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Billings VA clinic

The Veterans Affairs Clinic in Billings.

When the Veterans Administration released its most recent health care quality ratings, VA Montana scored at its highest level in two years.

The VA Medical Center that serves all of Montana earned three stars out of possible five for the April-June quarter. In January, VA Montana’s quality rating had slipped to one star, down from two in December.

One star meant that VA Montana ranked in the lowest 20 percent of VA medical centers nationwide for quality. Three stars means the latest quality ranking is in the middle quintile, with 40 percent of VA medical centers ranking better and 40 percent ranking lower.

The improved quality score reflects progress in mental health continuity of care, reducing health care associated infections, reducing in-hospital complications and improvement in inpatient survey results.

“It is gratifying to see the results of our hard work,” Dr. William Campbell, chief of staff, said in a press release. “It is highly unusual for a VA health care system to make this dramatic an improvement in just three quarters.”

Campbell is part of the new senior leadership team that has come aboard in the past year. Other new VA Montana leaders are Director Dr. Kathy Berger, Chief Nurse Executive Nina Morris, Associate Director Anthony Giljum and Assistant Director Kirby Ostler.

Back in March, the VA Office of Inspector General reviewed VA Montana and made 19 recommendations for improving communication with patients, care documentation and replacing missing ceiling tiles at Fort Harrison. The Montana VA presented a plan to make all those corrections by September.

So it appears that progress has been made, but the byzantine bureaucracy that is VA still hinders care. As The Gazette reported Wednesday, the Billings VA outpatient clinic has had no dentist seeing patients since January. VA spokesman Mike Garcia in Helena told The Gazette that a dentist will be hired and at work in Billings in January 2018. That’s an entire year of no dental service at the state’s busiest VA outreach clinic.

That gap in dental care has been a hardship for Billings area veterans. With no dentist to see veterans here, some have been referred to VA clinics hours away in Helena and Sheridan, Wyoming. Others have been offered appointments locally with non-VA dentists, but the local referrals ceased during the summer. Garcia said that was the result of “temporary funding constraints at the national level.”

The effort to improve care quality for our veterans must be robust and continuous. The system still needs changing, and veterans' needs change, too.

Just last week, President Donald Trump signed into law a bipartisan bill to prevent numerous veterans’ benefits from expiring. The VA Expiring Authorities Act, championed by Sen. Jon Tester, D-Montana, ensures rural veterans who use transportation assistance to travel to and from medical appointments will have those services available through 2019. The new law also continues the Caregiver Support Program, which provides assistance to those who care for veterans; the Homeless Veterans Reintegration Program, which provides housing, counseling and career training to homeless or at-risk veterans; and the Deborah Sampson Act, which provide more opportunities for women veterans to seek readjustment counseling.

According to Tester’s office, Trump has signed five other veterans bills the senator co-sponsored, ranging from improving the Veterans Choice program to protecting VA whistleblowers and supporting veterans education benefits.

Yet the work is not done. Montana veterans generally report they receive good care — when they can access it. Access obstacles and staff shortages continue to hamper VA Montana. Having no dental care in the Billings dental office for an entire year is a symptom of the persistent problems that keep VA from delivering the best care at the best time — every time.


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