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U.S. Sen. Jon Tester, D-Mont.

Kurt Wilson, Missoulian

MISSOULA — There are not enough health care providers in Montana to get all the military veterans the help they need, according to U.S. Sen. Jon Tester, D-Mont., and Dr. Kathy Berger, director of the U.S. Department of Veterans Affairs Montana Health Care System.

Tester was in Missoula on Wednesday to take part in a listening session with a panel of veterans and health care providers.

Tester is the ranking member of the Senate Veterans’ Affairs Committee, and his Veterans Choice Program Improvement Act passed both the U.S. House and Senate unanimously and was signed into law by President Donald Trump in April. Tester is now traveling the state to get an on-the-ground feel for what else needs to be done.

“The (health care) provider shortage is a huge issue that is persistent throughout the VA, but is also persistent throughout the civilian medical profession too,” Tester told the crowd. “I mean, we just don’t have enough providers. The problem is, when it comes to veterans, they can’t get in to see them. You guys put it on the line. You guys did what you needed to do to make this country what it is today. And we have to have providers. It has to be there.”

Berger said her office is working hard to address the problem.

“There is a shortage of primary care physicians,” she said. “We just don’t have as many as we need. In the short term, we are hiring providers to replace those that we’ve lost in Montana. We’ve got more in the pipeline. We are seeking to replace some of those absent providers. We know that’s an issue and we’re addressing it and we know that our providers are stressed. We know that, but help is coming.”

Berger said that it's difficult to attract physicians to Montana for various reasons, including the fact that the VA system doesn't conduct research and there aren't many advanced medical programs here. She said her office is in the process of getting a grant for a residency training program.

“We’re working on it,” she said. “It’s slow, but we’re willing to tackle that problem and work on a long-term solution.”

Berger also said that there is a huge problem with veterans taking their own lives, and many of those aren't enrolled in any VA health care programs.

Many veterans in the crowd expressed frustration at the long wait times they are forced to endure when they book appointments through Health Net, a government contractor.

Tester has urged VA Secretary David Shulkin to let VA Montana schedule Choice Program appointments directly. Tester has also introduced the VA Performance Accountability and Contractor Transparency Act, which he says would increase oversight and accountability among VA contractors.

Dr. Dean French, the CEO of Community Medical Center and a veteran who spent a decade with the U.S. Army, also agreed there is a provider shortage nationwide.

“I have a soft spot for our veterans and have had one for a long time,” French said. “I practiced family medicine in Montana up in Plains for a decade and had all sorts of issues with our veteran population who like to live in the hills. And trying to figure out how to manipulate and get them through the system back then, before the last 10 years of U.S. history and the explosion of veterans, was difficult then. It’s just gotten worse.”

French said the hospital's biggest issue is authorizations of veterans' applications for health care.

“We have staff tied up for hours trying to get authorizations done and it keeps them from doing their other work,” French said. “My bean counters will say, ‘Why do we do this?’ Of course, I say, "Because they’re veterans.'”

The Veterans Access, Choice, and Accountability Act of 2014 was sponsored by Rep. Harold Rogers (R-Kentucky) and was signed into law by President Barack Obama. However, Tester has been critical of the program and says he is trying to reduce confusion and out-of-pocket expenses for veterans while getting them in to see their doctors faster.

“The Choice Program was designed to serve veterans by improving access to care, but it’s been a bureaucratic mess,” he said. “This plan will reduce the red tape vets have to cut through to see their doctors.”

In March, Tester introduced the Deborah Sampson Act, named after a woman who disguised herself as a man to serve in the Continental Army during the American Revolutionary War.

The bill would require every VA medical facility to have a women’s primary health care provider, it would strengthen peer-to-peer counseling for women veterans most at risk of becoming homeless, and expand existing call center and counseling services. Tester is now working with Johnny Isakson, the Republican chairman of the Senate Veterans’ Affairs Committee, to draft bipartisan legislation that will reform the Choice Program.

The Choice Program’s funds expire later this year, which will require the Senate to redo the VA’s community care initiatives.

“Montana veterans know how the Choice Program works better than anyone,” Tester said in a statement after the event in Missoula. “Today I got feedback that will be instrumental in crafting the future of community care and making sure that veterans are getting the quality care they have earned.”