Sick veterans currently forced to travel thousands of miles for care could soon be allowed to get lifesaving organ transplants closer to home.
The action comes more than a year after a joint investigation by KARE 11 and other TEGNA television stations questioned why veterans were being forced to crisscross the country to have transplants.
“When we found out that veterans actually had to travel so far to get their transplants it didn’t make sense right on the face of it,” Rep. Neal Dunn (R-FL) said.
Rep. Dunn introduced the Veterans Increased Choice for Transplanted Organs and Recovery (VICTOR) Act of 2017, which allows veterans who live more than 100 miles from one of the nation’s VA transplant centers, to seek care at a federally certified non-VA facility that covers Medicare patients.
“The VICTOR Act is a commonsense solution to a problem that is quite literally hurting our veterans and preventing them from receiving timely organ transplants,” said Dunn, who is also a medical doctor, and former Army surgeon. “Many veterans are forced to sit on waiting lists for organs they may never receive. This needs to change.”
A recent case out of Colorado illustrates the problem. Jim Thayer, of Las Animas, CO, reached out to KARE 11 in August 2017 after seeing our reporting online, regarding the VA organ transplant program. KARE partnered with our sister TEGNA station, KUSA in Denver, to tell his story, which is one of mistakes, miscommunication and mismanagement within the Department of Veterans Affairs, which repeatedly delayed the Colorado veteran from getting a life-saving lung transplant.
“I can’t help but think that something is going on that shouldn’t be going on,” Thayer said.
Letters obtained by TEGNA investigators provide some insight into delays in care for Thayer, an Air Force veteran who served from 1979-1983, and the many pitfalls in a VA system that requires some veterans to travel hundreds of miles in order to receive a transplant - even if a civilian transplant center is available in their home state.
Thayer has received treatment for his chronic obstructive pulmonary disease (COPD) at the Denver VA since April 2015. By the end of the year, his disease had progressed and was considered likely to “become fatal.”
Still, he was told that he was not eligible for a lung transplant. That was the first mistake.
Thayer’s VA doctor in Denver had “confused Mr. Thayer with another case,” according to one letter from the Eastern Colorado VA Health Care System Director, Sallie A. Houser-Hanfelder. “I was in real bad shape and they should have started the process for sending me for an evaluation for a lung transplant four months before,” Thayer said.
As a veteran, he had limited options. The VA national transplant program has only 14 transplant centers - and just two of those provide lung transplants. Those two are in Madison, Wisconsin and Seattle, Washington.
Thayer’s case was submitted to Seattle which is 1,500 miles from his home. To receive the transplant in Seattle, Thayer would need to move there, along with a caregiver. He would be forced to sell his house and leave his family behind.
“They’re uprooted from their homes, they’re uprooted from their jobs, they’re uprooted from their families,” Jaime McBride, a VA whistleblower told TEGNA media investigators last year. He’s the Program Manager for Solid Organ Transplants at the VA in San Antonio, TX, and believes "thousands” have died due to the current VA transplant system.
“I've gone through every channel we can,” McBride said. “And the reason that I'm here speaking about it is because the problem has not been solved.”
A 2014 case study from the University of Pennsylvania shows that distance can negatively impact the transplant care a veteran receives.
“Veterans that were more than 100 miles away from the closest transplant center are disadvantaged,” Dr. David Goldberg said. He was the lead researcher of the study. “They have less access to a lifesaving transplant - which directly correlates to a higher chance of dying.”
The VA has already sent Jim Thayer to the Seattle transplant clinic twice. Both times he returned home thinking he was on the waiting list, not knowing that his transplant listing was “deferred” and that, later, he had been denied a lung. “I just don’t think this traveling back and forth is working, they need to do it at a local hospital,” Thayer said.
Rep. Mike Coffman (R-CO) also said that he thinks veterans should receive more accessible treatment.
“It’s better for the taxpayers it’s much better for the patients to receive their care, within their respective states, within their respective communities,” Coffman said.
The VA says that the current transplant system helps manage costs, but it’s unclear to what extent. One estimate from a charter plane company showed that a medical charter flight from Pueblo, near Thayer’s home in Las Animas, to Seattle could cost $18,000 one way. TEGNA investigators are awaiting records that detail the amount the VA spends to fly veterans across the country for transplants.
The VA also denies that distance increases the risk of death.
“I can tell you that the risks imposed by distance did not translate to a risk of death,” said Dr. William Gunnar, the VA Director of Surgery, in an interview with TEGNA Media investigators in late 2016. He did admit that most veterans do have to travel.
But a seemingly simple solution to this problem does exist. McBride, the whistleblower, suggests the VA should contract with local hospitals to save money and lives.
And sometimes, the VA does do just that.
After KUSA shared Thayer’s story the VA began working with him to explore transplant possibilities in Colorado.
“I don’t feel like going out to Seattle anymore, I don’t trust ‘em,” Thayer said. “They’re just gonna let me die, and a lot of other veterans. I’m not the only one.”
If the VICTOR ACT passes, Thayer and thousands of other veterans who don’t live near a VA transplant center would be able to seek transplant care in non-VA facilities closer to home.
“It’s better care for the veterans,” said Rep. Dunn. “Simply they’re much more likely to get a transplant, they’re much more likely to have a successful transplant and of course that improves their survival as well.
The House Veterans’ Affairs committee is holding a hearing to mark up the VICTOR ACT on Thursday, Nov. 2. From there it will go up for a vote before the full House.