Peninsula veterans were briefed on continuing changes to the way their appointments will be scheduled and given a chance to air their concerns to the new director of Alaska’s Department of Veterans Affairs Healthcare System this week.

The Alaska VA Healthcare System’s new director, Dr. Timothy Ballard, has begun making the rounds to town hall meetings around the state since he took over the position July 11. He began Tuesday’s town hall meeting at Kenai Peninsula College in Soldotna by addressing the Alaska VA’s recent change to its contract with TriWest Healthcare Alliance in relation to the program set up by the Veterans Access, Choice, and Accountability Act. The Alaska VA took back the duty of scheduling veterans’ medical appointments from the Arizona-based provider.

“There are some more nuances, but the main difference … is that when we would send a referral, we would send it to TriWest (and) they would handle everything — scheduling, establishing the network (of providers that work with the Choice Program), the billing reimbursement and everything,” Ballard said. “Now we’re doing all the scheduling. We do have a provider relations process, but for the most part it’s us setting up referrals for beneficiaries, and then TriWest handling the network piece.”

The Choice Program, as it’s commonly referred to, was implemented in 2014 and intended to provide better access to health care to rural veterans by allowing them to get appointments with their own local providers rather than visiting a VA facility. TriWest was tasked with delivering Choice Program services. Veterans who have testified at town hall meetings on the peninsula for more than a year continually cite issues like longer wait times for appointments, lack of communication between the program and the VA, and lack of understanding and training of TriWest staff.

To rectify these issues, the Alaska VA took back the duty of scheduling appointments for veterans from TriWest starting July 18, said Alaska VA Public Affairs Officer Samuel Hudson in an email. Area veterans learned of this transition at a previous town hall meeting at the college in late June.

TriWest is still a contractor for the Choice Program, responsible for reimbursing health care providers and taking care of provider relations, Ballard said. However, it was decided that scheduling appointments for veterans should be given back to the Alaska VA because its staff are more familiar with the geographical and other barriers to getting health care in the state.

“The Alaskans hoped that TriWest would have phone line reps in the state who understood how all this worked, and they were using a call center out of Puyallup (Washington) and when you get to that (phone) number you get a general person who may not know the difference between … Juneau and Sitka,” Ballard said. “‘Oh, they’re right next to each other, just drive there.’ Well, you don’t know what you’re talking about, because you can’t drive from Juneau to Sitka or vice versa.”

The transition of giving scheduling duties back to the Alaska VA took about five to six weeks due to lack of communication between the department and TriWest, Ballard said. The Alaska VA was under the impression that TriWest would continue handling certain duties, Ballard said, like approving secondary authorization requests that allow veterans to continue getting care for an issue after an initial referral is made, but TriWest gave those to the VA before staff was ready. The Alaska VA didn’t have the resources to go back and look at how TriWest was making those referrals, and staff finished getting through the back log about a week ago, Ballard said.

“There were some communication errors that negated a smooth transition to the pilot program,” he said.

Reverting scheduling duties from TriWest to Alaska VA staff is part of what Ballard and Hudson called a new pilot program. This is different from the pilot program originally embarked on to fix the issues with the Choice Program, which involved getting TriWest staff on the ground in Alaska. There are still four or five TriWest representatives in Alaska — and one in the Kenai Peninsula region – that Ballard said will stay and continue their work in health care provider relations.

“How TriWest supports it (the contract) with their staff on the ground is up to them,” he said.

Veterans at Tuesday’s listening session continued to voice concerns about long wait times for medical appointments, though many said they are grateful that duty has been put back in the hands of Alaska VA staff. They also cited frustrations and confusion over how to fill prescriptions through the VA while going to their local providers, as well as Choice Program representatives who don’t seem well trained over the phone.

Veterans can call 907-257-6904 for general questions about community care, and 866-606-8198 for new requests for the Choice Program or questions about referrals for the Choice Program. If veterans call this number and enter their zip code, they will be routed to the Alaska VA call center, Hudson said in an email.

Reach Megan Pacer at megan.pacer@peninsulaclarion.com.