The VA Montana health system had 40 vacancies for licensed practitioners at the end of June. The geographically largest VA service area outside of Alaska is short on doctors and other providers across our great, big state.

Seventeen vacancies are in Helena, the location of the only hospital and inpatient VA services in Montana.

Nine vacancies are specific to Billings in the home county of the state’s largest veteran population. According to information from VA Montana, the Billings veterans clinic vacancies include: regional deputy chief of staff, regional primary care chief, psychiatrist, two psychologists, psychiatric nurse practitioner, ophthalmologist, orthopedic physician assistant and another nurse practitioner.

This staff shortage alone is a huge challenge to the VA, which also is recruiting nurses and other key health care staff in addition to the 40 practitioner vacancies.

But there continues to be disturbing news of problems with present staffing, and we wonder if that may be hurting recruiting and retention efforts.

The Billings VA clinic employs a dentist who hasn’t seen patients since January, as the Gazette’s Rob Rogers reported on June 28. VA spokesman Mike Garcia in Helena declined to comment on why the Billings dental clinic has been closed, and told Rogers he didn’t know when it will reopen.

Meanwhile, Billings area patients needing routine care have been referred to VA dental clinics in Fort Harrison (Helena), Sheridan, Wyoming, and Spokane, Washington. Veterans with emergencies and those in need of extensive treatment have been referred to private dentists in Billings.

It’s absolutely unacceptable to force our veterans to travel two hours to Sheridan — or farther — to receive dental care that is available to private patients in Billings. It’s incomprehensible that the VA employs a dentist who hasn’t seen patients or been replaced (at least temporarily) for nearly six months.

VA Montana’s vacancy list includes openings in Helena for a dental chief and two more dentists. No dentist vacancy was listed for Billings as of June 26, yet there is no dentist providing care at the clinic.

VA Montana Director Dr. Kathy Berger needs to see that this dental care gap is resolved quickly. Berger, who previously served as director in Sheridan, Wyoming, and only received her permanent Montana appointment last fall, would help the VA’s reputation by being more forthcoming about the reasons for obstacles to care access and the efforts to correct them.

A week before Gazette readers learned about the closed dental clinic, reporter Holly Michels told them about a list of possible service cuts that had been presented at a regional VA meeting in Helena.

Berger was adamant that there are no plans for cutting services or laying off employees when she spoke with The Gazette on June 22. In Billings for a town hall meeting at the VA clinic, Berger said: “We’re not closing anything and we’re not projecting any losses of jobs.”

However, Berger said the VA has been directed to look for efficiencies by a presidential order that covers most all government agencies. Berger, who holds a doctorate in nursing, said the VA is continually evaluating its operations to be effective and responsive to changing demands.

In Montana, veterans generally say they are satisfied with VA care they receive, but many have trouble getting timely care at a convenient location.

Laws enacted this year aim to improve the Veterans Choice program and to allow the VA to fire bad employees more quickly while protecting whistleblowers who report problems. The accountability act, which Sen. Jon Tester helped draft and President Donald Trump signed just two weeks ago, also is supposed to expedite the process of hiring VA medical center directors. In Montana, Berger’s appointment as director was finally approved in October, about four months after her predecessor left. She became the third VA Montana director in as many years.

We want to see the new accountability law working in Montana. Veterans and dedicated VA staff deserve to know what’s going on at the agency and to have the assurance that they can complain without fear of retaliation.

We call on Berger to be transparent. Communicate regularly with veterans and their communities about VA plans — before decisions are final. And for goodness sake, get the Billings dental clinic open so veterans don’t have to drive for hours to get their teeth fixed.