Distance, delays and denial within VA's Organ Transplant Program
Author: KVUE Staff
Published: 10:28 PM CDT August 16, 2016
Updated: 5:03 PM CDT August 17, 2016
DEFENDERS 4 Articles

As Aaron Arch looked over the collection of coins, given to him for his service and sacrifice, he thought about the men and women still serving.

“They needed help and I was able to help in the kind of support they needed,” said Arch as he put down one of his favorite coins.

It was from the Ft. Hood military base where Arch served in the hospital. He treated men and women who got injured during service.

Now, he’s the one who needs help.

“My lungs are damaged as a result of seeing something foreign about it,” said Arch.

Arch got sick in Operation Desert Storm. Doctors don’t know what caused Arch’s immune system to fail. They only know Arch will eventually need a new lung.

EXPLORE

Distance, delays and denial within VA's Organ Transplant Program

DEFENDERS
Chapter 1

DELAYS:

His local VA in San Antonio does not perform lung transplants, but it is next door to a surgery center. The University Hospital boasts a 92 percent success rate. Arch can’t go across the street. Instead, the VA sends him 1,200 miles to Madison, Wisconsin.

“It just makes me more susceptible to infections. I’ve had pneumonia a few times - things like that,” said Arch.

He risks his life with each flight. It’s a risk Jamie McBride says is unnecessary.

McBride is a registered nurse, certified clinical transplant coordinator, and Veteran Affairs whistleblower.

“If you look at Madison, Wis., for example, list themselves as doing different types of transplants. They don't actually do any transplants. Our patients fly to Madison, Wis., to go across (the) street to the local university,” said McBride.

McBride wants the VA to operate the same way in San Antonio.

The VA in Wisconsin has a contract in place with another hospital. The hospital does the work and the VA picks up the bill. Veterans who need a transplant must go to one of 13 transplant facilities within the VA.

Researchers looked at VA liver patients who travel hundreds of miles for care. Their study, published in the Journal of the American Medical Association, states veterans are more likely to die if they have to travel for transplant

“Veterans that were more than 100 miles away from the closest transplant center are disadvantaged. They have less access to a lifesaving transplant which directly correlates to a higher chance of dying,” said Dr. David Goldberg, author of the study.

This study is real life for Pam Moore, of Minnesota.

“I think they should be home where they’re comfortable,” said Moore.

Her husband, John, died waiting for a liver transplant. He was a military police officer who caught hepatitis C from a blood transfusion while in the Army. The family spent years on a VA wait list. The VA sent them every three months to Texas to seek treatment for his liver.

“If it would have been done here, I think he would have had lived. I think he died unnecessarily. That’s truly what I believe,” said Moore.

Chapter 2

DENIALS:

“They said your only chance of survival is with a bone marrow transplant,” said Tammy Baggett of Atlanta.

The Navy veteran recalled her reaction to the first time she heard she had cancer.

“I was like, how long am I going to live? It looked very grim on (the doctor’s) face. I said my son graduates from middle school next month will I be able to make it,” said Baggett.

Baggett said the VA wanted her to travel to Nashville, Tennessee. In order to get the surgery, she needed to be in full remission. Her rounds of chemotherapy did not stop the Leukemia.

She sought care locally. Emory University Hospital accepted her as a patient and performed the bone marrow transplant that extended her life. The VA denied her request for covering the cost of the procedure.

A 2012 VA Office of the Inspector General’s report highlighted wrongful denials within the VA.

“VHA should consider if changed to their transplant review process should be made to address facility specific absolute contraindications to transplant,” said inspectors in the report.

It showed the VA denied a transplant to a patient while a private hospital determined the veteran was a good candidate.

“When I sit across from someone who I know has survived being overseas, being in war, and they're having trouble surviving the VA transplant system, it breaks my heart,” said McBride.

Chapter 3

A CHOICE:

A VA program called “choice” was designed to help.

The Veterans Access, Choice, and Accountability Act of 2014 was signed into law August 7, 2014. It was designed to give veterans access to healthcare closer to home if traveling to a VA more than 40 miles from their home was an excessive burden.

Charles and Tamara Nelson, of Leander, TX, thought this would be the program to give new life.

“It’s called Focal segmental glomerulosclerosis,” said Charles. He explained his disease causes kidney failure in adults.

Nelson received his first kidney transplant in 2000. The VA paid for the procedure. Nelson used a live donor, his sister.

The procedure worked, but Nelson needed another transplant this year.

“This last time we went to Nashville. It was hard on us,” said Tamara Nelson, wife of Charles Nelson.

They requested to use money from the Choice program since the VA Transplant Center is more than 40 miles away and considered an excessive burden, especially since the living donor was also a family member.

“It was a big fight with the VA. They wanted us to either go through Oregon or Nashville. Charles and I were like you have a Choice program now,” said Tamara. “Why would we travel and do that to our kids?”

They agreed the burden to travel wasn’t worth the risk. They kept requesting for Choice money while they chose to get care closer to home.

The VA denied coverage.

“For the transplant part of (choice) there is a stipulation. They don’t fund any money to non-veterans,” said Tamara.

The VA told the Nelsons they wouldn’t qualify for choice money because the donor wasn’t a veteran. It was Charles’s son.

“It was just unbelievable is what it was,” said Charles.

McBride contacted the Inspector General’s office.. An investigation noted it would be up to Veterans Health Administration (VHA) in conjunction with congressional oversight bodies to make a change in policy.

Senators John Cornyn and Mark Kirk vowed to help. They filed Senate Bill 3052.

“What we’re trying to do is solve this going forward for other veterans to make sure there is not a similar delay or confusion,” said Cornyn.

The bill has sat for two months. It was introduced in the Senate, but no other action since

Cornyn promised the KVUE Defenders to make sure it gets picked up in September.

“We’re getting two medical bills a day,” said Tamara.

The Nelson’s will still pay out of pocket for their surgery, even if the proposed bill passes. They said their fight continues to others can have a choice without facing distance, delays, and denial.

Chapter 4

VA RESPONSE:

The U.S. Department of Veterans Affairs denied repeated requests for an interview.

They, instead, issued this statement:

The Department of Veterans Affairs (VA) is committed to providing the very best in quality health care services to our Nations Veterans. VA provides comprehensive transplant care and treatment to eligible and enrolled Veterans through a network of 1,055 outpatient clinics and 168 VA Medical Centers of which twelve are designated VA Transplant Centers (VATC). The VATCs comprise the VA Transplant Program, which evaluates approximately 2,500 referrals and performs more than 550 solid organ (heart, liver, lung, kidney) and bone marrow transplants annually. VA’s Transplant Program outcomes compare favorably to all United States Transplant Centers as publicly reported by the Scientific Registry for Transplant Recipients (SRTR).

Jaimie McBride said the VA isn’t telling the full truth.

“Many of the surgeries performed at the VATCs (VA Transplant Centers) are performed in the community via contracts. For example, Madison, Nashville, Virginia, etc. perform some or ALL of their transplants outside the VA facilities. We are asking for the same capabilities,” said McBride.