, a period of time spent observing the clinic staff by a trained VA representative, should take place to ensure proper care is given to their patients.

Access
Access is another issue for local veterans, veteran Steve Duke said.

Some veterans have been denied treatment, Hendrix said, relating an incident where a fellow veteran was turned away from the outpatient clinic when he requested counseling.

She, herself, does not feel at all welcome at the clinic, Hendrix said. Veterans have also been referred to facilities in northern Utah for services. Some don’t have the time, money or a vehicle to travel that far.

Duke said that veterans often have to “go over the head” of the local clinic in order to overcome problems with access.

Some area veterans have given up on getting behavioral health treatment from the Community-based Outpatient Clinic, and are going to Las Vegas instead. Several committee members said they can get better and faster behavioral health care at a VA facility in Las Vegas.

Fear of reprisals

Hendrix said many veterans are afraid to complain, and have no hope that they can change things at the VA. A common fear is that veterans who complain will lose their benefits. Even though that would be illegal, she said, the fear is real.

However, after doing some research, Solomon said, the fear is unfounded. It would be extremely difficult for a veteran to lose his compensation.

“It would take almost congressional action to take away any veterans benefits for any reason,” he said.

“So the big fear that hangs over all these guys’ heads, about ‘if you mess with the VA they’ll take away your compensation,’ it’s just a boogeyman,
Solomon said, “it’s not real.”

VA response

When contacted by St. George News, St. George Community Based Outpatient Clinic officials including Dunnigan would not comment, and referred questions to Jill Atwood, chief communications officer for the VA Salt Lake City Health Care System.

Atwood said the clinic’s management will meet with the veterans committee in the near future.

While client satisfaction ratings are high at the St. George outpatient clinic, Atwood said, any problems will be investigated and addressed.

“Of course we’re looking at it, of course we’re going to look for ways to improve either the system or the communication,” she said, “and what’s going on between providers and veterans.

“We don’t like to hear about one veteran that’s unhappy, let alone a handful, let alone 50. So this is very much a priority, and very much on our leadership’s radar.”

Atwood said that it is not unusual to not have a psychiatrist on staff at the Community Based Outpatient Clinic, although that may change in the future. There are currently staff members at the outpatient clinic trained in mental health treatment for veterans, and prescribing medication.

The staff member currently prescribing medication is an advanced practice registered nurse, with specialized training in treating veterans, Atwood said. But that’s not to say that needed changes won’t be made.

“We will make the improvements that need to be made, to make sure these veterans are satisfied,” she said.

“The leadership is going to meet on this particular topic and there will be a formal review of what’s happening in St. George and the veterans issues will be looked at closely,” Atwood said.

“All veterans will be taken care of,” she said, “no veteran will be turned away, and any issues in St. George are going to be taken care of.”

Resources

• Veterans Crisis Line 1-800-273-8255, press ‘1’
• St. George Vet Center | 1664 So. Dixie Drive Suite C-102, St. George | Telephone 435-673-4494
• Community Based Outpatient Clinic | 230 N. 1680 East, Building N, in St. George | Telephone 435-634-7608

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